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Displaying items by tag: scoliosis brace treatment
1.) All scoliosis is not the same. Scoliosis is often used as a general term without much specific information given. For instance a child who has a curvature that measures 15 degrees on an x-ray is told they have scoliosis while another child has a curvature that measures 50 degrees and is also told they have scoliosis. The first child let’s say 12 year old female has a 15 degree spine curvature with the apex of the curve at L2 with no other secondary curves and also has a pelvis which is tilted by 6 degrees. The second child also a 12 year old female has a primary curvature of 50 degrees with the peak of the curve at T9 in the thoracic spine with a secondary curve in the lumbar spine of 30 degrees with a completely level pelvis. Again both kids are diagnosed with scoliosis. The point is that scoliosis is often talked about in general terms and no specific information is given so if you are a parent starting to research scoliosis on the internet it is recommended that you keep in mind information may be specific to a case like the second child or may be relevant to the first scenario or may not pertain to either type.
3.) Nothing can be done accept brace treatment to prevent progression and avoid surgery. This is probably the biggest misconception that surrounds the diagnosis of scoliosis. In fact the orthopedic surgeon and often even the pediatrician will tell parents this exact statement. Nothing could be further from the truth. Scoliosis rehabilitation involving neuromuscular training has successfully stopped progression, reduced the size of the scoliosis, and permanently stabilized thousands of scoliosis curvatures worldwide over the past 10 years. Innovation and doctors in private practice are leading the revolution to rid children of invasive procedures like bracing and surgical fusion for scoliosis. This statement is not only false but it is almost a complete opposite of the truth. Most studies indicate a significant failure rate when scoliosis brace treatment is applied and often the scoliosis curvature becomes more rigid in the apex zones and creates more permanent deformity according to some potentially ground breaking research being performed by some of the top scoliosis scientists. In addition rigid bracing decreases breathing capacity in children and may cause psychological problems. If your child has been diagnosed with scoliosis regardless of the size and location of the curvature you should seek an immediate evaluation by a properly trained rehabilitation specialist.
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The current medical management of idiopathic scoliosis is fairly straight forward with 3: main recommendations:
~Smaller curves below 25 degrees monitor with no scoliosis treatment.
~Large curves over 40 degrees, multiple level scoliosis surgery.
The problem arises with parents of children who have entered the 40 degree zone when the typical orthopedic response is your child needs scoliosis surgery and many of these parents simply don’t want scoliosis surgery and feel that it is too invasive a procedure at this point. So what are the options? Is there a nonsurgical management plan for scoliosis? What are the real consequences of choosing not to do a multiple level scoliosis fusion surgery on a child with a 40 degree, 50 degree, 60 degree scoliosis?
The answer to these questions is going to be different based on the facts of the individual child’s clinical picture. If we look at options for nonsurgical management of larger curvatures we won’t find a whole lot of current literature or choices. Some of the more common but rather generic options are exercises, chiropractic, massage, and other alternative back care choices that don’t offer much in terms of addressing some of the more important aspects of larger scoliosis curvature. Many parents and children feel that addressing posture, function levels, breathing capacity, rib deformity, and pain are the major concerns with managing a larger scoliosis curvature.
The other concerns are often regarding the future health of their child. Will the scoliosis continue to progress? Are their cardiovascular or respiratory risks not just a shallower breathing pattern, but real tangible health concerns with a larger curvature? Can my daughter have children? What about sports? As you can see there certainly is a plethora of questions facing a nonsurgical choice when it comes to scoliosis and probably why tens of thousands of scoliosis fusion surgeries are performed annually. It’s easier to swim downstream then to swim upstream especially when you have some of the most respected surgeons advising you to do the surgery.
