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

My Story: Life after Scoliosis Surgery

By Maggie Victoria

I am afflicted with scoliosis. I was diagnosed at a young age with 3 major curves with rotation, a severe rib hump, and winged scapula. My scapula was so winged that my father could fit his fist under it. Within a very short time frame, I was diagnosed, and was sent home for the wait and watch "scoliosis treatment" protocol. My parents had great confidence as I was being seen and followed by one of the best surgeons in the country. I was getting worse with each visit. I was fitted for the Milwalkee scoliosis brace.

I remember when they finally brought the scoliosis brace to me, for my first fitting, how extremely big and awkward it was. I remember looking at it, thinking, oh my word, how I am going to wear that thing. It looks like a cage, and I am going to look like a freak. There was no hiding it, as the scoliosis brace went straight up to my neck. It was very heaving, and very tight, there was no way to move. It was hot and sticky, and it blistered my hip bones as I was so thin. I was supposed to sleep in this thing. I couldn’t sleep. It was so hot and so uncomfortable and the pain I felt while wearing it, was not manageable.

Well, then it was time to return to school. It was September. It was a new school. The kids looked at me and stared. I was the only child in the school of about 800 kids wearing this scoliosis brace. A girl even came up to me and asked me, what happened to me. She didn’t care at all and I felt she was being nosey. I tried to wear it, I just couldn’t. I didn’t want to stand out for these reasons. I refused to wear it.

My visit back to the surgeon and I told him, that I was not adjusting to the brace and that it was too painful, and I felt like a complete freak. What could he say? He likely knew back then, that the brace was not going to hold me that my curve would progress anyway. but of course that information was never shared with us. I know that now as an adult. Was it worth the emotional torment to me? No, of course it was not.

Well, my scoliosis progressed at each appointment, in my six month follow-up. I was booked for my first scoliosis surgery. I underwent scoliosis surgery, where there was significant blood loss and I underwent my first blood transfusion. I spent three weeks in a bed, flat. Then I was fitted for a body cast. I remember the first time they stood me up, I passed out. I literally, from my young perspective looked like someone who had died.

I spent six months in a body cast then returned to the hospital for a spans-splint scoliosis brace. I was fitted for it, had a few days in the hospital and then sent home with my new scoliosis brace. I was happier about having the cast off but someone was cruel enough to refer to my  scoliosis brace as a chastity belt. Being such a young child I had no idea what that even meant; but the comment stayed in my mind and later in life I learned just what that comment meant. I was also told that I was “washed up” post scoliosis surgery and my gymnastics career was over. I felt alone, I felt overwhelmed but was glad the scoliosis surgery was over and I could return to my normal life; so I thought.

I ended up with two more scoliosis surgeries; one for re-fusion, and rod adjustment, and the other complete rod removal, replacement, for longer, more flexible rods. Life after scoliosis surgery was challenging to me. I continued to have pain at the left side of my back, I continued to explain that to my surgeon, it was marked on my charts, and then I was sent home.

Scoliosis surgery was not going to get me down. I ended up in the gym three times per week, and was returning to my athletic self. I was a lean 110 pounds of solid muscle without bulk. Even though I had scoliosis surgery, I still would feel pain. I learned to live with the pain, and continued with my life.

I was married, had two children, without epidural due to fusions and the pain and strain on my spine, at the time unbearable. I went back to work and continued to work through the pain.

I am not feeling sorry for myself in “life after scoliosis surgery”, I am not trying to scare anyone, I am trying to explain to folks that life after scoliosis surgery, on the short term once you have recovered from the initial trauma is fine. One can return to a fairly normal life for a set period of time relatively pain free as I did.

My future in “Life after Scoliosis Surgery”

The following is what I had to find out on my own, and I know that you will likely be concerned reading this but it is my truth and I feel that life after scoliosis surgery and its ugly truth must be told.

The question of “how to treat scoliosis” has been asked over and over again for the past 3,500 years of recorded medical history and the controversy the “how to treat scoliosis” question still rages on to this day. 

