Live "Scoliosis Awareness" Interview (3 min)

Just got done with a LIVE (yikes!) interview on Fox 43 morning news and I'm thrilled they were so generous with the coverage of a traditionally under reported condition like scoliosis. Here is the link to the 3 min. interview.

http://www.fox43.com/videobeta/74368618-469f-4ef6-aaf9-0c3e1e33461c/News/6-23-SCOLIOSIS-HELP

Thanks for your support and PLEASE help us, help others by copying and pasting the link to this artilce on all of your Facebook and Twitter accounts. Posting it on blogs, forums, and other online outlets is also a wonderful way to help our message go "viral" and create awareness about scoliosis and it's treatment.

Thank you.

Best in health,

Clayton J. Stitzel DC

Official Response to CLEAR Institute Complaints

Official Response to CLEAR Institute Complaints

Chiropractic treatment for scoliosis

Does Traditional Chiropractic Help Scoliosis?
In 1997, Dr. Charles Lance of "The Chiropractic Foundation for Research" conducted a 3 year study to study the effect of traditional chiropractic spinal adjustments, heel lifts, and postural counsiling on mild scoliosis (scoliosis less than 20 degrees). Of the 150 children whom started the study, only 40 completed the entire 3 years and the average reduction of the scoliosis spine curve was only 1.4 degrees. Given the fact that the study cost over $143,000, the financial costs of $10,241 per degree is unacceptable and unaffordable.

Fresh all the heels of this studies completion, the scoliosis researchers and clinicians at the CLEAR Institute began work on a finding a better way to treat scoliosis.

In 2004, the CLEAR Institute held it's first seminar at Parker College of Chiropractic and unveiled the Scoliosis Traction Chair for the first time. This innovative scoliosis treatment methodology focuses on treating scoliosis primarily like a neurological condition that develops a spinal curvature as it's primary symptom, which is an evolutionary step forward in terms of scoliosis treatment philosophy.

Since that time, the CLEAR Institute has continued to innovate, discover, and improve the scoliosis treatment process and application. Today, most adolsecent idiopathic scoliosis patients are able to reduce their spinal curvatures by 30%-50% on average and maintain their spinal health/quality of life through out adulthood.


Source: http://www.squidoo.com/scoliscoreScoliscore and CLEAR Institute Chiropractic Scoliosis Treatment
On March 6, 2010 the leadership team of the CLEAR Institute met with the Scoliscore leadership team at the Axial Bio-Tech labs in Salt Lake City, Utah to explore how genetic testing combined with environmental influence reduction could improve scoliosis treatment. The result was the development of an entirely new scoliosis treatment paradigm in which genetic testing would determine the most appropriate course of treatment and early stage scoliosis intervention could eliminate the need for scoliosis brace treatment and scoliosis surgery in virtually all adolscent idiopathic scoliosis cases.

Genetic Pre-Disposition + Environmental Influences = Idiopathic Scoliosis

Anybody with even the most basic understanding of algebra can tell you that a problem with 2 unknown variables can not be solved, therefore the multi-factorial nature (genetics and environment) of each patient's case made treatment recommendations very difficult, uncertain, and inaccurate. This means doctors often over or under treated scoliosis patients and had very poor scoliosis treatment success rates. However, having the ability to accuately determine the patient's genetic pre-disposition allows doctors to select the most appropriate level of treatment invasiveness and re-evaluation time frames.

"At Home" Scoliosis Treatment Tips....

Scoliosis 101 - Scoliosis is a mulit-factorial condition
Idiopathic Scoliosis is a multi-factorial condition with both environmental influences and genetic pre-disposition. While the new Scoliscore test can determine genetic pre-disposition for idiopathic scoliosis, we can not currently alter the genetics at this point; however there are many new and exciting ways of reducing and eliminating the environmental influences that actually drive the spinal curvature progression.

Environmental Influences of Idiopathic Scoliosis

The environmental influences that cause the scoliosis spine progression are poorly understood and even more poorly researched, but piecing together the data we do have available it appears the environmental influences fall into one of three broad categories. NOTE: None of these categories are mutual exclusive to each other and each category influences and interacts with the other categories to varying degrees in each scoliosis case.

•Bio-Mechanical
•Bio-Chemical
•Activity Related
Based on these three categories I have created a list of "10 scoliosis treatment tips"

Not "Scoliosis Friendly"

Source: FixScoliosis.com10 Scoliosis Treatment Tips
1. Beware of back bends in gymnastics and ballet.

Why: Circumstantial evidence has determined that activities that cause a “flattening” or hyper-extension of the mid back may cause progression in scoliosis curves.

2. Clean your shower heads at least 1 time per month.

Why: The mycobacterium that grows inside the showerhead between uses can lead to chronic mycobacterium infection and drive up osteopontin levels.

3. No fish tanks in the house.

Why: Prolonged standing water (similar to the water inside the showerhead) can lead to chronic mycobacterium infection, which can increase osteopontin levels.

4. Don’t sleep on your stomach.

Why: 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.

5. Take 200 micro grams of Selenium a day (L-selenomethionine to be exact)

Why: Selenium is a naturally occurring mineral and is known to drive down excessively high levels of a cytokine called “osteopontin” which drives bone remodeling and has been found in excessively high levels in patients with severe scoliosis. In addition, a 2007 published study found Adolescent Idiopathic Scoliosis patients were frequently selenium deficient.

Note: Take with food for people with sensitive stomachs.

6. Avoid slumped postures when sitting at the computer and texting.

Why: Scoliosis 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.

7. Reduce backpack weight to less than 10% of the patient’s body weight.

Why: Abnormal weighting of the scoliosis compromised spine may lead to curve progression. 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.

8. Distribute backpack weight evenly.

Why: Asymmetrical loading of the spine with a back pack causes abnormal loading of the spinal curvature and could cause curve progression.

9. Back yard trampolines are a no, no.

Why: 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”.

10. Avoid high heel shoes.

Wearing high heel shoes can cause excessive lumbar lordosis (the normal side view curve), which is correlated with progressive scoliosis.

