Scoliosis bracing, as an example, is based upon the Heuter-Volkmann Law, which states (in a nutshell) that pressure on the endplates of the vertebral bodies causes those vertebrae to grow faster (with less pressure) or slower (with more).  Traditional rigid a scoliosis brace, therefore, is performed with the goal of reducing the forces acting upon the vertebral bodies to discourage the vertebrae from becoming more wedged, by reducing the forces of gravity acting upon those vertebrae.
 
This is disheartening, because the main source of pressure & force acting upon the vertebral bodies is not gravity, but the intrinsic core musculature of the spinal column.  A scoliosis brace immobilizes the muscles and the discs, creating a static environment that predisposes the scoliosis spine to maintain its current environment, rather than change the patterns of how these intrinsic muscles fire and thus truly alter the natural course of this spinal condition.
 
Consider: Scoliosis bracing has been around for over 500 years, yet has failed to demonstrate any evidence of corrective benefit.  The goal of scoliosis bracing is stabilization, not correction - and all too often, it even fails at that.
 
The main thrust of research today is into more advanced methods of scoliosis surgery.  Common sense dictates that, if you do not understand the cause of a disease, you can only treat the symptoms of said disease.  Scoliosis surgery does a wonderful job of improving the radiographic aesthetics of people with scoliosis; it fails to correct the driving forces behind the condition, as evidenced by the fact that scoliosis continues to worsen even after metal instrumention is implanted into the spinal column.
 
So what makes CLEAR Institute different?
 
Our basic premise is that it is better to re-train the brain to "learn' how to hold the spine into position than it is to FORCE the spine into position.  Our underlying philosophy is that Cobb Angle is merely a symptom of the disease, not the cause, and if you focus on treating only the symptoms of any condition, you will never provide any real benefit to the patient.
 
By re-programming the righting reflex of the brain to operate in such a manner that the scoliosis no longer provides mechanical advantage, the root cause of scoliosis can be addressed.  A side-effect of this is that the Cobb Angle reduces over time, without being forced into position with external hardware.
 
In the field of scoliosis treatment in the United States today, common sense is no longer common.  Be your own advocate.  Ask the tough questions of your doctor.  Once you find the question that he can't answer, try asking the same question of a CLEAR Institute doctor.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.

Cobb angles are the most common (not the best) method of describing an individual's scoliotic condition. However, Cobb angles are merely the end result of genetic and environmental factors interacting, so they (Cobb angles) are the symptomatic result of an underlying process, not the disease itself.

Therefore.......Genetic predisposition (GP) + Environmental Factors (EF) = Scoliosis (Cobb angles)

Based on this understanding, the only possible way to influence the end result (Cobb angles) is to manipulate either or both of the variables (GP and EF) from which the result (Cobb angle) is comprised from. I think this makes it pretty clear to see that any treatment approach that attempts to alter the result (Cobb angle) without altering the one or both of the variables (genetics and environmental factors) is doomed for failure.

This is the formula that should be applied to any scoliosis treatment methodology to determine if it is feasible or not.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.

How is CLEAR Institute different from scoliosis brace treatment and scoliosis surgery anyway?

I hope this can inform and/or clear (no pun intended) up any misconceptions.

Check out the 5 min introduction to CLEAR scoliosis treatment on www.clear-institute.org/freeinfo

The work we (CLEAR Institute) are doing is based on the fact that scoliosis is not just a spinal curvature, but involves abnormal spinal curves in the neck, as well as hip rotation. Active scoliosis patients always present with forward head posture and loss of cervical lordosis (side view of the neck)(seen on x-ray). There is also abnormal biomechanical malposition of the head and neck. Therefore before the lateral scoliotic curvature can be corrected the cervical lordosis in the saggital plane must be re-established. After which the lateral curve (Cobb angle) is reduced.. These results are achieved with a combination of specific spinal adjustments done with instruments, specific rehabilitative procedures including proprioceptive neuromuscular re-education, muscle and ligament rehab and vibration therapy. The scoliotic spine compresses and rotates three dimensionally; therefore it must be de-rotated, and de-compressed in order to correct. We use, among other things, vibration platforms and a vibration scoliosis traction chair as well as specific bracing to pull the Cobb angle back into proper alignment.

Scoliosis is the body's natural and innate response to the loss of mechanical
function provided by the normal curves of the spine. When these curves disappear, the
body re-inserts them in another dimension. If scoliosis has a "cause," then it can only be
described as the laws of physics!