The very nature of the scoliosis condition is a topic of great debate, which only fuels the “how to treat scoliosis” argument even further due to the uncertainty about what even causes idiopathic scoliosis.  Generally, there are several different schools of thought; for most of scoliosis medical history doctors and quasi-researchers have assumed that idiopathic scoliosis was caused solely by an abnormal spinal bone growth that caused one part of the spinal bones to grow faster on one side than another.  While it is without a doubt that Dr. Stokes’ 1996 publication of “the vicious cycle of scoliosis progression” outlines a mechanism in which asymmetrical loading on the scoliosis spine will cause the bones to grow in a slightly wedge deformity, it also clearly demonstrates this process is a secondary adaptation to the scoliosis spine and not the cause of idiopathic scoliosis.  Unfortunately, most scoliosis brace treatment is still to this day based off this false notion of being able to fix scoliosis through this “guided growth” attempt at “how to treat scoliosis” and is plagued by low compliance and high scoliosis treatment failure rates.  Essentially, scoliosis brace treatment attempts to treat the bone wedging symptom of idiopathic scoliosis, instead of treating the scoliosis condition itself.

The most current researchers almost unanimously agree that idiopathic scoliosis stems from a yet to be determined neurological feedback system that fails to coordinate the scoliosis spine in terms of neurological alignment to gravity when weight bearing and possibly the symmetrical growth of the nervous system (the spinal cord in particular) in relation to spinal bone growth.  Dr. Porter (a noted scoliosis researcher) supported the uncoupled neuro-osseous growth concept of idiopathic scoliosis being a physical manifestation of the mal-adaption of the growing immature spine to the tether created by the short spinal cord. This evidence for this was the finding that the conus medullaris (the end of the spinal cord) position is NOT significantly different from that of a normal spine.

Dr. Chu re-examined the Roth-Porter theory via an MRI study (comparing adolescent idiopathic scoliosis patients with severe curvatures vs normal subjects) in 2007. They found the vertebral column in the idiopathic scoliosis population was significantly longer, yet the there was no detectable change in spinal cord length. They speculated that the initiation and progression of Idiopathic scoliosis result from vertebral column over-growth through a mal-adaptation of the spine to the subclinical tether of a relatively short spinal cord.  This would suggest that the rapid curve progression seen in idiopathic scoliosis would be a twisting type reaction to too much stretching on the spinal cord as the scoliosis spine bone attempt to grow vertically.

Thus, all attempts in “how to treat scoliosis” in the future must be based on stimulating or re-training the neurological spinal feedback mechanisms and reducing the bio-mechanical stress on the spinal cord in the idiopathic scoliosis patient prior to the onset of the adolescent growth spurt (approximately age 12 in females). 

The early stage scoliosis intervention program was specifically designed to address these key concepts in the most updated understanding of the scoliosis condition and provide parents and patients the greatest opportunity for success in answering the “how to treat scoliosis” question.

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Seems like there should be pretty obvious answer to this question doesn’t it? However, this question between scoliosis exercises and scoliosis brace treatment has plagued the scoliosis treatment community for the past 463 years (Ambrose Pare created the first metal scoliosis brace in 1575!). 

Throughout the past several decades scoliosis brace treatment have become the preferred choice among the orthopedic scoliosis specialist community, aided in part to “designed-to-fail” research studies in the 1960’s-1970’s on the effects of scoliosis exercise, in which participants were asked to do exercises for scoliosis in a very general, non-specific manner (think sit-ups and push-ups).  This gave the justification to state that exercise for scoliosis was worthless and all the time, money, and energy should be invested into passive scoliosis treatment methods like scoliosis bracing.

Recent long-term studies published in major scoliosis research journals now call the effectiveness of scoliosis brace treatment into serious question in terms bracing’s ability to halt scoliosis spine progression, prevent the patient from reaching the scoliosis surgery threshold, or even alter the natural course of the condition in any statistically significant manner.  In fact, one of the oral presentations at the 2010 SOSORT meeting in Montreal even presented research on how simulated scoliosis bracing/long-term immobilization in rat tails (which simulate the human spine structurally) rapidly increased the rate of scoliosis disc deformity and thus increased the likelihood of scoliosis spine progression (as opposed to the intended slowing or halting of progression).  It is clear now that the path scoliosis brace treatment has lead the scoliosis community down should have remained “the path less travelled”.

