Scoliosis

What is scoliosis?

  • Scoliosis is a sideways curve of the spine that usually develops during childhood.
  • Normally the spine only has curves front to back.
  • If you were looking at someone with scoliosis from behind, their spine would have a “C” shape or possibly and “S” shape, instead of a straight vertical line.

 

 

How does scoliosis happen?

  • Most cases of scoliosis are considered idiopathic, meaning the cause is not known, although suggestions in the literature have been made to genetic factors, hormone activity, postural alterations (such as a short leg) and abnormal nervous system development.
  • The remaining cases of scoliosis are secondary to connective tissue disorders or neuromuscular disorders.

 

How is scoliosis determined / measured?

  • A simple forward bending test (Adam’s test) can be used to observe potential presence of rib prominence or “humping” on one side of the body.
  • Uneven muscle tone or side to side appearance is also often seen with scoliosis.
  • Spine x-rays can be taken and a measurement called the Cobb Angle is used to determine the degree of curvature in the spine.

 

Should I be concerned about progression?

  • As long as your child is still growing, progression of scoliosis is possible (progression usually ends after skeletal maturity).
  • Studies suggest female are at a greater risk of curve progression, with as much as a 10x greater risk compared to males.
  • More severe side effects of scoliosis are typically not seen until the Cobb Angle is greater than 40 degrees. Side effects past this stage may include moderate to severe back pain, pressure and altered function of internal organs and noticeable postural deformity.
  • Fortunately, curves greater than 40 degrees only occur in approximately 0.1% of the population.

 

How is scoliosis typically managed?

  • The standard medical approach for scoliosis is to regularly monitor curves for progression, use bracing if the curvature is progressing and finally use spinal surgery if the curve is severe or rapidly progressing past 40 degrees. However, there are still questions over the long term effectiveness and safety of spinal surgery for scoliosis.
  • Studies have shown bracing to be effective in slowing or even stopping progression of scoliosis, although compliance to the recommended bracing schedule can often be an issue.

 

 

 

references
Ahn, U. M., Ahn, N. U., Nallamshetty, L., Buchowski, J. M., Rose, P. S., Miller, N. H., … & Sponseller, P. D. (2002). The etiology of adolescent idiopathic scoliosis. American journal of orthopedics (Belle Mead, NJ)31(7), 387.
Danbert, R. J. (1989). Scoliosis: biomechanics and rationale for manipulative treatment. Journal of manipulative and physiological therapeutics12(1), 38.
Chen, K. C., & Chiu, E. H. (2008). Adolescent idiopathic scoliosis treated by spinal manipulation: a case study. The Journal of Alternative and Complementary Medicine14(6), 749-751.
Cleere, E. (2004). Scoliosis and Chiropractic. Dynamic Chiropractic22, 12.
Danbert, R. J. (1989). Scoliosis: biomechanics and rationale for manipulative treatment. Journal of manipulative and physiological therapeutics12(1), 38.
Gleberzon, B. J., Arts, J., Mei, A., & McManus, E. L. (2012). The use of spinal manipulative therapy for pediatric health conditions: a systematic review of the literature. The Journal of the Canadian Chiropractic Association56(2), 128.
Morningstar, M. W., Woggon, D., & Lawrence, G. (2004). Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series. BMC Musculoskeletal Disorders5(1), 32.
Morningstar, M. W. (2011). Outcomes for adult scoliosis patients receiving chiropractic rehabilitation: a 24-month retrospective analysis. Journal of chiropractic medicine10(3), 179-184.
Morningstar, M. W. (2011).  Four-Year follow-up of a patient undergoing chiropractic rehabilitation for adolescent idiopathic scoliosis.  J. Pediatric, Maternal & Family Health, 2, 54-58.
Morningstar, M. W. (2007).  Integrative treatment using chiropractic and conventional techniques for adolescent idiopathic scoliosis: outcomes in four patients.  JVSR, 7, 1-7.
Romano, M., & Negrini, S. (2008). Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review. Scoliosis3(2), 1748-1761.
Rowe, D. E., Feise, R. J., Crowther, E. R., Grod, J. P., Menke, J. M., Goldsmith, C. H., … & Kambach, B. (2006). Chiropractic manipulation in adolescent idiopathic scoliosis: a pilot study. Chiropractic & Manual Therapies,14(1), 15.
Tarola, G. A. (1994). Manipulation for the control of back pain and curve progression in patients with skeletally mature idiopathic scoliosis: two cases.Journal of manipulative and physiological therapeutics17(4), 253.

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