1.) Scoliosis is caused by a dysponesis (miscommunication) between the motor-
sensory input/output from the upper trunk to the lower. This is in turn caused by a
unilateral (one-sided) impairment of the spino-cerebellar loop, which is located in the
area between the occiput and the first cervical vertebra. Supporting this theory is the fact
that 100% of scoliosis patients have a problem with proprioception (orientation of the
body in time and space), and 100% of scoliosis patients have a loss of the curve in their
neck, resulting in forward head posture.

2.) Exercise rehabilitation therapy is mandatory to reverse the scoliosis. Without
patient compliance, no amount of care can help. It is necessary to retrain the postural
muscles of the body. Vibratory stimulation overrides the body's proprioceptive signals
and mechanoreceptors, thus facilitating retraining of the postural muscles.

3.) Cobb angles over 30 degrees cannot be reduced in the same manner as Cobb
angles under 30 degrees. The muscles contract more on the convexity of the curve, rather
than the concavity, as is the case with angles under 30 degrees. Normal laws of
biomechanics do not apply in patients with Cobb angles of more than 30 degrees!

4.) One component is universally lacking in nearly all
forms of scoliosis treatment today: the effect of the cervical
spine in determining spinal pathology, gait, stance, and overall
posture. The head controls all components of the spine below
it, much like how the engine controls the direction of a train.
Without regard for which direction the locomotive is heading
in, how is it possible to control the boxcars behind it? The very
first aspect that must be addressed in scoliosis correction is the
cervical spine; specifically, correcting the forward head posture
by restoring the curve and the normal ranges of motion in the
neck, especially between the occiput (C0) and the atlas (C1).
This is why lateral cervical views in neutral, flexion, and
extension are necessary. Follow-up x-rays should be performed roughly every three
months as objective proof of improvement; should the patient's progress plateau or
regress, additional rehabilitation or alterations to the protocol may be required.
Obviously thoracic views are necessary to measure the Cobb angle, but stay away from
full-spine views! The rate of distortion is too high to allow for consistency and accuracy
when comparing measurements between pre-and post-x-rays. It is also important to
evaluate the curve in the low back, and rotation in the hips with lateral and A-P lumbar x-
rays, and correct any deviation from normal that is found.

Don't let a lifetime be defined by idiopathic scoliosis

Now that genetic pre-disposition testing for scoliosis progression risk is available; An Early Stage Intervention Program has also been developed to provide scoliosis patients a non-bracing, non-surgical treatment option that allows them to take immediate action in the prevention of the next stage of the standard treatment process (scoliosis bracing or scoliosis fusion surgery).

While it is not the intention of CLEAR Institute to condemn the efforts of sincere and caring medical professionals who have dedicated their lives to helping individuals with scoliosis. We would, however, like to add to the current list of options; to educate those who are personally involved with scoliosis about what the research says; and, to empower these individuals to make their own decision regarding their own spine, and their own life.

The three medically-sanctioned methods of scoliosis treatment - observation, bracing, and surgery - have been around for decades. A great deal of research has been done on the risks & benefits of each option. However, the general conclusion of this research suggests that a new paradigm is desperately needed as there are many conflicts and inadequacies present in the current model.

Observation Only or the “watch & wait” stage

Once an individual has been diagnosed with scoliosis, no treatment is initially prescribed, and no action is immediately taken, until the Cobb angle has progressed to 25 degrees (which is an arbitrary figure. There is no clinical significance to this number). At this point, bracing is typically prescribed. This period, which is termed "watch & wait," consists only of regular visits to an orthopedic surgeon, where full-spine x-rays are taken consistently to gauge the progress of the patient's condition.

Scoliosis brace treatment (Generally recommended for curvatures 25 degrees and larger)
If there ever was a time when a patient could benefit most greatly from chiropractic, therapeutic exercise, or non-surgical intervention, it would undoubtedly be during the mild stages of the disease - before the muscles & tissues of the body have been deformed by months or even years of compensating for the abnormal twisting & bending of the spine.

Scoliosis bracing dates back to approximately 650 AD, when Paul of Aegina suggested bandaging scoliosis patients with wooden strips. The first metal brace was developed by Ambroise Pare in the 16th century. Today, there is a bewildering assortment of braces in use, ranging from the venerable and bulky Milwaukee brace, to the traditional TLSO (thoraco-lumbar-sacral orthosis) braces such as the Boston and the Wilmington brace. There are "part-time" braces, designed to be worn at night: the Providence brace, and the Charleston brace. There are also "dynamic corrective braces" which may use soft, elastic materials and claim to be able to do more than simply stabilize the progression of scoliosis. An example of a dynamic corrective brace would be the SpineCor brace, developed at the Sainte-Justine Hospital in 1992, or the Copes brace, developed by Arthur Copes to be used in conjunction with his STARS (Scoliosis Treatment Advanced Recovery System) rehabilitation protocol.

