| Abstract | Skolioza je trodimenzionalna deformacija kralježnice u sve tri ravnine, a danas se javlja sve češće zbog sjedilačkog načina života. Osoba koja ima skoliozu najčešće svoje držanje i posturu drži u pasivnom obliku zbog hipotonije ili hipertonije muskulature. Prema etiologiji skolioze možemo podijeliti na dvije velike skupine: funkcionalne i strukturalne. Funkcionalne se dijele na posturalne i kompenzatorne, dok se strukturalne dijele na kongenitalne i stečene (idiopatske) skolioze. Čimbenici koji utječu na pojavu skolioza najčešće su nagli rast u pubertetu, genetske predispozicije, neurološki deficiti, promjene u mišićnim i vezivnim strukturama, no najčešće je problem u načinu života, odnosno premalo tjelesne aktivnosti. Uz sve navedene moguće čimbenike postoje skolioze kojima je uzrok nepoznat i njih nazivamo idiopatskim. Češće su u djevojčica, nego u dječaka te stvaraju velike zdravstvene, ali i estetske probleme.Prognoza progresije deformiteta u idiopatskih skolioza jes dobra no svakako je od iznimne važnosti što ranija i podrobnija dijagnostika bolesti. Dijagnostičke metode uz pomoć kojih se ustanovljuje idiopatska skolioza su klinički pregled koji obuhvaća specifične testove, mogućnost rendgenskih snimaka te ostale slikovne metode kao što su CT i magnetska rezonanca. Popularna metoda tretiranja idiopatskih skolioza koja je uvriježena među stručnjacima jest konzervativno liječenje i sve metode koje ono zastupa. Fizikalna terapija pripada u konzervativne načine liječenja i cilj joj je poboljšati, korigirati znakove i simptome idiopatske skolioze te spriječiti daljnju progresiju deformacija u razdoblju zamaha rasta. Nakon što se u potpunosti iscrpe sve metode konzervativnog liječenja a progresija deformiteta i dalje progradira stručnjaci u dogovru sa timom i pacijentom odlučuju o daljnjem operacijskom liječenju. U daljnoj rehabilitaciji idiopatske skolioze neophodna je suradnja svih članova medicinskog tima, obitelji i pacijenta. Osim fizičke pacijenti osjećaju i psihičku odnosno duševnu patnju jer im se mijenja njihova slika o sebi i primorani su je promijeniti zbog deformiteta. Zbog toga bi bilo od iznimne koristi uz obiteljsku potporu osigurati i onu psihološku, kako bi izbjegli dodatne komorbiditete poput depresije ili anksioznog poremećaja. Zaključno, progresiju idiopatske skolioze možemo spriječiti edukacijom populacije, ranim probirom te podrobnom dijagnostikom i liječenjem. |
| Abstract (english) | Scoliosis is a three-dimensional deformation of the spine in all three planes, and today it occurs more and more often due to a sedentary lifestyle. A person who has scoliosis usually keeps his posture in a passive form due to hypotonia or hypertonia of the musculature. According to the etiology of scoliosis, we can divide into two large groups: functional and structural. Functional are divided into postural and compensatory, while structural ones are divided into congenital and acquired (idiopathic) scoliosis. Factors influencing the occurrence of scoliosis are most often sudden growth in puberty, genetic predispositions, neurological deficits, changes in muscle and connective structures, but most often the problem is in lifestyle, i.e. too little physical activity. In addition to all the above possible factors, there are scolioses whose cause is unknown and we call them idiopathic. They are more common in girls than in boys and create major health and aesthetic problems. The prognosis of deformity progression in idiopathic scoliosis is good, but it is certainly of utmost importance to have an earlier and more detailed diagnosis of the disease. Diagnostic methods that establish idiopathic scoliosis are a clinical examination that includes specific tests, the possibility of X-rays and other imaging methods such as CT and magnetic resonance imaging. A popular method of treating idiopathic scoliosis, which is common among experts, is conservative treatment and all the methods it advocates. Physical therapy belongs to conservative ways of treatment and its goal is to improve, correct the signs and symptoms of idiopathic scoliosis and prevent further progression of deformities in the period of growth momentum. After all methods of conservative treatment have been completely exhausted and the progression of deformities continues to be graded by experts in consultation with the team and the patient decide on further surgical treatment. In the further rehabilitation of idiopathic scoliosis, the cooperation of all members of the medical team, family and patient is necessary. In addition to physical patients, they also feel psychological or mental suffering because their self-image changes and they are forced to change it due to deformities. Therefore, it would be of great benefit to provide psychological support in addition to family support, in order to avoid additional comorbidities such as depression or anxiety disorder. In conclusion, the progression of idiopathic scoliosis can be prevented by educating the population, early screening and detailed diagnosis and treatment. |