New ideas in scoliosis treatment

New ideas are almost never readily accepted....even when they are good ideas. Many times new ideas are met with skepticism (understandably) and rejection, simply because it challenges the current conventional wisdom. The general public aren't the only ones whom are prone to this "knee jerk" type reaction to new ideas. Many established "experts" in the field are quick to condemn new ideas without investigation and generally their condemnation is based off a "That isn't the way we do things around here" [protecting their status quo] or "It wasn't invented here" [protecting their egos] perspective. Most will hide behind the "evidence based medicine" (which, as a note of reference, I fully support) excuse, until it is undeniably pointed out that scoliosis brace treatment and scoliosis surgeryhave no evidence based medicine basis either, but that doesn't stop them from recommending it to patients despite their extreme invasiveness and poor long-term outcomes.

None-the-less, many people feel the need to look for the negative attributes in new ideas and the CLEAR Institute Scoliosis Treatmenthas not been immune to this type of criticism, so I have written this hubpage to address 8 of the most common "CLEAR Institute complaints" that I have come across thus far. I'm sure more will be added to the list in time.

1.No two scoliosis cases are the same.
2.Are the results long lasting?
3.Is CLEAR Institute Scoliosis Treatment cost effective?
4.Is there any CLEAR Institute Scoliosis Treatment research?
5.Improving CLEAR Institute technology yeilds continually better results.
6.Patient compliance with the home rehabilitation program is MANDATORY.
7.Late stage (severe) scoliosis intervention.
8.Realistic scoliosis treatment expectations.

Additional "Idiopathic Scoliosis" Related Hubpages and Squidoo Lens

http://hubpages.com/hub/Spinal-bracing-for-Adolescent-Idiopathic-Scoliosis-has-NO-effect-on-Adolescent-Idiopathic-Scoliosis
http://hubpages.com/hub/Idiopathic-Scoliosis-Treatment
http://hubpages.com/hub/Scoliosis-treatment-in-30-minutes-a-day
http://hubpages.com/hub/Scoliosis-Treatment-Chiropractic
http://hubpages.com/hub/yogaandscoliosis
http://hubpages.com/hub/Scoliosis-Treatment-Tips?done
http://hubpages.com/hub/Scoliosis-Surgery-Is-NOT-Inevitable

http://www.squidoo.com/treating-scoliosis-with-chiropractic
http://www.squidoo.com/clear-institute-method-for-scoliosis-treatment
http://www.squidoo.com/yoga-for-scoliosis
http://www.squidoo.com/scoliosis-nutrition
http://www.squidoo.com/scoliosis-exercise
http://www.squidoo.com/scoliosis-bootcamp

Scoliosis Treatment in State College, Pa Area

Scoliosis Treatment in State College, Pa

Scoliosis Treatment in Wilkes-Barre Area

Scoliosis Treatment in Wilkes-Barre

Scoliosis Treatment in Scranton Area

Scoliosis treatment in Scranton

Scoliosis Treatment in Allentown Area

Scoliosis Treatment in Allentown

Scoliosis Treatment in Harriburg Area

Scoliosis Treatment in Harriburg

Scoliosis Treatment in Pittsburgh Area

Scoliosis Treatment in Pittsburgh

Scoliosis Treatment in the Milwaukee area

Scoliosis treatment Milwaukee

Scoliosis Treatment in the Chicago area

Scoliosis Treatment in Chicago

Scoliosis Treatment in Washington DC area

Scoliosis Treatment in Washington DC

Scoliosis Treatment in Baltimore area

Scoliosis Treatment in Baltimore

Scoliosis Treatment in Philadelphia

Scoliosis Treatment in Philly

Scoliosis Squidoo Lens!

Here is a complete list of all my Squidoo lens as of May 5, 2011

http://www.squidoo.com/scoliosis-exercise

http://www.squidoo.com/scoliosis-bootcamp

http://www.squidoo.com/early-stage-scoliosis-intervention

http://www.squidoo.com/health-insurance-coverage-scoliosis-treatment

http://www.squidoo.com/surgery-scoliosis

http://www.squidoo.com/scoliosis-surgery

http://www.squidoo.com/scoliscore

http://www.squidoo.com/clear-institute

http://www.squidoo.com/scoliosis-brace

http://www.squidoo.com/scoliosis-of-spine

http://www.squidoo.com/scoliosis_spine

Scoliosis Hubpages!

Here is a list of all my scoliosis hubpages through May 5, 2011


http://hubpages.com/hub/www-Scoliosis-Treatment

http://hubpages.com/hub/Scoliosis_Surgery

http://hubpages.com/hub/Scoliosis-Brace

http://hubpages.com/hub/Scoliosis-of-spine

http://hubpages.com/hub/Spinal-bracing-for-Adolescent-Idiopathic-Scoliosis-has-NO-effect-on-Adolescent-Idiopathic-Scoliosis

http://hubpages.com/hub/Idiopathic-Scoliosis-Treatment

http://hubpages.com/hub/Scoliosis-treatment-in-30-minutes-a-day

http://hubpages.com/hub/Scoliosis-Treatment-Chiropractic

http://hubpages.com/hub/yogaandscoliosis

http://hubpages.com/hub/CLEAR-Method-for-Scoliosis

Scoliosis BootCamp

Reduce your scoliosis by 30-50% in as little as 2 weeks!


Scoliosis BootCamp

Scoliosis Brace Treatment

Scoliosis Brace Treatment

Scoliosis Treatment needs to be safe, effective, targeted, and practical for the "everyday" life of today's teenagers

Scoliosis treatment needs to be re-invented.
Genetic testing for idiopathic scoliosis (Scoliscore) is a dramatic breakthrough in prognostic testing for idiopathic scoliosis and can now accurately identify the children with scoliosis whom are most genetically pre-disposed to developing a severe scoliosis spine. This is spell the end to “observation only” type protocols which simply “watch and wait” until the scoliosis spine gets “bad enough” to provide ineffective and intolerable scoliosis brace treatment. In fact, this would be the most optimal time to introduce an early stage scoliosis intervention program that focuses solely on the reduction and elimination of the environmental influences that actually drive the scoliosis spine, rather than only treating the curvature itself, and specifically targets the re-training of the (presumably) under-developed automatic postural control centers in the brain stem. This can actually targeted, postural center re-training rehabilitation approach can be accomplished quickly, conveniently, and in only 30 minutes a day (two 15 minute sessions to be exact).