This dizzying variety is further complicated by the fact that not every doctor prescribes the braces to be used in the same manner, and not every patient may follow their doctor's recommendations to the same extent. As a result, research is often conflicting (to say the least) in regard to the true effectiveness of bracing in scoliosis treatment. Some studies have shown very little difference between patients who wore the brace for the prescribed time, and those who wore it barely, if at all. Others have demonstrated patients who have been successfully stabilized for years by wearing a bracing constantly; yet, there are also studies on patients who wore the brace for 23 hours out of every day, seven days a week, and continued to worsen. In every case, all corrective benefit is lost very quickly once the patient stops wearing the brace, and the general consensus is that bracing may prove helpful for some, but not for others.

Scoliosis surgery (Generally recommended of curvatures 40 degrees and larger)
Those patients for whom bracing fails to prevent the progression of their scoliosis are left with only one option: surgery. Those who are confronted with this choice may be told that having a metal rod fused to their spine will not impair their daily activities, and will reduce the rib arch & improve their cosmetic appearance. However, research has consistently shown that surgery - which primarily focuses upon the sideways bending, and does little to address the rotation of the spine (and hence the rib protrusion) - will actually cause the rib arch to worsen (Chen 2002, Goldberg 2003, Hill 2002, Pratt 2001, Weatherly 1980, Wood 1991, Wood 1997).

Scoliosis surgery, like most highly-invasive procedures, carries with it the ever-present risk of death. Although mortality rates of less than one percent are claimed, no surgeon can completely eliminate this possibility. There is also the danger of neurological damage, resulting in the loss of sensation or motor function to the arms & legs (paraplegia or quadraplegia). This has become a greater concern in recent years, as surgeons strive for greater corrections in their patients, and place more stress upon the nerves running through the spinal column.

The rate of hardware failure is virtually 100% over the course of a normal lifetime. It may occur immediately after the surgery or several years later, but one or more components of the hardware placed inside the body is highly likely to fail or break. The author of one study stated, "One would expect that if the patient lives long enough, rod breakage will be a virtual certainty". Another study found that amongst seventy-four patients who underwent the surgery, pseudoarthrosis (failed fusion) occurred in 27% of patients within a few years after the procedure.

The truth of the matter is that scoliosis is an abnormality of the spine which involves much more than merely a sideways curve. Yet the "effectiveness" of surgery is measured only by the degree to which it can reduce the lateral deviation through the application of brute force, and a fused spine is every bit as abnormal and dysfunctional as a scoliotic spine.

We can alter the natural course of this disease by identifying which patients are at the highest risk for severe progression via genetic testing (Scoliscore) and by implementing an aggressive, non-invasive Early Stage Scoliosis Intervention program that re-trains the brains involuntary postural controls centers before the spinal curvature reaches the 30 degree "buckling" point

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.

Segments adapted from: Cobb's Angle in Scoliosis: Gold Standard or Golden
Calf? A Commentary on Scoliosis Outcome Assessments
Mark Morningstar, D.C., Clayton Stitzel, D.C.

J. Pediatric, Maternal & Family Health - January 19, 2010

Cobb angle should not be the Gold Standard for radiographic evaluation of
idiopathic scoliosis. While Cobb angle has been the subject of numerous reliability studies, there are several disadvantages to benoted. These disadvantages range from high inter-examiner variability to lack of validity. Cobb angle is oftentimes only as good as the film it is drawn upon. There are various alternative methods that involve measuring the Cobb angle as well as its rotational component. Since chiropractors are particularly focused on obtaining radiographic evidence of treatment success, the profession at large should use radiographic analytical methods that provide more information on the presenting three-dimensional spine and spinal disorder.

Scoliosis is classically described in the literature as a curvature of the spine greater than 10 degrees on radiographic study. This measurement is taken using a Cobb angle, a measurement first illustrated decades ago in an effort to quantify scoliotic curvatures and the progression or correction thereof.

Classically, the Cobb angle has been the gold standard forassessing spine curvatures both in the sagittal and coronal planes. While this measurement has remained through the decades as the chief outcome assessment in scoliosis, this measurement has both a high degree of variability and virtually no validity. It provides no information on segmental or global spinal function, it gives little insight as to the risk of curve progression, it does not correlate to any subjective outcome, and it provides only two-dimensional information about a three-dimensional spine, hence failing to account for vertebral rotation. Since there are other newer methods to evaluate spine structure, which have a higher degree of reliability, we will discuss our opinion in this article that the Cobb angle should be abandoned for scoliosis radiographic evaluation.

