You may have learned recently that  your son or daughter has idiopathic scoliosis.  You visit an orthopedics and he x-rays him/her.  You find out she has a approximately 20 degree curvature of the spine and the surgeon says there is nothing he can do at this point but lets "watch and wait" and lets see you in 6 months. He advises that if in 6-months the curve progresses to 25 degrees...He will recommend a scoliosis brace. You go home. You wrestle with the "wait and see" guidance.  Your paternal instinct nags at you, "there must be more we can do than "wait and see" if the curve gets worse!"  YOU are RIGHT. You have options. GOOD options!

            Number one on my "3 things scoliosis patients should never do" list is:

                        #1. DONT: Wait and See. 

                                    DO:  Be proactive. Own your scoliosis. Do SOMETHING to stop progression. 

                                Specifically: Consider taking a program like Early stage scoliosis intervention (ESSI).  This is a one week program that helps kids with small curves to reduce them to a point where the curve is below 10 degrees and is then no longer considered scoliosis.  Kids are then given a specific home routine to follow to help keep the spine in the best possible position.

#2 on my "3 things scoliosis patients should never do" list is: 

                        #2 DONT do competitive swimming.  The problem with this is that when you are swimming a lot of laps everyday for hours this causes the thoracic spine to become more flat (hypokyphosis) the flattening of the thoracic spine can drive the curve of the thoracic spine to progress this would be considered an environmental driver.  It is important that all 3 dimensions of the spine are as close to normal as possible to avoid a scoliosis from worsening.

#3 on my "3 things scoliosis patients should never do" list is:

                        #3 DONT do any one-sided rotational sport (i.e., tennis or golf) 

There is research that shows that the rotation comes before the curve comes into play.  That means that you can see the rib hump before you would see the scoliosis curve on an x-ray.  This is why we use a scoliometer to check the rib hump or the rotation for a scoliosis screening.

Above are 3 things scoliosis patients should never do.  These are at the top of my list, however there are other such as sleeping on your tummy or ballet, among others!

By Dr. Aatif Siddiqui

HELP!  A Step by Step guide through the Scoliosis Treatment Process

Step #1. Don’t panic.  While scoliosis can be a rapidly progressive condition it is usually measured in terms of months, not days.  You should set up an appointment with a health care provider immediately for a initial full spine standing x-ray analysis.  This is the only way to definitively confirm the presence of a curvature of the spine. 

Step #2.  Start with the end in mind.  It is VITALLY important that you understand the entire process of the scoliosis evaluation and treatment process from the beginning, rather than at the end.  Having an overall understanding of the complete treatment process will have a dramatic effect on the decisions you make at the beginning of treatment.

The standard medical recommendations for evaluation and treatment of scoliosis

1. The medical or orthopedic doctor will take a full spine x-ray to confirm the presence of a curvature of the spine and report the size of the curvature to you using a system of degrees called a Cobb’s angle.  Cobb’s angles are notorious for being prone to measurement error (+/- 5 degrees at least) and doctor subjectivity, so it’s primary value to merely to confirm the presence of the curvature and provide you a general figure as to the size of the spine curvature.
2. The doctor will make one of 3 standard treatment recommendations based solely off the Cobb’s angle measurement as follows:
3. 1. 0-24 degrees.  No treatment recommended! Observation only/watch and wait.
   3. 25-39 degrees.  23 hour-a-day rigid spinal bracing recommended.
   5. < 40 degrees.  Spinal fusion surgery for cosmetic purposes.
   7. Once a treatment recommendation has been implemented the doctor generally will re-evaluate the patient with another full spine x-ray using the Cobb’s angle measurement.  Again, the Cobb’s angle measurement is generally accepted to have anywhere between +/- 5 degree measurement error and the overall measurement should be confirmed on several evaluations to eliminate false positive or false negative findings.
   9. The doctor will continue to make future treatment recommendations based off the Cobb’s angle measurement as the curvature progresses.

Step #3.  Get a full spine x-ray.  Again, the true value of this x-ray film is to confirm the presence of a curvature, and the size of the curvature (measured in degrees using the Cobb’s angle method) will only provide a general magnitude.  It is important for you to get a copy of the actual x-ray and report (on a CD is fine) before you leave the facility each time.  You will need them for 2^nd and 3^rd opinions and it will save you a lot of hassle tracking them down later. 