The body has a certain “set point” for normal posture called the “body schema”. This is neurological imprint your body uses as a “normal” template to constantly re-adjust your spinal alignment to in relation to gravity. It primarily accomplishes this by “lining up” the various major center masses of the body (head, torso, pelvis) to achieve maximum balance and stability. It is possible to influence where the brain “perceives” the center mass of a given body part (let’s say the head for this example) by simply making it artificially heavier in a strategically placed area and letting the body neurologically “react” to the artificially created “new” center mass of the head. The postural control centers in the brain automatically react in an attempt to re-adjust the “body schema” to the old normal and in doing so over-compensates in a predictable manner that shifts the head’s center of mass to the desired position. This reaction becomes “engrained” in the body schema over time and the brain slow begins to adopt it as the “new normal”. The FITT (Frequency, Intensity, Time, Type) principle requires at least 15 minutes of training per session twice a day over the course of 90-120 days for the neuro-muscular adaption to become a “permanent” connection and then only one full 15 min training session one time per week to

Are Cobb angles an obsticle for progress in future scoliosis treatments?

The history of scoliosis treatment is well documented over the past almost 500 years (1st metal brace was created in 1575) and dates back to the early writings of the Hippocrates himself (The Father of Medicine). For hundreds of years, if not thousands, scoliosis patients have been immobilized in various types and applications of scoliosis brace treatment without success, and the current clinical data appears the orthopedic community isn’t any closer to scoliosis brace treatment success even today. Dr. Stefano Negrini led a comprehensive review of scoliosis brace treatment and concluded “There is a very low quality of evidence in favor of using braces, making generalization very difficult.” 436 years of attempted scoliosis brace treatment experimentation and “very low quality of evidence” is the best they can come up with? Obviously, we need a better way.
The first scoliosis surgery was conducted (unsuccessfully) in 1865 and subsequently spurred on the first medical malpractice lawsuit in the orthopedic community shortly after. While scoliosis surgery techniques, hardware, and abilities have vastly improved since that time, the long-term negative complications of fusing multiple levels of freely move-able joints in a patient’s scoliosis spine still haunts the procedure; keeping in mind the wide spread agreement that the primary indication for scoliosis surgery is for improving one’s cosmetic appearance and not medical necessity.
The current state of scoliosis treatment appears to be scoliosis brace treatment is worthless and the scoliosis surgery procedure is worse than the condition itself in many cases.
The need for drastic change and over-haul to the scoliosis treatment system is clearly obvious, yet decade after decade, little to no progress is made other that “improvements” to the existing scoliosis brace protocols and scoliosis surgery procedures. The obvious question is simply, why? When the need is so glaringly evident and the technology and thought process is so clearly under-developed; why hasn’t the scoliosis treatment community rushed to meet the needs and demands of a world full of scoliosis patients? In my opinion it can be summed up in two words: Cobb angle.
Cobb angle first appeared on the scene in 1948 and has been adopted as the “common” (not necessarily “gold” standard) for scoliosis evaluation every since. Cobb’s angle is a completely obsolete system of analysis. Idiopathic scoliosis is a very complex condition and the more we learn about idiopathic scoliosis, the more complex it appears to be. Attempting to describe a condition as complex as idiopathic scoliosis purely by the means radiographic lateral flexion is the equivalent to attempting to describe all the features of your new luxury car by only its color. There is so much more to this condition than just a Cobb angle.
The “prognostic” or “predictive” value of Cobb angle in curve progression is only slightly better than the odds of flipping a coin and ALL of the Cobb angle prognostic assumptions are based off a single study by Lonstein and Carlson in 1984, which has never been repeated or re-produced to this very day.
The current treatment schedule for scoliosis (10 degree diagnosis and then “watch and wait”, 25 degrees scoliosis brace treatment recommendation, 40 degrees scoliosis surgery recommendation) was accepted almost entirely on one article in 1977, by one doctor (Dr. William Kane), who openly admits the numbers are arbitrary and based on a cost based analysis to fit a particular healthcare system. It is not necessarily based off science, and more importantly, not necessarily based off the patient’s best interests.

Cobb angle has a generally accepted +/- 5 degree intra-examiner (same doctor measuring) “measurement error” between 2 separate x-rays and up to a 9.8 degree inter-examiner (different doctor) “measurement error” between 2 separate x-rays. This means a scoliosis brace treatment recommendation is essentially being made with an “acceptable” 20% error rate in scoliosis brace treatment recommendations for scoliosis cases of 25 degrees and scoliosis surgery recommendations are being made with a 12.5% error rate for scoliosis cases of 40 degrees. These measurement error rates are simply unacceptable when making recommendations for highly invasive procedures which have life-long lasting impacts (physically, emotionally, and psychologically) on those scoliosis patients unfortunate enough to be subjected to them.
Cobb angle is measured out of tradition, not an updated scientific understanding of idiopathic scoliosis.
So what is the link between an obsolete, un-reproducible, and un-reliable measurement system (Cobb angle) and the stagnant progress of scoliosis treatment (more useless scoliosis braces and more ways to induce spinal fusion through surgery)? All “mainstream” scoliosis treatment protocols (scoliosis brace treatment and scoliosis surgery) are entire predicated on Cobb angle. Remove Cobb angle from the equation and there is no indication for scoliosis brace or scoliosis surgery treatment. It’s really that simple. Cut off the head of the beast and the body dies.
Scoliscore genetic testing and Early Stage Scoliosis Intervention combine to create a new future for scoliosis treatment.
It has been said that one has to “replace” or “break” a current system, before the old one can be replaced. For example, email “broke” and “replaced” the fax machine. Almost overnight the fax machine became completely obsolete. Generally speaking it is easier to “break” the existing system than to “replace” it with something entirely brand new (which is really hard to do and needs to be invented first). In the case of over-hauling and replacing the current scoliosis treatment system it will need to be “broken” AND “replaced”.
Scoliscore genetic testing for idiopathic scoliosis will “break” the current scoliosis treatment system, because it “breaks” the use of Cobb angle as a predictive tool of curve progression. Idiopathic scoliosis a multi-factorial condition (aka: a combination of both genetic pre-disposition and environmental influences) and completely unique to every patient’s individual scoliosis case. No two cases of idiopathic scoliosis will ever have exactly the same genetic pre-disposition and/or environmental influences, so having a “known” variable like the patient’s genetic pre-disposition become invaluable in determining their true curve progression risk. In other words, a low genetic risk scoliosis case with a 20 degree Cobb angle looks exactly the same as a high genetic risk scoliosis case with a 20 degree Cobb angle on an x-ray; and under the current system to scoliosis treatment they would both receive the same scoliosis treatment recommendation (which in this case would be “observation only”).
The Early Stage Scoliosis Intervention program will “replace” the current scoliosis treatment model when used in combination with the genetic predisposition information provided by the Scoliscore test. Again, based on the new understanding that idiopathic scoliosis is a multi-factorial condition with both genetic predisposition and environmental influences resulting in the development of a spinal curvature; the current scoliosis brace and scoliosis surgery treatment protocol only attempts to deal with the end result (the spinal curvature) rather than treating and preventing the spinal curvature from developing by reducing/eliminating the environmental factors (the only variable we can currently control at this time). However, the Early Stage Scoliosis Intervention program is solely targeted towards reduction of the environmental influences and is centered around a neuro-muscular rehabilitation program the specifically targets the automatic postural control centers in the hind brain, which many researchers feel is genetically predisposed to being “under-developed” in idiopathic scoliosis patients.
This “one, two” punch of accurately determining which patients are most genetically predisposed to developing a severe idiopathic scoliosis curvature with Scoliscore genetic testing and immediately implementing an Early Stage Scoliosis Intervention program which re-trains the under-developed postural control centers in the brain, while simultaneously reducing environmental influences for idiopathic scoliosis is the most scientifically advanced approach to scoliosis spine treatment to date.
The current state of scoliosis treatment is deplorable. The Cobb angle system of scoliosis evaluation is antiquated (and thanks to Scoliscore genetic testing, now obsolete as well), and the scoliosis treatment system (scoliosis brace and scoliosis surgery treatment) employed under its (Cobb angle) direction is equally antiquated. In order to “turn the page” to a new day in scoliosis treatment, the scoliosis treatment community will need to embrace Scoliscore genetic testing as a way to “break” the hold Cobb angle has on scoliosis treatment protocols and adopt an Early Stage Scoliosis Intervention program to “replace” the current observation, scoliosis brace treatment, and scoliosis surgery treatment methodology in favor or a more pro-active strategy which prevents the spinal curvature (hence eliminating the need for scoliosis brace and scoliosis surgery treatment) and re-trains the neuro-muscular under-developmental cause of idiopathic scoliosis.

