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Curvature Vertebral Column

degree, left, children and portion

VERTEBRAL COLUMN, CURVATURE OF.A condition which consists in a deflection of the vertebral column to one side. It is a frequent disease in very young children and in children between the ages of five and six. The deflection is accompanied by a turning of the vertebrae around their long axis, and with them of the ribs. In consequence of this, the ribs protrude abnormally on the convex side of the curvature, while they are flattened on the other side. If the vertebral column is curved sideways only, it is called a curvature of the first degree. The second degree includes the axial deflection of the vertebrae. This deflec tion, as well as the curvature, may be somewhat corrected by pressure and by extension. When the vertebral column is absolutely inflexible. it is called a curva ture of the third degree. The curvature may be simple or multiple, according to whether the deflection is in one portion of the vertebral column only (either to the right or to the left), or whether there are two or three curvatures. In a threefold curvature, the lumbar portion may be deflected to the left, the thoracic portion to the right, and the upper thoracic and cervical portion again to the left (see Fig. 431).

A frequent cause of lateral curvature of the spine in school-children is the incorrect position they assume when writing. Some children press the right side of the body forward against the

table, and draw the left side back, at the same time elevating the right shoulder and lowering the left (Fig. 432). If attention be paid to it that the children assume a correct position when seated (Fig. 433), and if suitable places be provided for them to work at, this " getting crooked " would be averted. See illustrations under EYE, CARE OF.

In developed cases of curvature of the spine, only those of the first degree, and beginning cases of the second degree, can be fully cured. Cases of the third degree are incurable ; while severe cases of the second degree can be improved only. Early treatment enhances the patient's chances for a cure of spinal curvature. The fact that in some schools the children are examined by a physician in order to determine the possibility of an existing curvature of the spine, is a step in the right direction. Slight degrees of curvature are often overlooked by the parents. The treatment consists of massage, orthopxdic gymnastics, exercises with medico-mechanical apparatus, and the wearing of corsets made of special materials (plaster-of Paris or celluloid) and of supporting apparatus. The physician must determine which treatment best suits a given case.