This term is applied to cases where definite change has taken place
in the vertebræ. Organic curves may be simple when the deviation
is unaccompanied by any compensatory curve, or compound when a
compensatory curve is present. We shall consider the deformities as
they present themselves in the various regions of the spine.
=Cervico-Dorsal Curvature.=—This condition is comparatively rare and
according to Lovett occurs in only three and six tenths per cent of
cases. The head is slightly deviated towards the concave side, the
shoulder on the concave side is lowered, while on the opposite side or
the side of the convexity it is naturally at a higher level. The angles
of the upper ribs are prominent due to the co-existing rotation.
=The Dorsal Curvature.=—The shoulder is raised on the convex side, and
the rotation of the vertebræ is very marked, causing a very definite
projection of the angles of the ribs on the convexity. This rotation
also projects the scapula backwards on the convex side. On the concave
side the scapula is flat and sunken, and the inferior angle rotated
inwards and at a higher level than the opposite side. Viewed from the
front the thorax may not be displaced at all, or it may be displaced
toward the convex side, and if the latter is the case it is, of course
more prominent on the concave side. In severe cases the lower end
of the sternum is deviated towards the convexity and you will find
that usually the arm hangs further from the convex side than from the
opposite one.
=The Lumbar Curvature.=—Here we find the trunk displaced toward the
side of the convexity, and the waist retracted on the opposite side.
The difference in the level of the hips is the most prominent deformity
in this region, and it will be found that the hips are raised on the
concave side. Rotation in this region is much less evident than in the
dorsal region, but can be demonstrated by a fullness on the convex side
of the curve, due to the projection of the transverse processes.
=Dorso-Lumbar Curvatures.=—This condition is similar to a certain
extent, to a severe functional scoliosis. The findings observed in the
last two regions above described will naturally be present in this type
of curvature. It is not so frequently associated with compensatory
curves as in the other types described.
=Compound Structural Curves.=—The appearance in this type of scoliosis
will, of course, be a combination of those described above according
to the types of curvature in combination, that is to say right dorsal
and left lumbar, etc. If one type predominates the appearance will be
chiefly that found in that particular type of curvature. The relative
frequency of the common type, as given by Schaltless, in eleven hundred
and thirty seven cases is as follows; functional scoliosis, 15.39%;
lumbar, 11.7%; dorsal, 19%; dorso-lumbar, 20%; cervico-dorsal, 3.6%;
compound, 30%.
=Diagnosis.=—To the osteopathic physician the diagnosis of scoliosis
is not difficult. Let me caution you that true scoliosis must be
distinguished from the lateral curvatures caused by Pott’s disease.
Vertebral rotation, the absence of pain, the extreme rigidity, the
characteristic appearance of the ribs and thorax should, however, make
the diagnosis of scoliosis easy.
=Treatment.=—In general the treatment of scoliosis is difficult to
present, because every case is considerably different, and the amount
of correcting force used in any form is almost entirely a matter of
judgment, as is also the time when corrective pressure should be
discontinued. Continual practice in the treatment of these conditions
is most essential to your success with them. I have had most gratifying
results in a comparatively short time simply because I used osteopathic
treatment and exercises along with a modified Abbott method.