By Maggie Victoria

I write this article today from my own perspective one that I hope will provide insight into the world of long term surgical complications and what motivates me, to look for a better non-surgical scoliosis treatment approach to treating Scoliosis.

Brief Overview of My Scoliosis Surgery experiences

I like most, was a young girl when I first underwent my first scoliosis fusion surgery. I was eager to have the surgery because I did not want to go through life twisted and deformed. I didn’t understand then, as a young girl the long term complications nor did anyone else for that matter .

I went through scoliosis surgery, had rods implanted, had my fusions done, in the late 80s, had a body cast, and a brace, and looked forward to getting the brace off so I could see my wonderful new and straight body. I still had the rib-hump, and the protruding scapula when I was fully recovered. I wanted this fixed more than anything but it just wasn’t possible. The surgery to us didn’t seem like such a big deal. The recovery was long and challenging but I got through it. I went on to have two more surgeries because of complications and pain. The last surgery, I ended up with a chest tube due to a collapsed lung.

Even with all that in my young years, I seemed to bounce back, and have a full and happy 20 years, post operatively. I wasn’t thrilled with the cosmetic outcomes but still it was after all much better than what I was.

All was good, I did have some lumbar and cervical discomfort but went on to marry, have two children and a pretty normal life. Scoliosis and surgery was the furthest thing from my mind as I focused on career and family. In fact, I had learned to dress the deformity and no one even knew I had scoliosis. It was never anything I ever discussed, because it really was a non-issue to me, and had very little impact on the quality of my life. I was happy successful with two beautiful children can it get much better than that?

The Degeneration and Decline Begin

About five years ago, I began to notice bouts of pain that would last only a short time in my lumbar spine. I of course conferred with my Physician who prescribed NSAIDs and after x-ray diagnosed me with a little bit of arthritis. Happily I went on my way with meds in hand and continued my demanding but happy life. The pain never seemed to go away, I tried exercise and physiotherapy and for a while it seemed to improve. Within a year, the chronic pain began to set in. To keep this article brief, I am now in severe chronic pain, my shoulder shifting forward, a kyphosis is evident and I have degeneration in the c-spine, t-spine, and the l-spine now. I won’t go into the medical terminology of the exact degeneration but I will state the degeneration is severe, and my spine stressed and unable to carry out my daily responsibilities. I am on my way to becoming permanently disabled as my I can no longer meet the needs the demands of my daily life. I greet this with regret as I have always worked and enjoyed a full and prosperous life.

My Perspective - Scoliosis Fusion Surgery

I over simplified the impact this surgery would have on my life as a young teen. Somehow at that age, being in your 30s is ancient, and something we at that age can never imagine being that old. I didn’t realize the complexity of these Scoliosis surgeries. Exactly what they do, and how bio-mechanically altering it is to the human body. I thought, as my parents, no big deal, a couple of rods, force straightened with bones taken from my hips. Fusion, we had no idea even what that was.

Since my rapid decline and my degeneration, I have since done research on the surgical procedure itself, and the methods by which the human spine is straightened and fused. You may be thinking yes, but that is the old surgical method, the new and improved methods will be better. I am a skeptic, and I say not so fast. The new surgical procedures provide for better correction but are far more invasive than my surgical approach. There are few studies on the long term outcomes for my generation that are in my opinion quantifiable and unbiased. The new procedures have much more metal, and are far more invasive. Will the complications be much higher when this generation begins to age and the wear and tear of life begins to take its toll on the spine? Right now, we won’t know that for another 20 years. Salvage surgery now is complex and even more invasive than the original surgeries. I can’t imagine what it will be like when the pedicle screws have to be removed on an aged body.

I don’t expect anyone to go through life crooked and deformed. Surgery must be considered a viable option for those who will suffer emotionally form the cosmetic deformity of scoliosis. We have no right to tell another person what is right for them. If you choose to have surgery understand that you may be trading some of your deformity for a life of chronic pain and you may end up as I fighting to hold on to any quality of life. Surgery does not have perfect outcomes.

The Better Way –– Early Stage Scoliosis Intervention

We must begin to understand just how complex these surgeries are. We must know too, that there are other options to surgery. There are now non-surgical treatments that have had success in stabilization of the scoliosis condition, and reversal. These treatments are fast becoming more and more recognized by parents of children with scoliosis. We didn’t know 20 years ago, the dangers and the downfalls of these surgeries, but we do now. Retrospectively for myself, I would have opted NOT to have surgery. I have now closed the door on any non-surgical treatment that I might have benefited by because I am fused. My only way out, is more surgery, and there are no guarantees of any improvements whatsoever.