Step #4.  Send us the x-ray and set up consultation time.  While the Cobb’s angle measurement is often unreliable, most likely it is the only measurement you will have available to you at this point.  The current medical model of scoliosis treatment does not offer any treatment options for curvature of the spine less than 25 degrees, which is why an Early Stage Scoliosis Intervention program was started.  These cases should set up a consultation with one of our doctors immediately to determine the best course of early stage scoliosis intervention without delay.

 Curvature of the spine that measure 25 degrees or larger will be provided a 23 hour-a-day rigid spinal bracing treatment option (provided by the orthopedist) or the patient may be an excellent candidate for an Early Stage Scoliosis Intervention program (for spine curvatures 25 degrees for less) or a Scoliosis BootCamp program (for spine curvatures more than 25 degrees) which is also available at all of our clinic locations.

Patients with Cobb’s angles the measure greater than 40 degrees are often immediately referred for spinal fusion surgery.  It is important to note that this procedure is recommended for cosmetic purposes only and should only be considered urgent or life threatening when organic measures of health (cardiac output/ vital lung capacity) are threatened.  The determination of when a spinal curvature is becoming life threatening should NEVER be determined solely by a Cobb’s angle measurement.  Patient’s with spinal curvatures larger than 40 degrees should contact one of our scoliosis treatment locations immediately and inquire about the highly customized 10 day Scoliosis BootCamp program designed for these severe cases.

Step #5.  Set up immediate evaluation appointment with an Early Stage Scoliosis Intervention specialist.  Delaying the onset of scoliosis treatment is the single biggest and most common mistake parents make when their child is diagnosed with scoliosis, especially while the curvature of the spine is still less than 25 degrees.  Here is a common sense rule of thumb.  Smaller spinal curves in younger patients respond to treatment better than larger spinal curves in older patients.  Many times parents delay the onset of treatment because the orthopedic doctor has yet to recommend a viable treatment option, or only a treatment option including a rigid brace that offers no hope of curve reduction and destroying the child’s self esteem and body image.  This principles seems elementary, but time and time again parents continually “watch & wait”, while their child’s scoliosis becomes worse and worse.

Step #6.  Work with the doctor who respects your and/or your child’s individual treatment needs.  Like snowflakes, there are no two curvatures of the spine alike.  Your child is an individual and so is their condition.  Rigid bracing programs only provide 2-3 different versions of braces for an incalculable number of possible spine curvatures.  The truly skilled scoliosis doctors recognize that your child’s personal needs cannot simply be boiled down into one or two Cobb’s angle measurements.  The treatment plan needs to be customized for each patient with specific in office and home spinal rehabilitation programs based on the patient’s unique needs and presentation.

Step #7.  Creating a home rehab routine and schedule is the most critical aspect of your child’s successful participation in the home rehab portion of an Early Stage Scoliosis Intervention program.  While no one routine is successful for all patients, we have found that most of our patients chose to develop a weekday routine schedule and a weekend routine schedule.  On a daily basis, some patients find that completing a round of rehab immediately after school and right before bed works better than in the morning (before school) and in the evening.  Either schedule is acceptable as long as the patient’s muscles have adequate recovery time between sessions.

Step#8.  Re-evaluations and treatment plan changes are a necessary part of the continual treatment and management of any scoliosis case, especially until the patient reaches skeletal maturity.  Generally the re-evaluation times are every 4-6 months for adolescent patients and 1-3 years for adult patients.  All scoliosis patients are encouraged to continue with the prescribed home scoliosis exercise program on a daily basis in between re-evaluation periods.  It will most likely be necessary to make minor treatment plan changes to the home scoliosis exercise program after each re-evaluation in order to remain maximum effectiveness with the patients ever changing needs.

Step#9.  Continued in office treatment may be necessary in the event the curvature shows significant signs of the condition regressing during one of the regularly scheduled re-evaluations.  Generally speaking, there are four common reasons why a patient’s curve reduction/correction would begin to regress.