Measurement Issues

Cobb angle has been the subject of numerous reliability studies. From an intra-examiner standpoint, a single practitioner's Cobb angle will vary anywhere from 2-5 degrees depending upon whether the image is a plain-film radiograph, CT, or MRI study. The inter-examiner variability is unfortunately much higher, approximating 20 degrees or higher in some studies. Aside from the high degree of measurement variability, even the best Cobb angle measurement is only as good as the film it is drawn upon. Weinert demonstrated changes in anatomical measurements with only small incremental changes in patient positioning in radiographic practice models used in chiropractic colleges. In this study, ten degrees of rotation, for example, caused a six millimeter change in the width of the sacrum, as well as a six millimeter difference between the heights of the femur heads. One can predict the difficulty in repeating an x-ray of a scoliosis patient with a marked degree of pelvic rotation, which creates a significant amount of projectional distortion. Moreover, scoliosis radiographs are best taken with the central ray located at the level of scoliotic apical vertebra. This helps create a single point of origin from which to measure future comparative studies on full-spine 14"x36" radiographs. Since this method fails to account for issues such as pelvic positional changes on subsequent studies, a full-spine film lends to high variability, even when Cobb angle is drawn with 100% reliability. Another disadvantage of using the Cobb angle to evaluate
scoliosis is its lack of validity. Many signs and symptoms of scoliosis, such as reduced pulmonary function, may be related more to the rotational displacement caused by scoliosis compared to any lateral bending component. Cobb angle, however, does not account for spine rotation, since it is purely a two-dimensional measurement. To accommodate for these pitfalls, additional forms of measurement have been created,

such as the scoliometer, and Nash-Moe and Perdriolle measures of vertebral rotation. By contrast, surgeons report significant reductions in Cobb angle measurements following spinal arthrodesis. Despite these reported corrections, as many as 40% of these patients will be classified as permanently disabled as a result of the surgery, yet the Cobb angle is reduced.

Conclusion

Scoliosis is a multi-dimensional disorder. Biomechanically, scoliosis is a three-dimensional deformity of the spine. However, the radiographic Cobb angle measurement only
provides two-dimensional information. This in and of itself should make the measurement obsolete, given the availability of other published radiographic methods such as those
outlined here. Use of a Cobb angle, especially on full-spine radiographs, assumes that the patient placement on a full-spine film is consistent from pre- to post-treatment studies.
Since chiropractors are particularly focused on obtaining radiographic evidence of treatment success, the profession at large should use radiographic analytical methods that providemore information on the presenting three-dimensional spine.

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There are many symptoms associated with idiopathic scoliosis which range from spine/body deformity, pain, restricted breathing, depression to decreased social functioning, limited physical activity, and lower quality of life.  How every there is one symptom which is often over looked and left out entirely.

What if the Cobb angle is really just a "symptom" of the unseen neurological condition that is outwardly and physically manifested as idiopathic scoliosis?  I mean, scoliosis is a multi-factorial condition caused by the combination of genetic pre-disposition and environmental influences, so wouldn't anything else be considered a "symptom"?

It is kind of like watching the wind out a window. You can't see the wind, but you can see the effects of the wind on the trees, grass, ect....What if the same is true with scoliosis?...you can't see the neurological condition, but you can see it's effects on the spine.

So scoliosis bracing and scoliosis surgery would only be treating the symptom, not the condition itself.

Deep huh?

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The list of top 21 items of most importance when considering scoliosis treatment outcomes by SOSORT highlights a very commonly lost concept.

Idiopathic Scoliosis patients are people. They aren't floating spines that come wandering into doctor's offices. Where is an honest to goodness real live person attached to that spine.

The orthopedic community has become so soley focused on cobbs angle as the only unit of measure for scoliosis that it is completely understating the majority of the disease and the most important aspect of the disease......the patient.

Cobb's angle is simpily put nothing more than measurement of the gross lateral flexion of the curvature. Nothing more, nothing less. I doesn't provide any knowledge in terms of rotation, level arm biomechanics, pain, quality of life, organic health measures such as pulmonary or cardiovascular health; nothing.

It is a quick and dirty method of describing when a different treatmetn method should be applied (observation, scoliosis bracing, scoliosis surgery)

It understates the complexity of the disease and undermines the importance of the patient. Perhaps this is why SOSORT felt it appropriate to list aesthetics, quality of life, psychological well-being, disability, back pain, rib hump, breathing function, curve progression in adulthood, needs for further treatment in adulthood, knowledge/understanding of scoliosis in general and their specific growth pattern, and balance ahead of Cobb's angle in importance of scoliosis treatment goals.