We know better now, so we should endeavor to find a better way to treat. CLEAR Scoliosis Treatment Protocols, reversed my daughter kept her spine intact, preserved her emotional well-being and for that I am truly thankful. It is a new day, and we are turning the corner to treating this disease with an attack in early stage non-surgical scoliosis treatment. The choice is entirely yours, but for me, my experience was not one that I was willing to chance for my own daughter. It is better to try than to wait and do nothing. It can be a first class ticket to the Operating room.

If you opt. to have surgery understand that you are trading a mobile crooked spine for an inflexible fused spine that may give you long term complications. Who will have these complications, and why, is still unknown as there are not enough studies to quantify the outcomes.
The approach to me is to try everything before having scoliosis surgery. The risks to me are far too great.

I look at some of these kids that come out of the CLEAR Scoliosis Institute clinic while my daughter is being treated and I think, look at you, you are healthy, happy, and your spine, well, really, it isn’t that bad. I think to myself, that perhaps, they are better left maintaining their curves, than to end up like me. That is the treatment approach we have elected for our daughter and know what she looks absolutely fine. Surgery should be an absolute last resort and deformity must be severe enough to warrant such an invasive procedure. CLEAR treatment protocols have success and to me every success is one surgery less!

Scoliosis has been part of the recorded medical history for the last 3,500 years and our understanding of it is obviously much improved since then, but still poorly understood overall.  The newest research and understanding of the condition points to it being primarily a neuro-hormonal cause and the spinal curve (the scoliosis) is a reaction/ primary symptom.  
 
Scoliosis bracing and scoliosis surgery are based on the old philosophy that scoliosis is soley a spine disease, not primarily a neuro-hormonal condition that causes a spine disease, so their methodology is based on a "treat the spine only" mentality and this is reflected in the poor results each methodoloy displays in long-term research studies.  Essentially, scoliosis brace treatment is worthless and scoliosis surgery may be worse than doing nothing at all in many cases.
 
Here is where our scoliosis treatment system/methodology comes into the mix.  We recognize that scoliosis is primarily a neuro-hormonal condition and the spinal curve is merely a symptom of the underlying disease, which is why our program/product and message is so refreashing and unique.....and hopefully appealing and accepted.

Patients/parents are entering the scoliosis treatment process at different points and at very different levels of experience with scoliosis treatment.  The biggest difference isn't education about scoliosis or financial restraints, but rather sense of urgency.
 
The current scoliosis treatment model uniformally follows the guidelines of curves 0-25* are observed only/ no treatment; curves 25*-40* are recommended for some sort of bracing; and curves 40* and larger are recommended for scoliosis surgery, which is not medically necessary and primarily indicated for cosmetic improvement of the spinal/toso deformity.  Keep in mind that some of the long-term scoliosis surgery studies indicate failure rates as high as 40% only 17 years post op.
 
So the mother who googles "scoliosis treatment" after learning her 12 year old daughter has a mild scoliosis curvature and the ortho doctor has told her it's not big deal and we will just re-evaluate it again in 6 months has a low sense of urgency, but enough concern to go out on the internet and do some checking around for her own piece of mind.  While the mother with a 14 year old daughter with a scoliosis spine of 45* and the orthopedic surgeon is pushing her hard (usually via guild or fear) to schedule her daughter for scoliosis surgery ASAP is coming into the scoliosis treatment process with a high sense of ugency and anxiety sense of urgency.  The mother's with daughters in scoliosis braces are generally already in the process, but at their wits end, because their kid refuses to wear the brace or it isn't working, so the are left with a sense of frustration and defeat, instead of a sense of urgency.

We understand the scoliosis treatment process is confusing and frustrating.  Many consider it out-dated and techologically obselete in many ways.  We agree that we need a better way and that is the goal of creating a scoliosis exercise based treatment approach that permanently re-trains the brain to learn how to hold the scoliosis spine in a straighter position automatically.  We know it sounds too good be true to many, but some times the good things are true.  We need a better way and we hope you agree that future scoliosis treatments must make the transition towards minimally invasive, exercises for scoliosis based approachs that target the neuro-hormonal causes of the scoliosis condition and not just the scoliosis curve.