1. Non compliance with the home rehab program
2. Rapid growth spurt (more than 1” in two months time)
3. Significant spinal trauma (whiplash, falls, trampoline accidents)
4. Repetitive compression type activities (horseback riding, weight lifting, running on hard surfaces, ect)

Significant regression of the spinal curvature is a serious concern and should be treated immediately, before the disease can gain momentum through the “coil down effect” again.  Often this does not require a full scale program and lost gains in curve reduction can be regained in “mini” Scoliosis BootCamp sessions.

Another common concern is when curvature of the spine is showing signs of a treatment plateau.  This is when the re-evaluation demonstrates no further correction from the home rehab program alone.  Again, an additional “mini” Scoliosis BootCamp program is often utilized to “re-stimulate” the spine curvature into a corrective state again.

Step#10.  Caution;   Bumps in the road ahead.  Scoliosis is a highly progressive condition that manifests it’s self in dormant and active periods.  Generally, curve reduction gains are achieved during the dormant periods and hopefully maintained during the active periods.  The current “gold” standard, of the orthopedic community, for scoliosis treatment is considered curve stabilization, not curve reduction, so it is most important to understand the “roller coaster” type nature of treating this disease through the adolescent years.  Many patients experience some episodes of curve progression during the disease’s active period, but generally can regain the treatment losses and make continued improvements during the dormant periods.  A wise man once said, “the only people who get hurt on roller coasters are the ones who jump off”.  It is absolutely critical for a patient (and parents) to remain calm, supportive, and persistent when they hit the inevitable bumps in the road.  Further treatment may be necessary to gain control over the progressing curvature of the spine, and the patient should be prepared to re-commit their efforts to overcoming their spinal health crisis.  However, continual communication, compliance, and follow through of treatment recommendations will provide you and your child with a successful outcome in the future.

The Early Stage Scoliosis Intervention and Scoliosis BootCamp programs were developed specifically to provide a non-bracing/non-surgical treatment of idiopathic scoliosis in patients of all ages with curvature of the spine. For years, conservative treatment had little additional hope to offer the scoliosis patient. Results were varied, and successes inconsistent. Today, we can state confidently that this is no longer the case. We can offer real hope to people with scoliosis who are committed to avoiding psychologically scarring bracing treatment and/or preventing future surgical procedures, and confidently provide consistent, positive outcomes for this condition.

       The importance of early scoliosis screening and Early Stage Scoliosis Intervention

1.               It is agreed that very little is known about the cause and cure of the scoliosis patient.  Obviously, there is no cure for the disease, or no one would have it.  However, an effective system of treatment for the reduction and stabilization of scoliosis has emerged on the scene.  The fight against early stage scoliosis is being lead by doctors Clayton J. Stitzel and Brian T. Dovorany;  Who specialize in a system of scoliosis exercises, spinal adjustments, and vibration therapies that essentially “reverse engineer” the condition. This treatment provides a viable alternative to the “wait & watch” observation, traditional scoliosis bracing and scoliosis surgical treatment choices.

1.               Due to the lateral bending and rotation of spinal movement patterns, scoliosis creates a twisting of the spine around its own axis.  Much like twisting a rubber band from the top and bottom, the middle of the rubber band is susceptible to buckling into a curved and rotated position which is the beginning appearance of the spinal curvature.   
 

1.               The twisted and bent position of the spine creates a tremendous amount of torque which then further drives the existing spinal curvature into more twisting and bending and results in further buckling (increase in the spinal curvature).  This becomes a self feeding loop which is often referred to as the “coil down effect”.  Often at this point the spinal deformity starts becoming outwardly apparent in the form of a torso translation or a rib hump.

        A large scale, medically peer reviewed study clearly shows that curvatures under 30 degrees (measured with the Cobb angle method) in early spinal development (Risser’s sign of 0-1 indicting skeletal immaturity) will see their spinal curvature progress 68% of the time. (1)  Since the majority of spinal curvatures under 30 degrees are diagnosed in pre-adolescents, a progression of the spinal curvature can be expected over 2/3 of the time!