Shedding light in regards to nonsurgical management of larger scoliosis curvature generally above 40 degrees is something that needs to be done and I hope the following information will help do this. Statistically the chances of cardiopulmonary or cardiac dysfunction that will actually affect the health of the individual with scoliosis are rare. Most experts feel that only in grossly severe curves over 100 degrees is the heart actually in danger of being affected. Pulmonary changes are more common but only occur in thoracic primary curves above 60 degrees in addition the thoracic kyphosis also must demonstrate significant losses in order for more noticeable changes in respiratory capacity to be measurable. The ability to have children both carry and deliver a baby to term without complications is often unaffected by larger scoliosis and in some reports more of a problem with multiple level spinal fusion surgeries. Most patients with a larger scoliosis remain fully functional and continue to live normal lives and other than some visual body asymmetry really are at no increased health risks.
It would be interesting to argue that there are potentially more health risks and complications with surgically treated scoliosis versus non surgically treated. Experts could argue that nonsurgical leaves you at risk for progression, pulmonary deficiencies pain whereas surgical intervention yields no improvement in pulmonary deficiencies or pain and adds functional losses in movement ability, stiffness, scarring, and host of other reported health issues. One thing surgery definitely provides is 250 billion dollars of revenue annually.
Moving forward a new nonsurgical treatment option created by a group of doctors known as CLEAR scoliosis treatment provides the best opportunity to manage a larger curvature. The main premise of CLEAR treatment is to decrease soft tissue resistance and then rehabilitate the neuromuscular system using advanced cantilever body weighting that helps the spine adapt and learn a new straighter position without creating immobility. Soft tissue adaptations that are present with larger curves involve muscle, tendons, ligaments, and discs. These tissues become more rigid and asymmetrical in larger curve formation. Advanced biomechanical equipment used produces cyclical loading and unloading combined with low frequency vibration to stimulate collagen elongation thus increasing spinal flexibility. Once the spine is unlocked where soft tissue has disengaged the neuromuscular retraining begins. A series of engineering measurements are taken to allow the doctor to create the appropriate weight leverage needed to cause the bodies neurological righting mechanism to shift the spine to a more stable balanced position when the weight is placed on the patient. This shift in spinal position used to rebalance and redistribute the bodies center of mass causes the spine to become straighter. When used repetitively for approximately 90 days follow up x-rays will demonstrate average scoliosis curve reductions between 30-50% with doctors that have clinical experience and advanced training so it is important who you choose for this type of care program.
Unlike physical therapy or chiropractic care this group of doctors are specifically trained in scoliosis bioengineering, require additional training, specific clinical equipment, and are required to take multiple exams to become eligible to provide CLEAR scoliosis treatment . So if I were a parent choosing a nonsurgical scoliosis management system I would choose these guys hands down. I would also consider for those parents who are planning on multiple level scoliosis fusion surgery to get a consultation with a CLEAR practitioner prior to undergoing surgery for scoliosis you may in fact see more benefit in a nonsurgical approach. When it comes to risks versus benefits the tide is turning in regards to nonsurgical versus surgical management for scoliosis.
Scoliosis Brace Treatment Significantly Decreases Lung Function
The majority of adolescents that are prescribed scoliosis brace treatment are told to wear their scoliosis brace for 23 hours daily. As we start to dissect the physiological effects we can understand why a major issue exists with compliance when wearing the Boston Brace or any other rigid brace. The amount of physical discomfort that is occurring is in most cases ignored and poorly understood. If someone were to aggressively squeeze your chest wall and then press on your abdomen and then hold it for 23 hours daily how would you feel? The amount of functional loss to the patients breathing mechanics is upsetting and potentially dangerous. The respiratory studies indicated a significant decrease in breathing capacity and also in oxygen and CO2 exchanges ratios causing an innate neurological breathing adaptation to take place in order to survive. Most studies however indicated that the breathing and pulmonary testing returned to normal once the brace was removed but you have to wonder what type of cellular damage or other health implications may occur while in the scoliosis brace. Understanding human physiology, however complex, may be simplified to some general facts. Breathing isn't just affecting oxygen intake and gas exchange it has a major effect on other aspects of human health. Breathing has a significant impact on hormone regulation including estrogen, progesterone, growth hormone, and thyroid hormones. In addition breathing has a direct affect on muscle and fat composition as well as cognitive performance. Regardless if the breathing