A Scoliosis Patients Perspective and Experience

By Maggie Victoria

I am not a doctor, I am a scoliosis surgery victim, and I want to share and support you if you are in the same place as I once was. I have read many on-line articles that generally imply that we, scoliosis surgery patients, after about 20 years, begin to experience minor and insignificant mild back problems; oh, really, I beg to differ and the following is my perspective and experience and the journey of so many others who have no voice, who have no power and who have been silenced and gently swept under the rug. This experience of course is in contrast to those people who have not been surgically altered, diagnosed in their youth, and they seem to be living a quality of life pretty close to those who do not have scoliosis. Just know, that you are not alone in your pain, that there are so many others out there that are just like you. Understand that we as a community of post scoliosis surgery complication patients feel as you do and you are doing the right thing by reaching out because we have all been there, right where you are currently.

The most difficult part of this journey, through scoliosis pain syndrome post-op is an emotional battle of the spirit vs. the body that is failing us, in the very lonely world of post scoliosis surgical failure. The loss of control, we feel, the loss of our quality of life and the general betrayal of the scoliosis community in not allowing our voices to be heard, and the constant criticism we are subjected to, with unfounded suspicion and hostility. As you journey through your surgical pain symptoms post-op note that you are facing an uphill battle, you will fight and learn to become your own best advocate, you will know more about scoliosis and the dangers of scoliosis surgery and the scoliosis pain syndrome than you ever wanted to know. It will be a test of the human spirit but know this, we are coming together as a community of scoliosis pain syndrome survivors, and we are supportive understanding and caring. We will be heard, we will have accountability and we will survive. We will advocate that the wrongs of the past will not repeat themselves, and we will seek a better way for this new generation of scoliosis children; for the GOOD of all. Please reach out to us, on facebook, (Scoliosis – The Untold Truth) through this forum and you will be pleasantly surprised, that you are not alone, that your journey can be supported, by our community, and you will find peace in that.

The following are conditions, and details that I hope you will find helpful, to find the support you so desperately need. My motivation for this post, is simple, that no one will ever suffer, seeking the truth, being ignored by the medical community, feeling depressed, and alone. I have been there, and I will not allow our community of scoliosis surgical patients with these complications to go largely ignored and unsupported. You deserve better than that, we all deserve better than that.

Before Scoliosis Surgery

Before my  scoliosis surgery, although a long time ago, I don’t recall having any pain what so ever.

I found this to be rather puzzling, so I asked my daughter about her current scoliosis, and her pain levels, surprisingly, her response to me, was that she was actually not having any pain, and rarely had pain. I pressed her several times, and she got a little irritated because she felt I was doubting her; go figure, So, as far as pain goes prior to surgery, very little to none. She has also indicated her strong desire to be treated at CLEAR scoliosis treatment and would prefer to go through life twisted than undergo even these “more refined, uncomplicated scoliosis surgeries”

Post Scoliosis Surgery

These are my experiences, for your own complications please DEMAND diagnostics and DEMAND whatever you need to get answers. Understand, they will try to pacify you, have courage, have strength, as this is your precious life and your precious health and you must be a guardian and warrior to protect it. When my complications set it in was prescribed NSAIDs and then sent home. I failed to thrive and was told “you only have a little bit of arthritis”. Be prepared, but never allow yourself to succumb to this sort of attitude and question your very sanity! Many patients do, and they become afraid, and drift off to their worlds with no place to turn to for support, getting worse, emotionally and degenerating even further.

I support hundreds of women daily with complications post scoliosis surgery that range from months within the initial surgeries to even 20 plus years. We have come to terms our condition and we call it scoliosis surgery failure, or Scoliosis Pain Syndrome. The surgical methods range from Harrington rod placements, C&D instrumentation, Pedicle Screw instrumentation, and the newest latest and greatest surgical instrumentation methods.

The following are some of the Long Term Issues that are Possible that we define as scoliosis pain syndrome or scoliosis surgery failure and complications:

Sometime after scoliosis surgery you might notice that your shoulders and your hips become even more uneven or clothing may not fit the way it once did. The pain this causes as the rotation advances is absolutely incredible. My physiotherapist does his best to treat this and keep me comfortable but there is little else he can do.