Shifting the focus from the failure of scoliosis bracing efforts back towards exercise of scoliosis efforts, it is very clear that scoliosis exercises applied in a generalized and non-scoliosis specific manner will have little to no effect on idiopathic scoliosis.  The reason is because scoliosis primarily results from a problem in the automatic postural control centers of the brain (and potentially linked to melatonin signaling dysfunction as well) in which the brain doesn’t “recognize” the scoliosis spine is out of alignment and therefore, simply doesn’t trigger the spinal auto-correction mechanisms to kick in and fix the scoliosis curvature.  For whatever reason, the alarm bells just aren’t going off in the brain stem, so the brain just doesn’t know there is even a scoliosis problem to solve.

With this in mind, it becomes self-evident that the scoliosis exercise treatment needs to focus on creating a “stimulus” that triggers the brain to recognize that “something is going wrong down there” and make the necessary auto-correction to the spinal posture.  This means any type of voluntary movement exercises for scoliosis simply are over-ridding the subconscious automatic postural control centers in the brain and not allowing them to truly “learn” how to auto-correct the scoliosis spine (so much for all of the scoliosis exercise and scoliosis brace combinations!) and the only truly effective scoliosis exercises occur when the automatic postural control centers in the brain are stimulate subconsciously. 

Please click on one of the embedded links in this article for more information on how these new and exciting exercises for scoliosis treatment program can work for you.

“Observation only or scoliosis brace treatment showed no clear advantage of either approach. Furthermore one can not recommend one approach over another to prevent scoliosis surgery. They gave the recommendation for scoliosis brace treatment a grade "D" relative to observation only because of "troublingly inconsistent or inconclusive studies on any level." Those are the words directly from the conclusion of a 2007 peer reviewed published study in the prestigious SPINE journal.  The study was a comparison of 15 separate scoliosis brace studies in comparison with 3 observation only studies.  As shocking as this may be to some of you, the ineffectiveness of scoliosis brace treatment has been known in the Orthopedic community for quite some time as evidenced in a different article published in SPINE of 2001 “Since 1991, scoliosis bracing has not been recommended for children with adolescent idiopathic scoliosis at this center (…..If scoliosis braces do not reduce the proportion of children with AIS who require scoliosis surgery for cosmetic improvement of their deformity, it cannot be said to provide a meaningful advantage to the patient or the community.”  This does not inspire confidence in the hearts and minds of teenagers being asked to wear a scoliosis brace 23 hours a day, 7 days a week, for years on end; nor their parents whom know their child is going to be subjected to a highly invasive scoliosis surgery if the scoliosis brace treatment fails to halt the progression of the scoliosis spine. 

Another peer reviewed article in a 2007 edition of the Journal of Pediatric Orthopedics focused on the professional opinion of scoliosis brace effectiveness in comparison to no treatment and the results were a bit shocking.  Almost 50% of the respondents to the study felt bracing had no effect on the scoliosis spine, yet 100% still recommended scoliosis brace treatment.  This is disappointing to say the least and sounds almost border line unethical, but I suppose those doctors whom don’t feel scoliosis brace treatment has any effect on the scoliosis spine, but still recommend it are rationalizing it with the “it can’t hurt to try” theory.

No specific “scoliosis gene” has been ever identified, but the Scoliscore test can now identify specific sequences of genes that can predict a patient’s genetic pre-disposition or likelihood of developing a severe scoliosis spine.  The implications for its clinical use are immense, but it also has some surprising research implications as well.  In 2009 the developers of the Scoliscore test used the technology to “genetically risk stratify” scoliosis brace treated and un-treated scoliosis patients, so an “apples to apples” comparison of patients with similar genetic pre-dispositions could be made.  Not shockingly, the results of the study indicated that scoliosis brace treatment failed to alter the natural course of the condition and may have even slightly elevated the patient’s risk for curve progression in patients with an “intermediate Scoliscore”.

It is clear that scoliosis braces are not effective in the treatment of idiopathic scoliosis in terms of halting curve progression, preventing the “need” for scoliosis surgery, or altering the natural course of the condition.

