Orthopedics - Oleksa A.P. 2006

Scoliosis
Rachitic scoliosis

Rachitic Scoliosis is extremely rare in clinical practice because pediatricians prescribe vitamin D to one- and two-year-old children for both therapeutic and prophylactic purposes.

Vitamin D deficiency and insufficient sun exposure lead to osteoporotic Changes in the vertebrae due to calcium salt depletion. Similar changes occur in the Ribs, particularly in their proximal sections.

Under the load on the spine, early hyperkyphosis develops, especially in the thoracic region, along with lumbar lordosis.

If a child is improperly carried, put to bed, or seated when the torso Muscles are still weak, the spine may bend laterally, causing the vertebral bodies to grow unevenly on that side, leading to deformation and torsion. This results in unilateral, typically thoracic scoliosis, and less frequently, a typical S-shaped spinal curvature.

Clinical Diagnosis is straightforward, and The history of past and treated Rickets points to the cause of the spinal deformity. Confirmation may come from persistent "rachitic rosary" at the costochondral junctions, unclosed fontanelles, Skull and knee joint deformities, etc.

X-ray imaging reveals typical scoliotic changes in the spine and helps rule out congenital dysplastic scoliosis.

In cases of rickets, it is crucial to prevent spinal curvature. To achieve this, pediatricians must inform parents about potential consequences, administer anti-rachitic Treatment (vitamin D, quartz lamp irradiation, back Muscle massage, balanced Nutrition, etc.). The child must Sleep in a flat position, and during the acute phase of rickets, must not sit up, lean forward, etc. As a rule, rickets affects children in their first or second year of life, allowing parents to follow the doctor's recommendations.

The Prevention and treatment of rickets in children in Ukraine are quite well established, which is why post-rachitic scoliosis is exceedingly rare.

If post-rachitic scoliosis is detected, its conservative and Surgical treatment does not differ from that used for Idiopathic scoliosis.