 

1.               The current medical standard for the treatment of scoliosis does not recommend any treatment for spinal curvatures until they progress to a lofty 25 degrees Cobb’s angle.  At that point, spinal bracing is recommended which has not been showed to effect the progression of the curvature until it reaches a measurement above 30 degrees Cobb’s angle. (2)  While there have been no research attempts to introduce the concept of highly invasive surgery into the early intervention of scoliosis, one study shows a worse outcome for patients whom had the surgery at a younger age than patients whom were older at the time of the surgery. (3)  Spine Cor has attempted to introduce bracing into the realm of early scoliosis intervention with little to no success. (4)  Despite early scoliosis intervention in terms of patient age and size of curvature, both scoliosis bracing and scoliosis surgery have shown poor results.  It is apparent that a non-surgical, non-bracing early stage scoliosis intervention for the treatment of spinal curvatures and idiopathic adolescent scoliosis is long over-due. 

1.               The early stage scoliosis intervention program is built on the clinical observation that curvatures under 30 degrees when treated using their protocols respond even better than curves over 30 degrees. In most cases of curvatures under the 30 degree mark, full correction to under 10 degrees is not only obtainable, but fairly common.(insert pre post film). Spinal curvatures reduced to below 10 degrees are no longer considered a scoliosis by most authorities meaning it would be defined as a cure. The bio-mechanical reasoning for this response is most likely due to a lack of “crankshaft phenomenon” being present in curves at this smaller level. Radiographic review of smaller curves, under 30 degrees, demonstrate much less visible spinous process rotation at this level indicating less torque, and therefore more flexibility. The higher the degree of flexibility of the curve the greater amount of correction is possible.
2. There are several ways to identify smaller curvatures including visual posture analysis demonstrating a tipped shoulder, high hip, or even translation of the skull or pelvis, scoliometers can detect even relatively small curvatures.  The most reliable and definitive test would be to take a spinal x-ray. Other factors to consider when suspecting a possible curvature are forward head posture or sway back type postures. For more information regarding early detection of scoliosis curvatures please visit the “screening techniques” section of the website.

1. References:
2. 1.  Lonstein & Carlson, The prediction of curve progression in untreated scoliosis during growth, J Bone Surg Am 1984 Sep;66(7):1061-71

1. 2.  The etiology of Adolescent Idiopathic Scoliosis

                 Am J Orthop 2002 Jul;31 (7) :387-95

 Ahn et al, New Hampshire Spine Institute

1. 3.   Brace treatment during pubertal growth spurt in girls
   with idiopathic scoliosis (IS): A prospective trial
   comparing two different concepts                                                                                         
2. Pediatr Rehabilitation. 2005 Jul-Sep;8(3):199-206 (ISSN: 363-8491)
   Weiss HR; Weiss GM

1. 4. Hawes M., University of Arizona, Tucson, AZ 85721, USA. Pediatr Rehabilitation. 2006   

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

Scoliosis brace treatment and scoliosis surgery could soon be a thing of the past.  Idiopathic scoliosis is a multi-factorial condition in which one’s genetic pre-disposition and environmental factors (bio-mechanical, bio-chemical, and activity related) combine to create an abnormal neurological response to gravity during adolescent growth spurts.  While the exact mechanism remains a mystery, researchers at Axial Bio-tech have developed a new genetic test (Scoliscore) that can identify an individual child’s genetic pre-disposition for developing a severe scoliosis spine.  The test is 99% accurate in identifying the specific sequence of genes and can be utilized by girls and boys from ages 9-14 and scoliosis spine curves of 10-25 degrees.

This scientific break-through now allows clinicians (for the first time in human history) to identify the most genetically “at risk” children and start developing “early stage scoliosis intervention” programs that can prevent the curvature from progressing and potentially even reverse the condition to a large degree.  In addition, having known genetic risk data also allows for direct comparisons of patients whom under-went a specific scoliosis treatment allows for “genetic risk stratification” of the patient populations.  This means we can accurately compare the scoliosis treatment results of low genetic risk patients to low risk genetic patients and high risk with high risk, thus making the data far more relevant. 

Researchers are more and more convinced that idiopathic scoliosis is primarily a neurological condition with its primary effects on the spine in the form of a curvature.  With this in mind, a scoliosis think tank was formed (known today as the CLEAR Institute) with the goal of creating a scoliosis treatment system that could “re-train the brain” to “learn” how to hold the spine in a straighter position automatically.  This meant the entire rehabilitation system needed to be focused on creating a stimulus that generated feedback from the spine and was sent to the brain stem which triggered a “3-D auto-correction” reaction in the spine. 