Spinal bracing for Adolescent Idiopathic Scoliosis has NO effect on Adolescent Idiopathic Scoliosis

Scoliosis brace treated patients actually are worse off than un-treated patients when compared in a genetic pre-disposition study!!!!


Spinal bracing for Adolescent Idiopathic Scoliosis has NO effect on Adolescent Idiopathic Scoliosis

Scoliosis Treatment Begins in the Brain, Not in the spine.

“Idiopathic scoliosis” is term that has been present in recorded human history for almost 3,500 years, but the mystery of its “unknown cause” is slowly being discovered. As many experts have suspected for decades, breakthroughs in scoliosis genetic testing (Scoliscore) and the scoliosis blood test have uncovered sequences of genetic code that leave an individual “genetically pre-disposed” to the development of severe idiopathic scoliosis. However, since the condition doesn’t appear until adolescence in the vast majority of patients, the search for environmental influences that are connected to un-coordinated growth spurts is on-going.
Virtually all current idiopathic scoliosis research is pointing towards a neurological deficit/under-development in the automatic postural control centers of the brain stem as the root cause of the condition, but the factors that cause severe progression requiring scoliosis brace treatment and /or scoliosis surgery appear to be primarily environmental (bio-mechanical, bio-chemical, and specific activity related) driven.
Previous attempts in scoliosis treatment have entirely centered on treating the scoliosis spine itself and have almost entirely ignored the obvious neurological component of idiopathic scoliosis. Scoliosis brace treatment is a relatively simple minded approach to “guided growth” in which the spine is essentially forced into a straighter position (in the front view dimension only). The scoliosis spine growth mal-adapts to alter the bio-mechanical loading patterns provided by the scoliosis brace in an attempt to “out-smart” the developing pattern of the scoliosis spine. Unfortunately, this well-studied scoliosis brace treatment approach has been found very ineffective due to the inability for idiopathic scoliosis patients to comply with the 23 hour a day, 7 day a week, 365 day a year scoliosis brace treatment protocol and those whom do comply experience significant muscle atrophy (muscle weakening) and scoliosis brace dependency in which they need to be “weaned” out of the scoliosis brace over the course of weeks or months. In addition to not addressing the primary neurological cause of idiopathic scoliosis, recent research at the University of Vermont conducted on rat tails under simulated scoliosis brace conditions, suggests that scoliosis brace treatment may actually be causing permanent deformity to the scoliosis spine discs that could lead to further curve progression during adolescences or adulthood.
Scoliosis surgery is a “brute force” approach to scoliosis treatment and has under gone many advancements since its inception in 1865, but even to this day the scoliosis treatment goal remains the same…..complete multi-level spinal fusion. While most orthopedic surgeons make substantial efforts to limit the number of vertebral segments fused during scoliosis surgery, it generally includes at least 5-6 segments out of a total 24 moveable spinal vertebrae which completely immobilizes an approximately 25% portion of the patients entire spinal column. The long-terms (15-20 years post scoliosis surgery) are very poor in terms of chronic pain and quality of life measures. Dr. Robert Saulter of the Toronto Hospital for Sick Children summed up the relationship between chronic dysfunction and chronic pain with is famous quote, “Restoration of function is more important than the relief of pain”. Unfortunately for the idiopathic scoliosis patients whom undergo scoliosis surgery the chronic dysfunction (multiple level spinal fusion)will almost certainly lead to severe chronic pain at some point in their lifetime. This may be considered an acceptable trade off if the scoliosis surgery was a “life-saving” procedure, but the research conducted on the effects of scoliosis surgery has concluded the procedures is primarily indicated for cosmetic purposes and is not medically necessary. This is a generally accepted fact with in the scoliosis treatment community, because scoliosis surgery does not improve cardiac function, pulmonary function, eliminate pain, or improve the adolescent idiopathic scoliosis patient’s quality of life in the long-term follow up studies. It should be noted, that a fused scoliosis spine from scoliosis surgery is every bit (or more) dysfunctional that an un-treated scoliosis spine. Perhaps most importantly, scoliosis surgery is not and will not lead to a cure for scoliosis since it still fails to address the underlying neurological deficit/ under-development that is the root cause of idiopathic scoliosis.
The concept of re-training the automatic postural control centers of the brain stem actually dates back several hundred years (if not much further back) to a time when young girls aspiring to become debutants practiced good posture by walking around balancing books on top of their heads (which is not a suggested scoliosis treatment). By making the head (temporarily) artificially heavier with the book, they essentially changed where their body neurologically perceived the center mass of their skull and caused their “body schema” (the neurological “set point” for normal spinal posture) to react to the perceived postural change. Over time the repeated re-training of the young girl’s automatic postural control centers in her brain stem resulted in a permanent change in the “body schema” and the improved posture simply, became “the new normal”. These very same principles (in a much more effective and advanced application) can be applied to scoliosis treatment and permanently alter the natural course of the idiopathic scoliosis condition by treating the root cause of the condition. The future of scoliosis treatment will be found in treating the scoliosis spine, by treating the automatic postural control centers in the brain stem first.

