Comprehensive assessment of the morpho-functional state of the back skin integument in adolescents with idiopathic scoliosis

Abstract

BACKGROUND: In the formation of scoliotic deformity of the spinal column, the skin of the back on the protruding parts of the body is a vulnerable area. However, the study of the characteristics of the skin condition of the back of adolescents with idiopathic scoliosis has not been given due attention. AIM: To conduct a comprehensive assessment of the morphological and functional properties of the skin of the back of adolescents with idiopathic scoliosis and to determine the information content of the research methods used. MATERIALS AND METHODS: In 20 adolescents with idiopathic scoliosis, the skin of the back was examined. The following methods were used: visual clinical examination, local thermometry, laser Doppler flowmetry, esthesiometry, elastometry, histological methods. RESULTS: Visually, in 70% of cases, a change in the skin was revealed. In the region of the spinal deformity apex, the skin temperature was higher on the convex side than on the concave side. In the skin of the paravertebral region, capillary blood flow from the convex side and in the distal spine was more intense than on the concave side. In the dermatomes corresponding to the apex of the deformity, hyperesthesia, hypesthesia, and the absence of thermal sensitivity were noted. In the paravertebral and scapular projections, in the region of the deformity apex, the lowest indicators of skin elasticity were recorded, compared with the areas located above and below. Histostructural differences in the skin were revealed in the area of the convex and concave sides of the apex of the deformity. On the convex side, a significant decrease in the thickness of the epidermis and dermis, an increase in the thickness of the subcutaneous fat, a greater severity of reactive-destructive changes in the fibrous, vascular and innervating components of the dermis were determined. CONCLUSIONS: The use of an integrated approach in the study of the skin of the back of adolescents with idiopathic scoliosis made it possible to identify the features of structural and functional changes, which indicates the information content of the selected methods. The results obtained must be taken into account when planning the treatment and rehabilitation process of patients with this pathology.