Disk degeneration – This is another very painful issue that can cause severe back pain.in your lower back. As the degeneration continues, it can cause the disks between these vertebrae to rupture, because they become so weak. . I have read so much online that says that disk degeneration does not cause severe pain in the scoliosis surgical patient. How do they know that? Did they ask us? I beg to differ! It is absolutely debilitating.

Those who were fitted with Harrington rods face even more severe degeneration because of the sheer weight of the rods, and salvage surgery is almost inevitable for these patients. These folks are aged well into the 50s and 60s by the time salvage surgery is required and recovery is nothing short of hell with these aged bodies lumbar flatback (some General MDs are not even aware of it) and by the time the patient is diagnosed with it they are often severely deformed and surgery to fix it is even more complex and the patient has suffered emotional trauma from the many years that have elapsed to even get a diagnosis. Most often, but certainly not always, flatback is caused by eliminating the lumbar lordosis (that is where your spine curves inward and is natural). It is claimed in general that it is caused from the Harrington instrumentation methods however it is still happening in other surgical approaches. Severe, neck, and back pain will result and eventually the person has such a severe forward bend that they can only look to the ground.

Post Scoliosis surgical scoliosis pain syndrome can also cause spondylosis, This is an arthritis in the spine that can develop. The joints can become inflamed, and the cartilage that cushions the disks thin and then bone spurs or (osteophytes) develop. This condition can lead to more surgery when the disk degenerates or the curve begins to progress and this does result in the vertebrae pressing on the nerves. Let me tell you, from first-hand experience, the pain is very severe and the only way to address this is yet more surgery.

My entire cervical spine and lumbar spine has now developed osteophytes. Scoliosis surgery can put you at greater risk for spondylosiss because inflammation will likely occur in the vertebrae above and below the fusions sites because the extra load those vertebrae must carry.

Your Rods can become loose and good luck getting that diagnosed. I had a blood pool study that confirmed it, and that diagnosis is still being denied. The rods can corrode, and the metal can “leach” into the blood stream, causing all sorts of issues, including, fatigue and autoimmune responses. I battle constant fatigue and exhaustion daily.

You can also have fusion failure where the bone fails to graft together. This can compromise the instrumentation and cause huge amounts of pain and again can only be addressed through more surgery.

You can also have spinal stenosis, facet joint arthropathy, fusion degeneration, kyphosis begins to set in. All of these conditions, from scoliosis pain syndrome are nothing short of life altering. I have all of these. While my spine remains stable at 30 degree thoracic and 30 degree lumbar, I am shifting rotationally which is causing me to have kyphosis, and the rib hump continues to get worse. I am concerned that my right shoulder will become displaced and dislocated. The pain is incredible.

Currently, 19 years post my last surgery, (note I am a health 105 pounds and was once a fitness buff. I stand about 5 feet 6 inches tall and am not over weight)

Post 3 surgeries, a dextroconvex scoliosis 30 degrees centered at T8, pedicle hooks at T4, A left fixation device T2 To L1, a fixation rod on the right T6 to T9, Clercage wire between the two rods at T8, 30 degree curve in the L-spine.

My surgical Pain Sydrome Implications:

L5-S1 spondylolisthesis secondary to bilateral L5 spondylolysis

Blood pool study – loosening of the metal rods and less likely arthritis

Lumbar Spine -Facet joint arthropathy lumbar spine, stenosis, and osteophyte formation at all levels.flattening of the of lumbar lordosis, DDD

C-spine -multilevel disc space narrowing degenerative osteophyes. Facet arthropathy

Thoracic spine – currently showing degeneration, DDD

Kyhposis is now present, rotation of the ribs in progress, and the rib hump progressing, shoulder and scapula beginning to displace, forward in my sagittal positioning. Currently, I have absolutely no stability.

Final Words

What Scoliosis surgery does, is trade a deformity for dysfunction for a life time of chronic pain. If you are reading this article and are without pain, and had scoliosis surgery, count your blessings, and know that at some point in your life, it will be your reality. We need a better way. We need the scoliosis community, to open their minds, stop the censorship, allow us to have a voice, and make non-surgical scoliosis treatment specialists, who treat without surgery, become the mainstream for treatment of this condition! CLEAR scoliosis treatment is definitely, on to something and in order to refine treatment, to improve treatment, we must, in the least make people aware that it is even available as a treatment option!