Idiopathic Scoliosis Hubpages!!!

Idiopathic Scoliosis Hubpages!!!

Discover the new thinking in idiopathic scoliosis cause, treatment, and a possible path towards a cure?

Specific scoliosis exercise is required.

Idiopathic scoliosis is primarily a neurological condition that has its primary effect on the spine, rather than "just a spine condition". With that in mind, it is no wonder scoliosis brace treatment and scoliosis surgery are becoming obsolete rather quickly. The advent of break through prognostic technologies like Scoliscore (genetic testing) and the soon-to-be-released scoliosis blood test are only going to increase the push for early stage scoliosis intervention scoliosis treatment technology as well. Fortunately, we are already well on our way towards prevention of the condition and hope to prove we can alter the natural course of the condition in even high risk genetically predisposed patients soon.

The scoliosis treatment process matters.

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.

Do the scoliosis treatment "ends" justify the scoliosis brace/ scoliosis surgery "means"?

"The ends justify the means" is a common statement in our everyday society and when applied to the greater or long-term good of the individual, organization, or humanity it is generally accepted. Unfortunately, this can not be said in regards to the current state of scoliosis treatment. For the last 3500 years of recorded human history (and the last 450 in particular) idiopathic scoliosis patients have been poked, stretched, cut, squashed, and even tied to various apparatuses and procedures in an attempt to alter the natural course of idiopathic scoliosis under the guise of "the ends justify the means".

Scoliosis brace treatment first appeared in recorded human history around 650AD and has taken virtually every form and approach the a human mind could conceive, yet when compared to the expected genetically predicted natural course of idiopathic scoliosis, the scoliosis brace treatment data shows absolutely NO effect. None! In addition, in 2007 Drs. Weinstein and Dorlan reviewed 15 comprehensive scoliosis brace studies (using virtually every kind of scoliosis brace on the market) and found that scoliosis surgery rates among the scoliosis brace study participants were exactly the same as the untreated idiopathic scoliosis patients. Finally, rat tail research being conducted at the University of Vermont is discovering that simulated scoliosis brace conditions on the rat tail (which is practically structurally identical to a human spine) actually makes the permanent deformity of the disc worse and probably increases the risk of curve progression in scoliosis adult patients.

Scoliosis surgery has been performed since 1865 and has changed both in procedure and intent since that time. The original scoliosis surgery was in hopes of halting progression of the curvature and that mindset held true all the way until the 1950's and 1960's when Paul Herrington introduced the "Herrington rod" scoliosis surgery. The pedicle screw system developed by Cotrel & Dubousset was the next (and still currently used) scoliosis surgery technique to be employed. While it allowed for much better correction of the idiopathic scoliosis deformity, it also came with a lot more complications and very poor long-term quality of life results. In fact, one study found that 40% of post scoliosis surgery treated patients were legally defined as "severely handicapped" only 16.9 years after the scoliosis surgery.

While both of these scoliosis treatment methodologies (scoliosis brace treatment and scoliosis surgery) are and were created with the best of intensions, it cannot be said that the means justify the end. In fact, a 50 year follow up study of untreated idiopathic scoliosis patient found they had a quality of life the exceeded the scoliosis surgery treated patients and one could only assume that the untreated idiopathic scoliosis patient's quality of life was at least equal to that of the scoliosis brace treated patients since scoliosis brace treatment doesn't seem to have any positive effect on idiopathic scoliosis anyway.

So where does that leave the idiopathic scoliosis patient in terms of scoliosis treatment? From my perspective, between a rock and a hard spot, but help is one the way. Scoliosis treatment is undergoing a revolution for the first time since scoliosis surgery was first performed. Early stage prognostic testing for idiopathic scoliosis is allowing us to determine which patients are at an elevated risk for severe scoliosis and which need extensive early stage scoliosis treatment to prevent the onset of a spinal deformity.

Cause of Scoliosis - Initiating and progressive factors

Cause of Scoliosis - Initiating and progressive factors

Idiopathic scoliosis is a complex multi-factorial condition........This thread on causes and curve progression driving factors is not. Understanding Idiopathic scoliosis made easy...and quick too.

SpineCor vs rigid Scoliosis Brace

SpineCor vs rigid Scoliosis Brace

Hmmm, which brace should we use....the worthless rigid brace or the even more worthless spine cor brace? How about NO Scoliosis brace!!!!!

Are these alternative treatments helpful?#post2913

Are these alternative treatments helpful?#post2913

Is the cure of scoliosis surgery worse than the condition itself?