After years of trial and error, research, and good old fashion hard work, the Early Stage Scoliosis Intervention™ program has been established to provide mild scoliosis patients with an elevated genetic pre-disposition a pro-active approach to treating scoliosis.  We call it “staying ahead of the curve”.

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

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

“How to fix scoliosis” doesn’t seem like it would be that difficult of a question to answer, yet, for 3,500 years of recorded human history no one has been able to answer, “how to fix scoliosis”.  Even with today’s genetic testing, computer data bases, and scoliosis blood test the question of “how to fix scoliosis” still remains.

Perhaps the reason the “how to fix scoliosis” questions hasn’t been answered is because no one has thoroughly examined the “why does scoliosis occur” question.  While there are many scoliosis theories abound, virtually all of them cite a neurological deficient in the automatic postural control centers of the brain as the root cause.  This means, idiopathic scoliosis is really primarily a neurological condition and secondarily a spine condition.  In other words, almost 500 year’s worth of scoliosis brace treatment attempts where doomed from the start, because it only attempt to treat idiopathic scoliosis as a spinal condition and not a neurological condition.  I guess scoliosis brace treatment only further proves “there’s no right way to do the wrong thing”.

In 1865 the French orthopedic community attempted to answer the “how to fix scoliosis” question with the first scoliosis surgery, which was shortly followed by the first orthopedic medical malpractice lawsuit (no kidding, it’s true).  Once again, scoliosis surgery is based on the premise that scoliosis is solely a spine condition with no neurologic root problem in the automatic postural control centers of the brain. 

The rate of complications during or shortly after scoliosis surgery is an alarming 68% (whist in all fairness includes things like bacterial infections that are present in all surgeries), which as very high number that should make everyone stand up and take notice.   Unfortunately, the long-term prognosis for scoliosis surgery treated scoliosis patients is even more bleak with one 2002 long-term study finding 40% of all scoliosis surgery treated patients qualifying as “severely disabled persons.”

So back to the question, “how to fix scoliosis”; Well scoliosis brace treatment appears to be worthless and scoliosis surgery may be worse than doing nothing, so now what.

Armed with the fundamental understanding the idiopathic scoliosis much be treated like it is a neurological condition first and a scoliosis spine condition second, a team of dedicated team of doctors across the United States began work on a scoliosis exercise based scoliosis treatment program that focused on re-training the automatic postural control centers in the brain, so the scoliosis spine would “learn” how to hold the spine in a straighter position automatically.

Over the course of several years this group morphed into what is now the CLEAR Institute non-profit organization.    

The Scoliscore genetic test was release and brought into wide spread use in 2010 and for the first time in human history, allowed doctors to identify the most “at risk” idiopathic scoliosis patients before the scoliosis spine began rapid progression towards scoliosis surgery.  This “scoliosis warning in alarm bell” in terms of genetic pre-disposition for a severe scoliosis condition has now created a demand for an Early Stage Scoliosis Intervention program that focuses on the environmental factors which trigger the genetics and create the condition known as idiopathic scoliosis. 

It appears that a “cure for scoliosis” may not be possible, but a combination of Scoliscore genetic testing and Early Stage Scoliosis Intervention may prove an effective “scoliosis prevention” approach to non-invasive scoliosis treatment.

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

The first scoliosis brace attempts date back to as early as 400 A.D. and have been applied in every conceivable manner (without success) since then. The first metal scoliosis brace we constructed by Ambrose Pare in 1575 and again, didn’t work.  Ever since that time scoliosis patients have been search for alternative scoliosis treatments to braces.  Scoliosis brace makers have continued to innovate without success. Hard scoliosis brace, soft scoliosis brace, night time scoliosis brace, flexible scoliosis brace, rotational scoliosis brace, traction scoliosis brace; in the end each attempt has prove to be as feeble as the last (not due to lack of effort, application, or funding).

The main problem with scoliosis brace treatment isn’t application, but rather process. As it turns out, treating a condition that is primarily a neurological condition like it is primarily a skeletal spine problem doesn’t work too well (shocking….sarcasm). This very simple understanding of idiopathic scoliosis makes almost 3500 years of scoliosis brace treatment completely obsolete and practically worthless.
In fact, Axial Bio-Tech (developers of the Scoliscore genetic test) did a comparison study of brace treated and un-treated scoliosis patients and found absolutely no difference between the two groups long-term treatment outcomes, even when compared genetically. Scoliosis brace treatment has absolutely no effect on the natural course of the idiopathic scoliosis condition. Essentially scoliosis brace treatment and doing nothing have exactly the same effect….None.