One of the most common mis-understandings people seem to have about idiopathic scoliosis and scoliosis treatment is that scoliosis is a chronic, progressive condition, but it isn’t necessary unstable and doesn’t come from having weak muscles.  In fact, there doesn’t seem to be anything wrong with the spine itself (other than being crooked), which is probably why scoliosis brace treatment and scoliosis surgery yield such poor short and long-term results, respectively, in most cases.  Whist, that being said, there are activities that scoliosis patients should avoid.  Some of these suggestions are rooted in research supported conclusion, but many haven’t been studied yet, and most are in reality just common sense.  

 “What position should I sleep in?” is a very common question  I get from scoliosis patients and generally speaking the only sleeping position scoliosis patients really need to avoid is “stomach sleeping”.   Sleeping on one’s stomach has multiple negative aspects (including lower and mid back pain), but more importantly for scoliosis patients it forces the normal spine position out of the side view dimension and into the abnormal scoliosis curve.  The take away message is don’t sleep on your stomach; especially if you have scoliosis

There seems to be enough circumstantial evidence/research to conclude that activities that cause a “flattening” or hyper-extension of the mid back may cause progression in scoliosis curves.  This type of motion is often referred to as a “back bend” and it seems to be related to the frequency (# of times) the patient is engaging in the bending, and not how much they bend each time.  Scoliosis patients in gymnastics and ballet classes should be particularly careful, because of the amount of back bends each requires for practice and competition.

A scoliosis spine already causes an abnormal loading of the spine and poor postural habits only serve to increase the abnormal bio-mechanical stress on an already compromised spine.  This is often increased greatly when the patient engages in slumped postures (seated or standing) during computer use, texting, and video game playing.  While no studies have actually been conducted to link these activities to scoliosis progression, it just seems like common sense to me.

Much like the slumped posture creates abnormal loading of the scoliosis spine; Over-loaded backpacks may lead to curve progression in adolescents with idiopathic scoliosis as well.  Most schools will readily provide an extra set of text books, so the student can keep a set at home and at school eliminating the need for transferring the books.  The total weight of the patient’s backpack should not exceed 10% of their body weight as a general rule of thumb.

Sticking with the abnormal loading of the scoliosis spine theme, uneven spinal loading with a back pack (carrying a back pack over one shoulder, instead of both shoulders) causes abnormal loading of the spinal curvature and could cause curve progression.  Again, there is no research to indicate this is a major concern in scoliosis, but I doubt any research has been done on the subject either…..and once again, it just kind of makes sense.

The wide spread advent of huge backyard trampolines has been a blessing for many young and teenage children, but it’s a curse for adolescents with scoliosis.  The compressive nature of the patient’s body weight multiplied by the number of times they bounce up and down in short period of time may lead to a rapid advancement of the spine curvature referred to as “postural collapse”.  Bottom line:  Back yard trampolines may be fun, but it isn’t worth the risk for scoliosis patients.

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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.

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.

• ~Medium curves over 25 and less than 40 degrees, scoliosis brace 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.

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Vertebral fusion surgery for scoliosis should be the absolutely last resort in terms of a scoliosis treatment option and even then, it's continued use is controversial due to high complication rates and poor long term outcomes.

Given the conclusions of a pair of large, long-term follow-up of scoliosis surgery patients studies (“40% of operated treated patients with idiopathic scoliosis were legally defined as severely handicapped persons” and “The psychological health status is significantly impaired.”) it makes one wonder if idiopathic scoliosis patient would be better of taking a different course of action.

Let's take a step back and examine the failed treatment process that leads idiopathic scoliosis patients to this point of "desperate measures" in terms of scoliosis treatment.  Let's face it, no body goes to bed with a straight spine and wakes up with a 40 degree cobb angle scoliosis.

Approximately 80-85% of all scoliosis cases begin between the ages of 9-12 years old, and unfortunately, are rarely diagnosed and/or rendered appropriate early stage scoliosis intervention treatment while the curvature is still small and hasn't gained any bio-mechanical momentum.  The defense for this "hands off" approach to observation of the spinal curvature was due to the uncertain nature of scoliosis progression, however the advent of genetic testing for idiopathic scoliosis (Scoliscore) can now identify which patients are at increase risk of progression and should be utilized in every applicable case.