capacity returns to normal after wearing the Boston Scoliosis Brace, we may instead want to discuss what impact it may have on a child's health while wearing it. There are currently no known studies addressing this issue but it would certainly be interesting to see how much of an impact restricting breathing capacity for 23 hours a day might have on a growing body. The Boston Scoliosis Brace mechanically produces pressure on both the chest wall and the abdomen allowing for little compensation within the breathing mechanism. The studies that were performed on children wearing the Boston Brace demonstrated a 30% decrease in VC (vital capacity) and a 45% decrease in ERV (expiratory reserve volume) the same type of decreases found in long term smokers. Symptoms related to respiratory distress may include headaches, anxiety, sleep disturbance, nightmares and cognitive dysfunction. It is unfortunate that such an invasive treatment is often utilized in hopes of preventing scoliosis progression with little consideration of how it will affect the child during and after the treatment. Such narrow minded thinking with a sole focus on a Cobb angle measurement seems to stifle all other rational thought as to side effects from scoliosis bracing. With recent evidence discovered by the genetic research team at Axial BioTech suggesting that spinal bracing does not alter the natural course of scoliosis, empirical data demonstrating the significant pulmonary stress while wearing the Boston Brace combined with the known psychological problems associated with scoliosis brace wear, parents and their doctor must closely consider risks versus benefits when considering use of the Boston Scoliosis Brace. Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.
SpineCor Brace Failure is Significantly Higher Than Traditional Scoliosis BraceFailure according to research performed by Dr wong and his team who were trained for 3 years at St Justine Hospital on the fitting and use of the spinecor brace. Rigid scoliosis bracing has been around for a hundred years attempting to halt progression of idiopathic scoliosis. Contraversy has surrounded rigid spinal bracing for decades and the orthopedic community still performs over 40,000 scoliosis surgeries annually in just the United States alone. Many studies have been performed demonstrating the efficacy and lack of efficacy for placing a child in a scoliosis brace. Some of the main issues surrounding rigid spinal bracing are the compliance, the physical appearance, and the poor long term results. Some scoliosis experts and even countries have abolished scoliosis bracing based on these issues. The general consensus among these researchers is if it doesn’t work, is uncomfortable, and psychologically damaging to children, then why use it at all? Interestingly enough is that countries that don’t regularly use scoliosis braces generally have no measurable differences in the number of scoliosis surgeries performed. The Spine Corporation created the SpineCor scoliosis brace in the attempt to compete with the rigid brace and of course turn a profit. The SpineCor brace claims to be 88% effective at halting progression of idiopathic scoliosis yet no independent research supports this claim. They also claim to be more user friendly, that is more comfortable, less pressure, easier to perform daily activities, and create a better self image. The suprising results indicate that SpineCor fails in all of these categories in which it was designed to outperform the rigid scoliosis brace.
Conclusion. The current study showed that the failure rate of the SpineCor was significantly higher than that of the rigid spinal orthosis, and the patients’ acceptance to the SpineCor was comparable to the conventional rigid spinal orthosis. Man Sang Wong, PhD
According to the Spinecorporation published studies regarding efficacy they are claiming that 57% of scoliosis patients with Risser scores 0-3 and scoliosis curvature less than 30 degrees were able to sustain a reduction averaging 8 degrees over the course of 2 years. This may sound impressive to some but there are several problems with this finding. The first is what about the other 43% and what if your child is one of this group. The other is the time of the studies because pubertal growth spurts are typically 30-36 months in length and if the results were obtained prior to the termination of this growth spurt they are premature.
75% of children with adolescent idiopathic scoliosis won’t progress to severe levels based on a low genetic predisposition. The majority of this group will have simple postural imbalances that are positively affected by chiropractic and rehabilitation. The fact that spinecor brace providers are chiropractors leads me to believe that the spinecor brace itself may have had absolutely nothing to do with the 8 degree reduction.
The fact of the matter is there is no right way to do the wrong thing. Scoliosis brace makers keep trying to improve upon an idea and concept that has been statistically proven to have no effect on the natural course of the condition. Simply calling it a dynamic motion brace and claiming it is easier to use and gets great results based on research from a non independent source is another corporate attempt to deceive the public and turn a profit. Scoliosis is a neurological disease combined biomechanical and biochemical accelerators that needs to treated with sole purpose of eliminating the portion of the disease that can be eliminated not by pushing around the symptom or Cobb angles in the middle of the spine.