It is not my intention to condemn the efforts of sincere and caring medical professionals who have spent their lives to helping individuals with idiopatic scoliosis. However, I like to add to the current list of scoliosis treatment options and empower these individuals to make their own decision regarding their own scoliosis spine, and their own life.
Scoliosis surgery has been a part of the scoliosis treatment landscape since 1865 (yep, the same year the civil war ended) and while the techniques and surgical hardward have vastly improved, the general conclusion of this research suggests that a new paradigm is desperately needed as there are many short and long term consquences to the highly invasive procedure.
Scoliosis surgery is Generally recommended of curvatures 40-50 degrees and larger. This number is rather arbitary and will vary greating from surgeon to surgeon.
Those patients for whom fail scoliosis brace treatment, they are often told scoliosis surgery is their only option. While the idea of having a metal rod fused to their spine that will impair their daily activities and in many cases leads to chronic pain may not appeal to most scoliosis patients, they often feel as though they have no other choice. In addition many are told the scoliosis surgery will reduce the rib hump and improve the cosmetic appearance of the condition. Unfortunately, current research has consistently shown that scoliosis surgery does little to address the rotation of the scolisis spine (and hence the rib hump) and will actually cause the rib hump to increase in time. (Chen 2002, Goldberg 2003, Hill 2002, Pratt 2001, Weatherly 1980, Wood 1991, Wood 1997).
Scoliosis surgery is highly invasive and carries with it a risk of death. Although death rates of less than 1% are reported, no one completely eliminate this possibility. There is also significant risk of injury to the nerves, resulting in the loss of movement to the arms & legs. This has become a greater concern in recent years, as surgeons strive for greater corrections in their patients, and place more stress upon the nerves running through the spinal column.
Surgical Hardware failure is virtually 100% over the course of a scoliosis patient's lifetime. It may occur immediately after the scoliosis surgery or several years later, but one or more components of the hardware placed inside the body is highly likely to fail or break. The author of one study stated, "One would expect that if the patient lives long enough, rod breakage will be a virtual certainty". Another study found that out of 74 patients who underwent the scoliosis surgery, failed fusion occurred in 27% of patients within a few years after the procedure.
Scoliosis of spine is an neurological condition primarily affecting the spine, which involves much more than merely a sideways curve. Yet the "success" of scoliosis surgery is measured only by how much it can reduce the Cobb angle (lateral deviation) through the application of artificial correction, and a scoliosis surgery treated spine is every bit as abnormal and dysfunctional as an untreated scoliosis spine.
“Scoliosis Surgery… is a major undertaking with significant risks, and rather than reinstituting normality, replaces one abnormality (a flexible, curved spine) with another (a rigid, straighter spine).” Goldberg, 2001.
Risks and complications of scoliosis surgery.
One study (Scoliosis. 2009 May 7;4:11.) found that 68% of patients experienced minor or major severe complications, including two deaths (out of 50 patients):
“Hemo/pneumothorax, pleural effusion, pulmonary edema requiring ICU care, complete spinal cord injury, deep wound infection and death were major complications; while pneumonia, mild pleural effusion, UTI, vomiting, gastritis, tingling sensation or radiating pain in lower limb, superficial infection and wound dehiscence were minor complications.”
Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation."

Where is the accountability in scoliosis treatment?

The treatment record for idiopathic scoliosis over the past 3500 years of human history is terrible.  An utter failure really.  Failed scoliosis brace treatments of every kind and variety.  Scoliosis surgery procedures that leave many of the patients (research suggest as much as 40% or higher) worse off 17 years post-op then idiopathic scoliosis patients 50 years post diagnosis that had absolutely no treatment at all.  In the immortal words of the late, great Vince Lombardi, "what in the hell is going on out there!". 

We need a better way.....a much better way.  A completely, utterly, and drastically better way.  The kind of better way in which the entire system is turned on top of it's head and shaken to its very core.  The search for a better way will tarnish academic reputations and shatter several thousand years worth of conventional wisdom, and it all comes down to making one small change that seems so insignificant that one would probably gloss right over it if they were reading it in a magazine or a book.  So what is this revolution that is going to uproot the scoliosis treatment world?  Here it comes......

Scoliosis is primarily a neurological condition that has it's primary affects (symptoms) on the spinal alignment.

Duh, no kidding right?  Ok, so the idea is pretty well established, but for some reason it doesn't seem to carry over into the realm of scoliosis treatment.  I mean, scoliosis brace treatment and scoliosis surgery are in no way making any attempt to actually treat the primary neurological deficits that are undoubtedly the root cause of the condition.  This is a kin to taking cough medicine for tuberculosis.  Sure, it will quite the cough temporarily, but the overall condition goes unaddressed.......resulting in significant long-term consequences.

So what can be done about this obvious blunder of logic.  Well, we can start by treating this neurological condition like it is indeed a neurological condition.  Here is one example.

Guest blogger: Dr. Brian Dovorany.

"The role of scoliosis exercise. 

There are many schools of thought regarding scoliosis, exercises, and the overall relationship between the two. Muscle fiber type dictates how a muscle responds to force/load principles. There are different fiber types in skeletal muscle not to mention many layers of muscles in the spine and pelvis. The deeper we go into the spinal column and evaluate the muscle structure it becomes obvious that the muscle length gets shorter and the fiber type becomes more populated with TYPE 1 non fatige-able antigravity musculature. This means that deep muscle groupings like the mutifidi serve to support the body relative to gravity and also have the largest ability to alter the structural position of a single vertebrae. Since scoliosis has apical vertebrae(the vertebrae at the apex of the scoliosis curve) which appear on both dissection and on radiographic evaluation to be grossly displaced relative to what is considered normal anatomical position it would be logical to assume that these deep muscles would be strong on one side and weak on the other. Unfortunately this assumption is false. Neurologically the brain controls the on-off switch for antigravity musculature and is in direct response to several sensory systems including the joint and muscle receptors of our feet, pelvis, trunk, and neck, our inner ears, and our eyes. These create receptors feed input to the brain , the brain then sends a motor signal to these muscles telling them to turn on or off.

Sherrington's law of reciprocal innervation (neurological stuff) dictates that an agonist and antagonist muscle group has a neurological system that allows the agonist(mover) to contract while the antagonist automatically will not contract to allow the movement to occur. In the tonic antigravity system since movement is not the primary function of these muscles. These deep muscles contain a very complex system that actually allows for shortening and lengthening reactions to control the center mass of the body in gravity so we don’t fall over. What happens is small changes in the environment are sensed and the tonic muscles adapt instantly through millions of shortening and lengthening responses to stabilize."

Now, I know that explanation maybe a little "out in the weeds" for most readers, but it certainly provides more hope and logical than stuffing a kid into a brace like they are a small tree staked to the ground in the backyard in hopes of "making" the scoliosis of spine grow straight and the scoliosis surgery is just the same principle applied more invasively and well, internally.

Scoliosis treatment has been the victim of under diagnosis and lack of creating thinking long enough. It is time to start holding the "experts" accountable and demanding more, much more.

Demand a better understanding of each patients actual condition other than just jumping into "one size fits all" treatment and hoping for the best.  Demand more treatment options, less invasive once that are based on new principles, not more of the same old tired and failed ones of the past.  Demand an updated outcome assessment system that reflects the true nature of the condition, not just one minor aspect (the magnitude of the curve's lateral bending as measured by Cobb angle).

Scoliosis patients (and parents of).......Demand more, expect better, and don't quit until you get it, because the level of understanding and treatment do exist, but will aways be shoved aside in favor of conventional wisdom until the public demands accountability and progress.