The second mis-handling of a adolescent idiopathic scoliosis case that leads to vertebral fusion surgery for scoliosis occurs once the Scoliscore test indicates an increase genetic pre-disposition for severe progression and the scoliosis specialists STILL waits for proven progression or even worse just skipped the genetic testing all together and just gambled with the child spinal health and hoped for the best.

Hoping doesn't fix scoliosis; action fixes scoliosis.  This leads us to the 3rd phase of case mis-management that leads to scoliosis surgery.  Scoliosis Brace Treatment.  The spine is a dynamic organ that requires movement and the freedom to orient itself to gravity on a continual basis.  Scoliosis brace treatment does just the opposite and recent research out of the University of Vermont now finds that a scoliosis brace will actually increase the spinal deformity of the discs (causing even more risk for progression in adolescence and adulthood).  Active rehabilitation that targets the automatic postural control centers in the brain can and will halt the progression of the spinal curvature and can even achieve significant scoliosis reduction in most cases.  The patients brain can be "re-trained" over a period of time (minimum 4-6 months) to learn the how to hold the spine in the new "straighter" position and thus becomes a permanent solution to the scoliosis condition.

As painfully obviouse as all of this is, scoliosis brace treatment failure is still the standard of care and the #1 reason over 20,000 adolscent idiopathic scoliosis surgeries are performed every year.

As you can see, the road to scoliosis surgery is a long and twisted one (no pun intended) fill with mis-handling of the condition, lack of certainty, and the continued usage of obsolete treatment procedures (scoliosis brace treatment).  The proper intervention at any stage of the scoliosis treatment process can prevent the "need" for scoliosis surgery.

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Idiopathic scoliosis of spine is a unique and rather confusing condition. Adolescent children (mainly girls) whom appear to have perfectly normal and healthy spines all of a sudden develop an unexplained scoliosis spine; often in only a few months. They didn't start to do anything differently, they didn't start eating anything differently, and perhaps most the weird part is that despite their scoliosis spine being crooked, they are still generally healthy.

Of course, not "knowing" the cause of the condition certainly makes the task of scoliosis treatment quite challenging; especially when one considers that researchers have yet to find anything actually broken or wrong with the scoliosis spine itself ......it's simply just crooked. In the early stage idiopathic scoliosis patients the discs appear to normal, the muscles appear to be normal, the vertebrae appear to be normal, the ligaments appear to be normal; the scoliosis spine just is crooked for no apparent reason.

This lack of evidence is what has lead to most idiopathic scoliosis researchers to begin looking for a neurological cause for scoliosis of spine, and they are collected a lot of compelling data/evidence to support a neurological under-development in the postural control centers of the brain stem as a root cause component (a combination of genetic and environmental influences) of the scoliosis of spine condition.

Armed with this knowledge, it is pretty easy to see why "mainstream" scoliosis treatment (scoliosis brace treatment and scoliosis surgery) have very poor outcomes and are basically obsolete at this point. As it turns out, process matters in scoliosis treatment.

I always like to use the "making bread" analogy when discussing the Mix/Fix/Set protocol developed by the CLEAR Institute. Throw eggs, flour, yeast, oil, ect into a bowl and toss it in the oven and you won't get bread.....you'll get warm goo. However, if you knead the ingredients into dough, let it rise in the fridge, cook it in a pre-heated oven for the prescribed amount of time you will most likely get bread. Same ingredients, different protocols, dramatically different outcomes.

The successful scoliosis treatment programs for scoliosis of spine in the future will primarily focus on the neuro-muscular component of the scoliosis spine and not just the curvature itself. It will begin as a pro-active scoliosis spine rehab program in the earliest stages of idiopathic scoliosis. And perhaps most importantly, it will focus on the elimination of the environmental influences that combine with the genetic pre-disposition that actually causes scoliosis of spine and will (hopefully) lead to a cure for idiopathic scoliosis.