I WILL NOT ALLOW THIS EXPERIENCE TO DESTROY ME, BUT I WILL BE HEARD, AND I WILL ADVOCATE FOR THE NON SURGICAL TREATMENT OF THIS DISEASE WITH PASSION, TRUTH AND DEDICATION! NO ONE SHOULD EVER HAVE TO SUFFER FROM SCOLIOSIS PAIN SYDROME BECAUSE THERE ARE NO MORE EXCUSES! WE KNOW AND ARE VERY AWARE OF THE LONG TERM IMPLICATIONS OF THESE SURGERIES ARE! NO MORE EXCUSES!

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

"No evidence has been found in terms of prospective controlled studies to support surgical intervention (for adolescent idiopathic scoliosis) from the medical point of view...... Until such evidence exists, there can be no medical indication for surgery (for adolescent idiopathic scoliosis). The indications for (scoliosis) surgery are limited for cosmetic reasons in severe cases and only if the parent and family agree with this." (Weiss, Disability and Rehabilitation, 2008; 30(10): 799 – 807).  Perhaps no truer words have been spoken in regards to the medical necessity of scoliosis surgery in the modern world of health care, yet mis-conceptions about the “need” for scoliosis surgery still run abound. 

No one is arguing that idiopathic scoliosis isn’t a serious health concern that can dramatically impact a person’s physiological and psychological well being, as well as quality of life standards in adulthood, but the assumption that scoliosis surgery improves or increase any of these important health measures.  In fact, a study published by Berven et al in Spine, Sep 2007, reviewed published scientific literature in an attempt to answer the question of “whether patients benefit from scoliosis surgery?”. The results supported their statement that “there are no current, definitive studies that answer the question posed above.”

Scoliosis surgery does not improve the patient’s physiological (breathing, heart, ect) health immediately or in the long-term.  I can’t tell you the number of times I have read posts from parents on Facebook or other scoliosis forums that emphatically claim that scoliosis surgery saved the life of their child with a 42 degree thoracic Cobb angle, because it was going to “crush” the lungs and they would suffocate.  While this statement is factually inaccurate, it is also rooted in the emotional justification any loving parent would turn to if they were presented evidence indicating they may have been mis-lead (perhaps unintentionally) into making the decision for their child to have a highly invasive spinal fusion surgery with a poor long-term prognosis.  However, a closer (and less emotional) look at the situation reveals that the lungs are basically fully developed by the age of 5 years old and thus the risk of life-threatening cardio-pulmonary compromise (cor pulomale) is almost non-existent in scoliosis patients whose spinal curvatures become severe after the lungs are fully developed.  Since over 80% of all scoliosis cases are classified as adolescent idiopathic scoliosis, the vast majority of scoliosis surgery candidates are well over the age of 5 years old.  It should also be noted that the correlation between the change in Cobb angle and the thoracic volume change was poor in scoliotic patients after anterior and posterior instrumentation (Int Orthop 2001;25(2):66-0); thus scoliosis surgery doesn’t resolve/address the cardio-pulmonary health concern anyway.  In fact, the  most recent studies show scoliosis surgery actually further decrease the patient’s breathing volume for a period of 3-6 months following the procedure.

              Scoliosis is more than “just a spine condition” in many regards, but perhaps none more (and least understood) than the psychological impact the progressive and image deforming effects has on a young adolescent (mostly female) group that in most cases is asymptomatic.  It is no secret or surprise that idiopathic adolescent scoliosis patients suffer from more depression, low self-esteem, and other psychological issues than their age matched non-scoliosis affected peers.  The “improved” cosmetic effects of scoliosis surgery correction are sighted as the primary reason for the procedure and it the positive effects on the patient’s psychological status are touted as one of the many benefits.  Unfortunately, the reality is far from the good intensions of the surgeon.  A long-term study on the psychological status of post-scoliosis surgery patients found, “The psychological health status is significantly impaired.” (Quality of Life and Back Pain: Outcome 16.7 Years After Harrington Instrumentation, Spine 2002 Jul 1;27 (13) :1456-63 Gotze et al, Dept. of O Surg, Hamm, Germany).  Furthermore, entire published and peer reviewed studies have been done on the “cognitive dissonance” in which patients achieve what is considered excellent scoliosis surgery correction, but are still dissatisfied with the results, affecting their psychological status even more so.   