So why do orthopedic doctors and some mis-guided chiropractors continue to prescribe a worthless and obsolete protocol like scoliosis brace treatment. Well the long answer is “this is the way we do things around here” syndrome and the short answer is financial gain.

Thousands of academic reputations and careers are based on the faulty logic that scoliosis brace treatment works and is effective, so to do an about face and reverse one’s position on the topic (even in the face of over-whelming evidence) would be career suicide for most.

The other motivation (financial gain) is a less complicated explanation, but probably more compelling. Scoliosis brace treatment generate hundreds of millions of dollars worldwide every year and you know what they stay about not finding the solution, when there is good money in prolonging the problem.
So how do we break out of this never-ending cycle of scoliosis brace treatment failure? Well, the good news is that we probably don’t have to; prognostic idiopathic scoliosis technology (Scoliscore genetic testing for idiopathic scoliosis, the scoliosis blood test, ect) will probably spell the death of scoliosis brace treatment all by itself.

These new technologies will provide a “heads up” to parents and patients in regards to their child’s idiopathic scoliosis condition and long before scoliosis brace treatment is indicated, so the scoliosis treatment market will naturally move towards more pro-active scoliosis treatment solutions like the Early Stage Scoliosis Intervention program we feature on this website. In fact, preliminary flowcharts and treatment models that focus on Scoliscore genetic testing for idiopathic scoliosis that completely eliminate scoliosis brace treatment and scoliosis surgery have already been developed and are being tested as you read this right now.

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

A wise man once said, "when in doubt, do something, because doing something isn't doing nothing, which isn't doing something......it's just doing nothing."

Quote from the NSF website.

"The data collected by orthopedists shows that without any form of treatment, 4 out of 5 minor curvatures will not progress beyond 20 degrees. For this reason, orthopedists no longer treat such minor curvatures but they do recommend periodic observation, especially in growing children."

Kind of sucks to be part of that 20% of patients whom the orthos are willing to throw under the bus huh? Anyway, the advent of genetic testing indicates that 25% (not 20%) of patient's diagnosed with Adolescent Idiopathic Scoliosis (AIS) are pre-disposed to developing a severe curvature (>40*).....Which isn't to say that the other 75* of geneticly low risk patients can't or won't still experience significant curve progression that often leads to moderate to severe impact on their quality of life in adulthood.

Adult Scoliosis: A health assessment analysis by SF-36
SPINE 2003; 28(6): 602-606

"adult scoliosis patients with spinal curves 10 degree or greater scored significantly lower in 7 out of 8 categories including physical functioning, general health, social functioning, and body pain when compared to the general population. In fact the researchers concluded "It is our conclusion that adult scoliosis is becoming a medical condition of significant impact, affecting the fastest growing segment of our society to a previously unrecognized degree."

38,000 spinal fusion surgeries (many of which with terrible long-term outcomes) are being performed and 30,000 children are being needlessly stuffed into braces (which often cause life long self esteem, depression, and other psychological disorders in addition to being generally ineffective) each year, because the conventional wisdom of yesterday has decided to take a 're-active' approach to treating rapidly progressing curvatures, rather than a 'pro-active' approach to stabilizing and reducing them BEFORE they become increasing, progressive curvatures.

Don't let a lifetime be defined by scoliosis. Be pro-active, be assertive, be informed, and when in doubt do something!!!

Early Stage Scoliosis Intervention is the best opportunity for a scoliosis patient to overcome and successfully manage their condition. This will require a completely new treatment schedule and system of treatment process.

“The treatment goals for an early stage scoliosis intervention program should be to hold the curvature under 20 degrees during the growing years and have the curvature measure no more than 25 degrees by the time the patient reaches skeletal maturity”

While there is still no cure for adolescent idiopathic scoliosis, theories abstracted from current research suggests the natural course of the condition can be altered with an active rehabilitation program that targets the involuntary postural control centers in the patient’s brain.

