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Scoliosis Treatment in the U.S. Surpasses Estimated Need

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According to the National Scoliosis Foundation, Scoliosis affects 2-3 percent of the population, or an estimated 6 to 9 million people in the United States. Scoliosis can develop in infancy or early childhood. However, the primary age of onset for scoliosis is 10-15 years old, occurring equally among both genders. Females, however, are eight times more likely to progress to a curve magnitude that requires treatment. Every year, scoliosis patients make more than 600,000 visits to private physician offices, an estimated 30,000 children are fitted with a brace, and 38,000 patients undergo scoliosis fusion surgery.

However, according to the Department of Orthopedic Surgery, University of Kansas Medical Center in only 0.25% does the curve progress to the point that treatment is warranted which leads one to believe somebody has their numbers wrong.

Even on the lower end of incidence levels of 6 million this would be only 15,000 patients needing treatment for curvature of the spine. It appears that number receiving treatment in the U.S. is double the estimated need. It is also surprising that if bracing actually worked you would see a far smaller number of scoliosis surgeries if standard procedure was scoliosis brace treatment after 25 degrees on all kids still at risk of progression. It is likely that scoliosis is undertreated with the correct type of program, that being a conservative exercise based program, and likely over-treated using ineffective brace treatment and invasive spinal fusion surgery. The United States should take note of the increase in European clinicians who are advocating scoliosis exercise programs in the early stages of the condition to help reprogram posture control and positively affect the extrinsic properties of scoliosis which statistically reduces the so-called need for more invasive procedures.

The failure of the orthopedic community to recognize innovative approaches to treating scoliosis in the immature stages is outrageous. The governing bodies and policy makers need to wake up and give our children here in the United States a better opportunity to take control of their situation rather than be treated like your dealt a bad hand of cards and the only solution is brute force and psychological scarring. I realize that the scientific community is waiting for this evidence to come out and punch them in the face so that something will actually be done but the reality is that RCT’s are not going to happen and scoliosis research is too unpredictable and often biased. There is enough data and clinical successes won in the trenches with exercise based programs that the least they could do is recommend trying it rather than this ridiculous do nothing “it probably won’t get worse” observation phase.

Since there is no cure for scoliosis and scoliosis fusion surgery permanently alters the normal functioning of the human spine, the ability to give every single child at least the opportunity to try controlling the extrinsic factors contributing to scoliosis progression is certainly justified and doesn’t take a perfect controlled research study to recommend some scoliosis specific exercises in the early stages of the condition. It is a good thing to do and the right thing to do. It seems the resistance to conservative care is more based on a patient wasting time and money on something others feel won’t work when in fact it often does work with the majority not the minority of patients with scoliosis, it is just more effective before progression occurs and that is where the challenge exists.

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