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The history of scoliosis treatment is well documented over the past almost 500 years (1st metal scoliosis brace was created in 1575) and dates back to the early writings of the Hippocrates himself (The Father of Medicine). For hundreds of years, if not thousands, idiopathic scoliosis patients have been immobilized in various types and applications of scoliosis brace treatment without success, and the current clinical data appears the orthopedic community isn’t any closer to scoliosis brace treatment success even today. Dr. Stefano Negrini led a comprehensive review of scoliosis brace treatment and concluded “There is a very low quality of evidence in favor of using braces, making generalization very difficult.” 436 years of attempted scoliosis brace treatment experimentation and “very low quality of evidence” is the best they can come up with? Obviously, we need a better way.
The first scoliosis surgery was conducted (unsuccessfully) in 1865 and subsequently spurred on the first medical malpractice lawsuit in the orthopedic community shortly after. While scoliosis surgery techniques, hardware, and abilities have vastly improved since that time, the long-term negative complications of fusing multiple levels of freely move-able joints in a patient’s scoliosis spine still haunts the procedure; keeping in mind the wide spread agreement that the primary indication for scoliosis surgery is for improving one’s cosmetic appearance and not medical necessity.
The current state of scoliosis treatment appears to be scoliosis brace treatment is worthless and the scoliosis surgery procedure is worse than the condition itself in many cases. The need for drastic change and over-haul to the scoliosis treatment system is clearly obvious, yet decade after decade, little to no progress is made other that “improvements” to the existing scoliosis brace protocols and scoliosis surgery procedures. The obvious question is simply, why? When the need is so glaringly evident and the technology and thought process is so clearly under-developed; why hasn’t the scoliosis treatment community rushed to meet the needs and demands of a world full of scoliosis patients? In my opinion it can be summed up in two words: Cobb angle.
Cobb angle first appeared on the scene in 1948 and has been adopted as the “common” (not necessarily “gold” standard) for scoliosis evaluation every since. Cobb’s angle is a completely obsolete system of analysis. Idiopathic scoliosis is a very complex condition and the more we learn about idiopathic scoliosis, the more complex it appears to be. Attempting to describe a condition as complex as idiopathic scoliosis purely by the means radiographic lateral flexion is the equivalent to attempting to describe all the features of your new luxury car by only its color. There is so much more to this condition than just a Cobb angle.
The “prognostic” or “predictive” value of Cobb angle in curve progression is only slightly better than the odds of flipping a coin and ALL of the Cobb angle prognostic assumptions are based off a single study by Lonstein and Carlson in 1984, which has never been repeated or re-produced to this very day. The current treatment schedule for scoliosis (10 degree diagnosis and then “watch and wait”, 25 degrees scoliosis brace treatment recommendation, 40 degrees scoliosis surgery recommendation) was accepted almost entirely on one article in 1977, by one doctor (Dr. William Kane), who openly admits the numbers are arbitrary and based on a cost based analysis to fit a particular healthcare system. It is not necessarily based off science, and more importantly, not necessarily based off the patient’s best interests.
Cobb angle has a generally accepted +/- 5 degree intra-examiner (same doctor measuring) “measurement error” between 2 separate x-rays and up to a 9.8 degree inter-examiner (different doctor) “measurement error” between 2 separate x-rays. This means a scoliosis brace treatment recommendation is essentially being made with an “acceptable” 20% error rate in scoliosis brace treatment recommendations for scoliosis cases of 25 degrees and scoliosis surgery recommendations are being made with a 12.5% error rate for scoliosis cases of 40 degrees. These measurement error rates are simply unacceptable when making recommendations for highly invasive procedures which have life-long lasting impacts (physically, emotionally, and psychologically) on those scoliosis patients unfortunate enough to be subjected to them.