Scoliosis surgery has never been proven to improve one’s long-term quality of life; In fact, there is reason to believe it has a more negative effect on the patient’s long-term quality of life than the scoliosis spine condition itself.  A 2003 50 year follow up study of untreated scoliosis patients out of the University of Iowa found they were generally functioning at a high level, despite increased back pain and cosmetic concerns, where as a long-term study (avg 16.9 years post scoliosis surgery) published in 2002 found that as much as 40% of scoliosis surgery treated patients were “legally defined as severely handicapped persons”.  In this regard, one has to wonder if the cure is worse than the condition.

Scoliosis surgery is a highly invasive and permanent treatment that has limited benefits and very severe long-term consequences for many of those whom chose to undergo the procedure.  Perhaps, the saddest part is that many of these individuals have no choice in the matter, as they were children at the time and the decision was made for them by their well intentioned patients whom blindly trusted the orthopedic surgeon who is naturally bias towards their “proven” treatment approach.  Unfortunately, because the long-term effects of removing the rods have proven to be so terrible (with the spinal structure basically completely destroyed), the new recommendations are, if you have to take the rods out for any reason, you have to put new ones back in.  If they take the rods out and do not replace them, the patient will most likely be in a wheelchair in a few years.  The spine will no longer work without the rods.

 People need to know that, once they decide to have the rods implanted, they will always need them.  Scoliosis treatment is a life long journey, with or without scoliosis surgery.

Scoliosis surgery is a highly invasive and permanent scoliosis treatment option that is generally reserved for severe scoliosis spine cases in adolescent and adult cases of idiopathic scoliosis.  Despite the many studies demonstrating poor long-term results of scoliosis fusion surgery, including chronic pain, psychological impairment and disability, the number of scoliosis patients opting for scoliosis surgery procedures continues to rise each and every year. 

There may be many reasons for the continued rise of scoliosis surgeries; more availability to health care coverage, increased societal pressure to eliminate physical spinal deformity, or a growing confidence in surgical procedures to provide an optimal solution, but to date, there is no significant reason to believe the poor long-term outcomes from updated scoliosis surgery procedures will be improved since they still ultimately result in multiple level spinal fusion.

A shocking 50 year follow-up on untreated scoliosis patients published in JAMA (Journal of the American Medical Association) in 2003 concluded, “Untreated adults with scoliosis are productive and functional at a high level at 50-year follow-up. Untreated scoliosis causes little physical impairment other than back pain and cosmetic concerns.  This is in sharp contrast with a 2002 long-term post scoliosis surgery study that found “40% of operated treated patients with idiopathic scoliosis were legally defined as severely handicapped persons”.  Essentially, the contrast between these two studies indicates the scoliosis patient is better off doing nothing than having scoliosis surgery.  Although, I must note that multiple studies have found that, while adolescent idiopathic scoliosis is not life-threatening, it will very often negatively impact one’s quality of life through-out adulthood.  With this being understood, I am not advocating for no treatment of scoliosis, but I feel it does suggest that we need to seriously entertain the idea that drastic measures like scoliosis surgery may be worse than the condition itself in the long-term outcomes for the patient.

Efforts to correct this glaring discrepancy have been undertaken in the form of earlier spinal fusion in children with early onset progressive scoliosis.  Here are the results from one such study, “Spinal deformity is apparently not well controlled by early fusion since revision surgery has been required in 24% to 39% of patients who underwent presumed definitive fusion in early childhood. Restrictive pulmonary disease, defined as forced vital capacity less than 50% of normal, occurs in 43% to 64% of patients who undergo early fusion surgery with those children who have extensive thoracic fusions and whose fusions involve the proximal thoracic spine at highest risk. Thoracic growth after early surgery is an average of 50% of that seen in children with scoliosis who do not have early surgery. Diminished thoracic spinal height correlates with decreased forced vital capacity…..The literature does not support routine definitive fusion of thoracic spinal deformity at an early age in children with scoliosis.”

So where did all of this go wrong?  The answer is, from the beginning.  The entire concept of fusing 6 to 12 vertebral levels of a person’s spine and not expecting a bio-mechanical disaster in the long run is simply delusional.  The simple fact that “There is no right way to do the wrong thing” still holds true as ever and scoliosis fusion surgery for the treatment of adolescent idiopathic scoliosis is no exception.