Envision a world with no Scoliosis brace treatment and no scoliosis surgery#post2887

Envision a world with no Scoliosis brace treatment and no scoliosis surgery#post2887

Posterior Fusion Scoliosis Surgery video#post2877

Posterior Fusion Scoliosis Surgery video#post2877

This can be a tough one to watch. Squeemish eyes should not view this video. Scoliosis surgery is a risky procedure with poor long-term chronic pain outcomes. It is not medically necessary and only indicated for cosmetic reasons.

Scoliosis of spine: Scoliosis brace treatment

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

The main problem with scoliosis brace treatment isn’t application, but rather process.  As it turns out, treating a condition that is primarily a neurological condition like it is primarily a skeletal spine problem doesn’t work too well (shocking….sarcasm).  This very simple understanding of idiopathic scoliosis makes almost 3500 years of scoliosis brace treatment completely obsolete and practically worthless.

In fact, Axial Bio-Tech (developers of the Scoliscore genetic test) did a comparison study of brace treated and un-treated scoliosis patients and found absolutely no difference between the two groups long-term treatment outcomes, even when compared genetically.  Scoliosis brace treatment has absolutely no effect on the natural course of the idiopathic scoliosis condition.  Essentially scoliosis brace treatment and doing nothing have exactly the same effect….None.

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

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

The other motivation (financial gain) is a less complicated explanation, but probably more compelling.  Scoliosis brace treatment generate hundreds of millions of dollars worldwide every year and you know what they stay about not finding the solution, when there is good money in prolonging the problem.

So how do we break out of this never-ending cycle of scoliosis brace treatment failure?  Well, the good news is that we probably don’t have to; prognostic idiopathic scoliosis technology (Scoliscore genetic testing for idiopathic scoliosis, the scoliosis blood test, ect) will probably spell the death of scoliosis brace treatment all by itself.

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

Scoliosis surgery: Friend or Foe?

There is no medically necessary reason for scoliosis surgery.   Sounds crazy right?  I mean, how could a scoliosis spine that is twisted and wrapped around itself not crush the lungs, heart, intestines, liver, and/or every other organ in one’s body?  Well, the medical facts are clear that is somehow doesn’t and won’t pose a life threatening risk to the patient if the severe scoliosis of spine developed after the age of 5 years old (the lungs are fully mature by the age of 5 and thus the risk of developing an actual life threatening condition called “cor pulmonale” is eliminated).  Believe it or not this isn’t even new information.  It has been common knowledge that scoliosis surgery isn’t medically necessary among orthopedic surgeons for decades.  Only  recently has a respected scoliosis spine researcher, Dr. Has Rudolf Weiss, come forward and published an comprehensive review of the medical necessity for scoliosis  surgery.  Here were his findings from this 2008 scoliosis surgery study published in the Journal of Disability and rehabilitation.

“The study found "no evidence has been found in terms of prospective controlled studies to support surgical intervention from the medical point of view...... Until such evidence exists, there can be no medical indication for surgery. The indications for scoliosis surgery are limited for cosmetic reasons in severe cases and only if the parent and family agree with this."

The indications for scoliosis surgery are limited for cosmetic reasons in severe cases (which is a whole other debate) and ONLY if the parents and family agree with this; which in my experience they don’t, because they are generally under the assumption the scoliosis surgery is medically necessary to save the patient’s life; Which it isn’t in cases of adolescent idiopathic scoliosis.

So how did all of this get started anyway?  Well the first scoliosis surgery was performed in 1865 (yes, that’s right, the same year the civil war ended!) and it didn’t go well.  The post-operative results were terrible, which lead to what many experts consider to be the first recorded instance of medical surgeons disputing in print & in court, and ending in one of the most famous orthopedic lawsuits in history: Guerin vs. Malgaigne. This defamation trial ended in Malgaigne's favor (the anti- scoliosis surgery doctor).

The first American doctors performed scoliosis surgery in 1914 and the procedure was becoming relatively routine by 1941.  Dr. Paul Harrington came to fame with the “Harrington Rod” scoliosis surgery in 1950’s and 1960’s.  The blood loss from this 8-12 hour marathon scoliosis surgery has huge and death of the patient was a real concern.  Unfortunately the rods kept breaking and by the 1970’s scoliosis surgery used 2 Harrington rods instead of one. 

By the 1980’s a new hook and pedical screw system has been developed that dramatically increased the amount of correction a scoliosis surgery could achieve, but it also dramatically increased the amount and severity of complications associated with scoliosis surgery. 

Some of the complications of scoliosis surgery include…

“Hemo/pneumothorax, pleural effusion, pulmonary edema requiring ICU care, complete spinal cord injury, deep wound infection and death were major complications; while pneumonia, mild pleural effusion, UTI, vomiting, gastritis, tingling sensation or radiating pain in lower limb, superficial infection and wound dehiscence were minor complications.”

Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation, Scoliosis. 2009 May 7;4:11.

The poor long-term results of scoliosis surgery, coupled with the significant risks of scoliosis surgery prompted a top scoliosis surgery researcher to state:

“Scoliosis surgery… is a major undertaking with significant risks, and rather than reinstituting normality, replaces one abnormality (a flexible, curved spine) with another (a rigid, straighter spine).”  Goldberg et al in 2001.

The Current System of Scoliosis Management in the United States is Not Supported by EBM

A "guest blog" by Dr. Josh Woggon.