Cobb angle is measured out of tradition, not an updated scientific understanding of idiopathic scoliosis. So what is the link between an obsolete, un-reproducible, and un-reliable measurement system (Cobb angle) and the stagnant progress of scoliosis treatment (more useless scoliosis braces and more ways to induce spinal fusion through surgery)? All “mainstream” scoliosis treatment protocols (scoliosis brace treatment and scoliosis surgery) are entire predicated on Cobb angle. Remove Cobb angle from the equation and there is no indication for scoliosis brace or scoliosis surgery treatment. It’s really that simple. Cut off the head (cobb angle) of the beast and the body (scoliosis brace and scoliosis surgery) dies.
Scoliscore genetic testing and Early Stage Scoliosis Intervention combine to create a new future for scoliosis treatment. It has been said that one has to “replace” or “break” a current system, before the old one can be replaced. For example, email “broke” and “replaced” the fax machine. Almost overnight the fax machine became completely obsolete and slowly, but surely email is replacing the US Postal Service. Generally speaking it is easier to “break” the existing system than to “replace” it with something entirely brand new (which is really hard to do and needs to be invented first). In the case of over-hauling and replacing the current scoliosis treatment system it will need to be “broken” AND “replaced”.
Scoliscore genetic testing for idiopathic scoliosis will “break” the current scoliosis treatment system, because it “breaks” the use of Cobb angle as a predictive tool of curve progression. Idiopathic scoliosis a multi-factorial condition (aka: a combination of both genetic pre-disposition and environmental influences) and completely unique to every patient’s individual scoliosis case. No two cases of idiopathic scoliosis will ever have exactly the same genetic pre-disposition and/or environmental influences, so having a “known” variable like the patient’s genetic pre-disposition become invaluable in determining their true curve progression risk. In other words, a low genetic risk scoliosis case with a 20 degree Cobb angle looks exactly the same as a high genetic risk scoliosis case with a 20 degree Cobb angle on an x-ray; and under the current system to scoliosis treatment they would both receive the same scoliosis treatment recommendation (which in this case would be “observation only”).
The Early Stage Scoliosis Intervention program will “replace” the current scoliosis treatment model when used in combination with the genetic predisposition information provided by the Scoliscore test. Again, based on the new understanding that idiopathic scoliosis is a multi-factorial condition with both genetic predisposition and environmental influences resulting in the development of a spinal curvature; the current scoliosis brace and scoliosis surgery treatment protocol only attempts to deal with the end result (the spinal curvature) rather than treating and preventing the spinal curvature from developing by reducing/eliminating the environmental factors (the only variable we can currently control at this time). However, the Early Stage Scoliosis Intervention program is solely targeted towards reduction of the environmental influences and is centered around a neuro-muscular rehabilitation program the specifically targets the automatic postural control centers in the hind brain, which many researchers feel is genetically predisposed to being “under-developed” in idiopathic scoliosis patients.
This “one, two” punch of accurately determining which patients are most genetically predisposed to developing a severe idiopathic scoliosis curvature with Scoliscore genetic testing and immediately implementing an Early Stage Scoliosis Intervention program which re-trains the under-developed postural control centers in the brain, while simultaneously reducing environmental influences for idiopathic scoliosis is the most scientifically advanced approach to scoliosis spine treatment to date. The current state of scoliosis treatment is deplorable. The Cobb angle system of scoliosis evaluation is antiquated (and thanks to Scoliscore genetic testing, now obsolete as well), and the scoliosis treatment system (scoliosis brace and scoliosis surgery treatment) employed under its (Cobb angle) direction is equally antiquated. In order to “turn the page” to a new day in scoliosis treatment, the scoliosis treatment community will need to embrace Scoliscore genetic testing as a way to “break” the hold Cobb angle has on scoliosis treatment protocols and adopt an Early Stage Scoliosis Intervention program to “replace” the current observation, scoliosis brace treatment, and scoliosis surgery treatment methodology in favor or a more pro-active strategy which prevents the spinal curvature (hence eliminating the need for scoliosis brace and scoliosis surgery treatment) and re-trains the neuro-muscular under-developmental cause of idiopathic scoliosis.
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