We need a better way.  We need a rehabilitation based scoliosis treatment system the pro-actively trains the brain’s automatic postural control centers and corrects neurological spinal feedback mechanisms.  But, here is the trick.  The rehabilitation stimulus needs to stimulate the brain to recognize the scoliosis spine alignment is incorrect and trigger the auto-correction message which is then sent to the spinal muscles.  Currently this can only be done through specialized scoliosis rehabilitation that actually alters where the brain subconsciously perceives the various major alignment points of the head, torso, and pelvis by having the patient wear lightly weighted hats, hip belts, and specially designed long lever arm torso weighting.  This creates a true “re-active” brain-muscle response that signals to the brain that something is wrong and provides the exact feedback it needs to self correct the scoliosis spine to a large degree.  This is in stark contrast to the “muscle memory” spinal feedback efforts in re-training the brain seen by some of the dynamic scoliosis braces on the market today.

The take home message about the future of scoliosis treatment is...."scoliosis treatment needs to start in the brain, not the spine."

The term “Idiopathic” means “unknown cause” and when applied to scoliosis it can cause sheer terror in the hearts of parents, anxiety in the minds of teenagers, and bewilderment in the thought process of treating doctors.  For literally centuries, the standard of scoliosis treatment has been scoliosis brace treatment and scoliosis surgery, which are only concerned about treating the spinal curvature itself, but not the underlying cause of the idiopathic scoliosis condition.

The most current research and theories on idiopathic scoliosis are focusing the concept of the scoliosis condition being primarily a neurological condition with its primary effects on the spine.  That would mean the crooked spine seen on the x-ray is really a symptom of the underlying neurological condition and not the condition itself.  Metaphorically it could be described as watching the wind through a window.  You can’t actually see the wind, but you can see the effects of the wind (direction, hard it’s blowing, ect) on the trees, grass, flags, ect. and determine a lot of accurate information about what’s going on out there.  The same can be said in regards to the viewing the scoliosis spine on and x-ray and determining a lot of accurate information about the neurological effects of scoliosis.

It’s not surprising that traditional approaches to scoliosis treatment have been skewed to only treat what they can see (since that is human nature) and it is equally not surprising that much of the history of scoliosis treatment (scoliosis brace treatment and scoliosis surgery) is based on this “over-simplified” understanding as well.  Fortunately, the winds are change are once again blowing and new concepts of neurological re-training the automatic postural control centers in the brain as a primary form of scoliosis treatment are starting to emerge. 

While most people take normal spinal posture (automatic neurological orientation to gravity) for granted, this is the core dysfunction the idiopathic scoliosis patient faces.  These automatic postural control centers are located in the hind brain in the same areas many of the other automatic body functions are controlled (heart rate, breathing, digestion, ect) and are not voluntarily controlled.  This means any attempts to stimulate these automatic postural control centers cannot come from voluntary movement patterns that require intentional effort.  The only way to re-train these automatic postural control centers is to create a “re-active” rehabilitation effect that sends correct feed back into the hind brain, which in turn sends out a correct response to the spinal muscles resulting in a 3-D auto-correction of the scoliosis spine.

While this seems rather complicated and difficult to do, it really isn’t all that tough once you understand how the system works.  When the brain automatically orients the spine to gravity it essentially is trying to “line up” the major center masses of the torso (head, torso, pelvic) in 3 dimension space.  This is done through a series of reflexes called “the righting reflexes” which send feedback from the eyes, inner ears, cervical spine, torso, pelvis, and feet.  While it remains unclear exactly which of the feedback mechanisms is not reporting or mis-reporting information to the brain, it clearly is having a dramatic affect on the scoliosis spine position while the patient is vertically relating to gravity (sitting or standing). 

The neuro-muscular re-training system developed specifically for scoliosis by the CLEAR Institute creates the exact stimulus that triggers the auto-correction response from the automatic postural control centers in the brain and will actually “re-train the brain” to “learn” how to hold the scoliosis spine in a new and straighter position if utilized on a daily basis for an extended period of time (4-6 months).  This non-invasive, exercise based approach is the first to target the exact automatic postural control areas through a “re-training” effect and address the underlying root cause of idiopathic scoliosis.

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

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.

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.

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

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.

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

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.