Just one man's opinion (Supported by some of the foremost scoliosis experts in the world).

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Here is a ranking of the top 20 most important factors to be considered in idiopathic scoliosis treatment according to SOSORT (Society of Scoliosis Orthopedic Rehabilitative Treatment). Note Cobb's angle (which I will from now forward refer to as radiographic lateral bending) ranks 11th out of 20 on the list.

I can't say that I agree with everything on the list, but it is interesting.

Ranking Importance of factors in scoliosis according to SOSORT

1. Aesthetics

2. Quality of life

3. Psychological well-being

4. Disability

5. Back Pain

6. Rib hump

7. Breathing function

8. Progression in adulthood

9. Needs of further treatments in adulthood

10. Knowledge and understanding of scoliosis in general and
their specific
pattern

11. Scoliosis Cobb degrees (radiographic lateral flexion)

12. Self control of posture

13. Movement of the vertebral column (sagittal plane)

14. Perdriolle degrees (radiographic rotation)

15. Kypho-lordosis Cobb degrees (radiographic lateral alignment)

16. Sensory motor integration of the corrective ideal pattern

17. Exercise efficiency

18. Equality of weight bearing

19. Improved body motor awareness and motor learning skills

20. Improved processing of vestibular input

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The history of scoliosis treatment is well documented over the past almost 500 years (1^st 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.

The work we are doing is based on the fact that scoliosis is not just a spinal curvature, but involves abnormal spinal curves in the neck, as well as hip rotation. Active scoliosis patients always present with forward head posture and loss of cervical lordosis (seen on x-ray). There is also abnormal biomechanical malposition of the head and neck. Therefore before the lateral scoliotic curvature can be corrected the cervical lordosis in the saggital plane must be re-established. After which the lateral curve (Cobb angle) is reduced.. These results are achieved with a combination of specific spinal adjustments done with instruments, specific rehabilitative procedures including proprioceptive neuromuscular re-education, muscle and ligament rehab and vibration therapy. The scoliotic spine compresses and rotates three dimensionally; therefore it must be de-rotated, and de-compressed in order to correct. We use, among other things, vibration platforms and a vibration scoliosis traction chair as well as specific bracing to pull the Cobb angle back into proper alignment.

Scoliosis is the body's natural and innate response to the loss of mechanical function provided by the normal curves of the spine. When these curves disappear, the body re-inserts them in another dimension. If scoliosis has a "cause," then it can only be described as the laws of physics!

1.) Scoliosis is caused by a dysponesis (miscommunication) between the motor-sensory input/output from the upper trunk to the lower. This is in turn caused by a unilateral (one-sided) impairment of the spino-cerebellar loop, which is located in the area between the occiput and the first cervical vertebra. Supporting this theory is the fact that 100% of scoliosis patients have a problem with proprioception (orientation of the body in time and space), and 100% of scoliosis patients have a loss of the curve in their neck, resulting in forward head posture.

2.) Exercise rehabilitation therapy is mandatory to reverse the scoliosis. Without patient compliance, no amount of care can help. It is necessary to retrain the postural muscles of the body. Vibratory stimulation overrides the body's proprioceptive signals and mechanoreceptors, thus facilitating retraining of the postural muscles.

3.) Cobb angles over 30 degrees cannot be reduced in the same manner as Cobb angles under 30 degrees. The muscles contract more on the convexity of the curve, rather than the concavity, as is the case with angles under 30 degrees. Normal laws of biomechanics do not apply in patients with Cobb angles of more than 30 degrees!

4.) One component is universally lacking in nearly all forms of scoliosis treatment today: the effect of the cervical spine in determining spinal pathology, gait, stance, and overall posture. The head controls all components of the spine below it, much like how the engine controls the direction of a train. Without regard for which direction the locomotive is heading in, how is it possible to control the boxcars behind it? The very first aspect that must be addressed in scoliosis correction is the cervical spine; specifically, correcting the forward head posture by restoring the curve and the normal ranges of motion in the neck, especially between the occiput (C0) and the atlas (C1). This is why lateral cervical views in neutral, flexion, and extension are necessary. Follow-up x-rays should be performed roughly every three months as objective proof of improvement; should the patient's progress plateau or
regress, additional rehabilitation or alterations to the protocol may be required. Obviously thoracic views are necessary to measure the Cobb angle, but stay away from full-spine views! The rate of distortion is too high to allow for consistency and accuracy when comparing measurements between pre-and post-x-rays. It is also important to evaluate the curve in the low back, and rotation in the hips with lateral and A-P lumbar x- rays, and correct any deviation from normal that is found.