Sponsored by the Scoliosis Research Society, June is scoliosis awareness month. The purpose of scoliosis awareness month is to highlight the growing need for education, early detection and awareness to the public about scoliosis and its prevalence within the community. With that in mind lets review a few of the key points about scoliosis.
Our spines should have curves in the side view but from the front (or back) our spine should be straight. Sometimes, but not always, curves viewed from the front (or back) are caused by a scoliosis. A scoliotic curve will make a person’s posture appear uneven and can cause rotation in the should blades that can be easily viewed when the person is bent forward form the waist. Most cases (80%) of scoliosis are caused by “unknown” factors and are called idiopathic, we believe this is caused by the vertebrae developing unevenly due to the expression of a gene. The other 20% of cases can be due to neuromuscular disorders, the presence of a hemi-vertebrae, or possibly a fractured vertebrae to name a few causes. Children with scoliosis have typically little to no pain, even adults have few instances of pain due to a scoliosis.
The best way to determine if someone has a scoliosis is by x-ray examination, a physical exam can screen those who might have scoliosis but only an X-ray is definitive. A standing x-ray is best because the measurements we make to determine if a curve is a true scoliosis are most accurate when the patient is weight bearing. The most common forms of treatment are observation, bracing, and surgery. Observation is typically done when curves are less than 40 degrees in adolescents at the end of skeletal maturity and adults, it is sometimes combined with therapy. Bracing is typically used for curves between 25 and 45 degrees in children before they reach the age of skeletal maturity. While bracing sucks, it has some of the best evidence today for slowing the progression of a curve or even reducing it. Surgery is most commonly reserved for children with curves greater than 50 degrees and/or smaller curves which are rapidly progressing towards 50 degrees. Surgery is super invasive and involves placing anchors at various points of the spine for rods to go through which fuse the spine straight. Surgery, while typically the least desirable option, may be necessary in some cases which is why working with a reputable surgeon who has good surgical technique and good discernment to who does and does not qualify for surgery is important.
What is really great is that what we do in chiropractic is at the leading edge of scoliosis care. Clinicians and researchers with Chiropractic BioPhysics have developed a brace which places the patient into a mirror image posture (opposite posture) brace to over correct the scoliosis. Most bracing today takes the patient to straight, or neutral, the Scoli-brace is designed to take the patient past neutral and has been generating fantastic results. CBP affiliated clinicians are combining this brace with our structural rehabilitative care to get results few have seen. We are presently not able to make this brace, but we have been successful with rehabilitation on several scoliosis cases.These have been adults we don’t expect to completely straighten out but we have been able to reduce their curves. In the case of children, there are several clinics close who can fit the brace and therapy can be completed here.
Scoliosis doesn’t have to mean surgery nor does it mean a lifetime deformity. There are effective options for care if you look in the right places.