For many early stage scoliosis patients, treatment will be a necessary and ongoing process until they reach skeletal maturity (16-17 for females and 18-20 for males), and some patients will require ongoing treatment throughout life. However, the risk of progression significant curve progression in skeletally immature patients and skeletally mature patients can greatly reduced by developing a “20/25 vision” ongoing treatment plan during their “growing years” and before skeletal maturity.

Current research has found that younger patients with spinal curvatures that measure 0-19 degrees have a 14%-22% risk of further progression while they are growing, but the risk increases more than 3 fold (68%) for the same patients if their increases to the 20-29 degree range (1). Therefore, it is vitally important to halt or reduce the curvature below the 20 degree mark in order to reduce the adolescent patient’s risk of progression by up to 46%.

Long-term research has discovered that idiopathic adolescent scoliosis patients whom have spinal curvatures that measure greater than 25 degrees have a 68% risk of continued progression in their scoliotic curvature throughout adulthood that will cause severe pain and disability, however scoliosis patients who whose curvatures measured 25 degrees or less only experienced further curve progression 8% of the time throughout adulthood.(2)

(1) Lonstein et el, The prediction of curve progression in untreated idiopathic scoliosis. J Bone Joint Surg AM.1984,661061-1071

(2) Curve Progression in Idiopathic Scoliosis – Follow up study to skeletal maturity
Ken-Jin Tan, et al.
SPINE.2009.vol34(7).697-700

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What do scoliosis and heart attacks have in common?

Well, cardio-vascular disease (CVD) and idiopathic scoliosis are both "multi-factorial" diseases, which means the condition is caused by a combination of both genetic pre-disposition and environmental factors.....NOT just one or the other.

CVD stats from the Nation Institute of Health indicate a the annual number of deaths from CVD increased substantially from 1900 to 1970. The death rate for CVD increased from 1920 until it peaked in 1968. Since then, the trend has been downward. In 2007, the rate was near the all-time low in 1900. While some of this undoubtly can be contributed to improved care at the time of the event, most researcherc cite the decline in the death rated to the fact that fewer and fewer heart attacks are occuring per capita.

So what has changed between 1968 and now? Well, modern medicine stopped treating heart attacks and started preventing them.....mainly through the elimination and reduction of the environmental factors which helped to mimimize the risk of CVD even in patients with high genetic predisposition.

It has become so common place in CVD that mainstream medicine and has basically adapted the concept as the stardard of care.....Cholesteral/ blood pressuring lowering drugs, special diets, stress reduction, avoidance of cigarette smoke, and a new emphasis on aerobic exercise are all efforts to reduce/minimize the enviromental factors, that when combined with one's genetic predisposition, cause heart attacks.

The same should hold true for scoliosis treament, but yet it doesn't. The spinal curvature (often expressed in terms of Cobb angles) is the end result of genetic pre-disposition and environmental factors.....essentially, the spinal curvature is the "heart attack" (metaphorically speaking).

The advent of scoliscore genetic testing can now provide us reliable and accurate information in regards to one's genetic pre-disposition and allow us to shift our focus from the treatment of the end result (scoliosis/heart attack), to a prevenative approach of environmental factor reduction/elimination (biomechancial factors, high risk activities, nutritional modifications, ect.) This approach will allow us to alter the natural course of the condition (just like it has in CVD) and prevent small curves from progressing to surgical threshold. In fact, The most recent understanding of epigenetics strongly suggests Early Stage Scoliosis Intervention that reduces/eliminates the patient's risk of severe scoliosis progression could and should be utilized with or without genetic testing and regardless of the high, low, or intermediate genetic risk in an effort to reduce the risk of passing over-stimulated scoliosis genetics on to future generations.

"Could you reduce the risk of passing scoliosis genes onto your children?"

http://www.fixscoliosis.com/threads/...-your-children strategy has been successfully deployed in other conditions as well, with similar success.

This Early Stage Scoliosis Intervention + Genetic testing are the keys to altering the natural course of the condition will one day lead to a cure for scoliosis, but only after modern medcine makes the treatment shift to reducing/eliminating environmenal factors that cause scoliosis; rather than attempting to treat solely the scoliotic curvature after it has already progressed to a severe degree.