It has been well-documented that patients with scoliosis demonstrate a significant increase in neuroanatomical abnormalities of the corticospinal tract, as well as neurophysiological abnormalities, especially in the areas of vestibular function, proprioception, vibratory sensation, postural reflex mechanisms, abnormal reflex processing, and disordered postural equilibrium.50-60
Lateralization of neurophysiology also occurs more frequently in patients with idiopathic scoliosis (IS), and this can be correlated to the convexity of curvature.61-63 However, it has been suggested that this laterality is a result, rather than a cause, of scoliosis.64
While many authors have suggested that brain asymmetry may play a role in the etiology of scoliosis, one recent study did “not support the concept of a generalized brain asymmetry in idiopathic scoliosis,” but noted instead that the trend towards asymmetrical neurophysiology was “probably representing subclinical involvement of the corticospinal tracts secondary to mechanical compression.”65
The goal of the chiropractic manipulative therapy provided by CLEAR Institute doctors is to reduce this mechanical compression and thus restore normality.
Neurophysiological compensations may develop as a mal-adaptation to disordered spinal structure; similarly, disordered spinal structure may create muscle imbalances & exacerbate existing neuromuscular imbalances.66
Scoliosis has been induced in an animal model following unilateral vestibular compromise (when one part of the balance system of the body was disrupted).67
However, scoliosis only developed when the animals were subjected to gravity, thus lending further credence to the statement made by Stokes, Burwell & Dangerfield that, “independent of whether a scoliosis is congenital, neuromuscular, or idiopathic, mechanical factors become predominant relative to initiating factors during rapid adolescent growth, when the risk of curve progression is greatest” or, as expressed succinctly by Hawes & O’Brien, “no matter what you believe to be the cause of AIS, ultimately the problem can be reduced to the production of an imbalance of forces along the spine.”31,68
The simplest explanation for the cause of scoliosis is a biophysical adaptation to gravity. Understanding why this adaptation occurs is paramount to designing an effective treatment regimen.
Using innovative concepts such as whole-body vibration and advanced spinal weighting techniques to improve the body’s posture & balance and re-train how the brain activates different muscles in response to gravity, we are able to address the neuromuscular compensations that occur in scoliosis.69-72
50) Mihaila D, Calancie B: Is corticospinal tract organization different in idiopathic scoliosis? Stud Health Technol Inform. 2008;140:350.
51) Woods LA et al: Decreased incidence of scoliosis in hearing-impaired children: implications for a neurological basis for idiopathic scoliosis. Spine, 1995;20:776.
52) Goldberg C J et al: Adolescent idiopathic scoliosis and cerebral asymmetry. An examination of a non spinal perceptual system. Spine, 1995;20:1685-1691.
53) Geiselle A E et al: Magnetic resonance imaging of the brain stem in adolescent idiopathic scoliosis. Spine, 1991;16:761-763.
54) Stevens et al: MRI of the posterior fossa and evoked potential analysis in adolescent idiopathic scoliosis. In: Proceedings of the Scoliosis Research Society, 27th Annual Meeting, Kansas City, Missouri, USA, September 23-26, 1992, p. 89-90
55) Maguire J: Intraoperative long-latency reflex activity in idiopathic scoliosis demonstrates abnormal central processing. A possible cause of idiopathic scoliosis. Spine, 1993;18:1621-1626.
56) McGovern A et al: Reflexes induced by vibration in the superficial paraspinal muscles of girls with adolescent idiopathic scoliosis. In: Proceedings of the British Scoliosis Society, 21st Annual Meeting, London 20-22 March 1996. Journal of Bone and Joint Surgery Orthopaedic Proceedings, British Volume, In Press.
57) Arai S et al: Scoliosis associated with syringomyelia. In: Proceedings of the Scoliosis Research Society, 27th Annual Meeting, Kansas City, Missouri, USA, September 23-26, 1992, p. 139.
58) Barnes PD et al: Atypical idiopathic scoliosis: MR imaging evaluation. Radiology, 1993;186:247-253.
59) Evans SC et al: MRI of ‘idiopathic’ Juvenile scoliosis. A prospective study. Journal of Bone and Joint Surgery, 1996;78B:314-317.
60) Lewonowski K et al: Routine use of magnetic resonance imaging in idiopathic scoliosis patients less than eleven years of age. Spine, 1992;17:S109-116.
61) Sahlstrand T: An analysis of lateral predominance in adolescent idiopathic scoliosis with special reference to the convexity of the curve. Spine, 1980;5(6):512-8.
62) Grivas TB, Vasiliadis ES, Polyzois VD, Mouzakis V: Trunk asymmetry and handedness in 8,245 school children. Developmental Neurorehabilitation, 2006;9(3):259-266.
63) Goldberg C, Dowling FE: Handedness and scoliosis convexity: a reappraisal. Spine 1990;15(2):61-4.
64) Goldberg CJ, Moore DP, Fogarty EE, Dowling FE: Handedness and spinal deformity. Stud Health Technol Inform. 2006;123:442-8.
65) Kimiskidis VK, Potoupnis M, Papagiannopoulos SK, Dimopoulos G, Kazis DA, Markou K, Zara F, Kapetanos G, Kazis AD: Idiopathic scoliosis: a transcranial magnetic stimulation study. J Musculoskelet Neuronal Interact. 2007;7(2):155-60.
66) Chu W, Lam W, Ng B, Tze-Ping L, Lee K, Guo X, Cheng J, Burwell R, Dangerfield P, Jaspan T: Relative shortening and functional tethering of spinal cord in adolescent scoliosis - Result of asynchronous neuro-osseous growth, summary of an electronic focus group debate of the IBSE. Scoliosis, 2008;3:8.
67) Lambert FM, Malinvaud D, Glaunès J, Bergot C, Straka H, Vidal PP: Vestibular asymmetry as the cause of idiopathic scoliosis: a possible answer from Xenopus. J Neurosci 2009 Oct 7;29(40):12477-83.
68) Hawes MC, O’Brien JP: The transformation of spinal curvature into spinal deformity: pathological processes and implications for treatment. Scoliosis, 2006;1(1):3.
69) Tjernström F, Fransson P, Hafström A, Magnusson M: Adaptation of postural control to perturbations – a process that initiates long-term motor memory. Gait & Posture 2002;15(1):75-82.
70) Fontana T, Richardson C, Stanton W: The effect of weight-bearing exercise with low frequency, whole body vibration on lumbosacral proprioception: a pilot study on normal subjects. Aust J Physiother., 2005;51(4):259-63.
71) Issurin V: Vibrations and their applications in sport: a review. J Sports Med Phys Fitness, 2005;45(3):324-336.
72) Kluzik J, Peterka R, Horak F: Adaptation of postural orientation to changes in surface inclination. Exp Brain Res. 2007;178:1-17.
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