Evidence-based medicine (EBM) or evidence-based practices (EBP) are poorly understand by the general public and also by many members of the healthcare profession. They are often misinterpreted to mean that only interventions with published research can be considered part of EBM; this is untrue. EBM began in Ontario, Canada, at McMaster's University, as a way of closing the gap between clinical practice and clinical research. David Sackett, one of the originators, describes EBM as: "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research. [emphasis added]"
It is also important to note that it is the patient who has the final say in accepting, rejecting, or modifying care. For example, if surgery is found to be the best intervention through research and the clinical expertise of the doctor, but the patient either does not want surgery or there are reasons why that individual patient might be at a greater risk in having the surgery performed, the published research & doctor's expertise play only a secondary role to the free will of the patient.
The triad of EBM is thus; the patient's preferences, combined with the doctor's clinical expertise, and the best available research evidence.
The difficulties arise when no high-quality evidence is available on a specific intervention. In these cases, it is appropriate to apply lower levels of evidence, such as observational studies and case reports. According to a study published in the British Medical Journal in 2007, 15% of the interventions evaluated so far have been proven to be beneficial; 22% are likely to be beneficial; 2% appear to be a "trade-off" between potential risks & benefits; 5% are unlikely to be beneficial; and, 4% have been shown to be likely to harm. The remainder of interventions, 47%, do not have sufficient evidence to make a decision either way.
One of the most interesting facts about EBM is that it itself fails its own test! The process of EBP has not been rigorously tested according to its own standards, so we do not know for certain if it actually results in improved health. (Straus & McAlister 2000) This does not mean that EBP has been proven to be ineffective; it means, quite simply, we do not know enough to decide either way. "No evidence of effect is not the same as evidence of no effect." (Tarnow-Mordi & Healy 1999)
When the standards of EBM are applied to scoliosis brace treatment (Surgical rates after observation and bracing for adolescent idiopathic scoliosis: an evidence-based review, Dolan & Weinstein, Spine 2007), the conclusion is, "Comparing the pooled rates for these two interventions shows no clear advantage of either approach. Based on the evidence presented here, one cannot recommend one approach over the other to prevent the need for surgery in adolescent idiopathic scoliosis. This recommendation carries a grade of D, indicating that the use of bracing relative to observation is supported by 'troublingly inconsistent or inconclusive studies of any level.'"
When EBM is applied to surgery, "a medical indication for this treatment cannot be established in view of the lack of evidence." (Weiss & Goodall, Rate of complications in scoliosis surgery - a systematic review of the literature, Scoliosis 2008)
Interestingly enough, exercises have been shown to have the most evidence to support their use in the scoliosis treatment, yet there are no medical scoliosis centers in the United States that currently utilize these methods.
"A growing body of evidence from independent sources is consistent with the hypothesis that exercise-based approaches can be used effectively to reverse the signs and symptoms of spinal deformity and to prevent progression in children and adults." (The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature, Hawes 2003)
"Contrary to current dogma, the condition may be corrected with this therapy." (Mooney et al, Exercise for managing adolescent idiopathic scoliosis, Journal of Musculoskeletal Medicine, 2007, 6th Interdisciplinary World Congress on Low Back & Pelvic Pain)
"Results show that in literature there is proof of level 1b on exercises." (Negrini et al, Rehabilitation of adolescent idiopathic scoliosis: results of exercises and bracing from a series of clinical studies, Europa Medicophysica-SIMFER 2007 Award Winner, Eur J Phys Rehabil Med 2008)
On the topic of chiropractic and scoliosis, preliminary evidence appears to indicate that manual therapy alone (e.g., chiropractic adjustments performed in the absence of any other modalities) does not alter the natural history of scoliosis (Negrini et al, Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review, Scoliosis 2008). However, a growing body of case reports have reported positive results when manual therapy is combined with other rehabilitation approaches (Brooks 2009, Chen 2008, Brooks 2007, Morningstar 2004 & 2006). According to the standards of EBM, case reports and case series are considered level 3 evidence - above expert opinion, but below case-control studies, RCT's & systematic reviews. This places the level of evidence in support of the CLEAR Institute treatment approach as equal to the level of evidence in favor of bracing. All it will take is one well-conducted case-control study to place the level of evidence in favor of CLEAR above the level of evidence in favor of bracing(and believe me, I'm working overtime and donating all of my time to make that happen!).

Warm Regards,
Josh Woggon DC
Director of Research, CLEAR Institute
jwoggon@clear-institute.org

The case against surgical intervention for scoliosis in adolescent patients.

The case against surgical intervention for scoliosis in adolescent patients.

Scoliosis surgery in adolescent idiopathic scoliosis patients isn't medically necessary and has proven poor long-term outcomes. In fact, a 50 year follow up study showed the majority of untreated patients had a higher quality of life than scoliosis surgery patients just 16.9 years after the procedure. Not good.

We need a better way. Work is under way to develop a neuro-muscular rehab based scoliosis spine treatment that is out-performing every single scoliosis brace in existance and will eventually eliminate the "need" for scoliosis surgery in the future. The CLEAR Institute is leading the way and combined with the advent of genetic testing for scoliosis (Scoliscore) can actually start working towards a cure for the condition by eliminating environmental factors in patients with an elevated genetic predisposition.

Exciting new work in the field of eipgenetics is also providing promise of being able to "turn off" active scoliosis genes that will hopefully result in reducing the elevated genetic predisposition for future generations.

Would current treatment even pass evidence based medicine standards?#post2857

Would current treatment even pass evidence based medicine standards?#post2857

Scoliosis brace treatment has been around since the dawn of man and the first scoliosis surgery was performed in 1865, so both treatments pre-date the era of "Evidence Based Medicine". Which makes one wonder, based on the current research data for bracing and surgery, would they even pass the basic standards of care for scoliosis treatment today?

Scoliosis surgery is an elective cosmetic procedure

Scoliosis surgery is an elective cosmetic procedure?

Current research suggests scoliosis surgery isn't medically necessary.

We need a better way for scoliosis spine treatment.......

We need a better way for scoliosis spine treatment....... The current treatment system is too broken and too obselete to fix....It needs to be replaced.

Is a scoliosis brace emotionally scarring?

Is a scoliosis brace emotionally scarring?

Scoliosis Surgery: Trading deformity for dysfunction?

Scoliosis Surgery: Trading deformity for dysfunction?

Scoliosis of spine treatment: Where are we now and where are we going?

 There is very little doubt that it is possible (or needed) to reduce the need for surgery in the  scoliosis spine treatment.

It also should not and  cannot be argued against that there is a need for the advancement of research into manners by which a mild scoliosis can be prevented from progressing into a serious spinal deformity.

If the current stardard of treatment attempts (bracing and surgery) were successful and effective ways of treating scoliosis, there would not be a need for advancement into new treatment methods.  Necessity is the mother of all invention.  Also, there is increased need for physicians of all specialties to collaborate in the realm of scoliosis treatment.

Many scoliosis doctors part fulfilling these needs by attending conferences of international scoliosis experts (SOSORT), working with recognized scoliosis specialists in all fields of healthcare, participating in debates about the future of scoliosis treatment, and providing more options to people living with scoliosis.  More collaboration among the best, brightest, and most motivated physicians needed now more than ever.

Here is a "state of the union address" of the current standard of  care for scoliosis treatment.....

~ The current system of scoliosis detection, evaluation, early intervention, treatment protocols, and treatment methods need to be completely re-invented. The current system is too patch-worked and broken to be fixed......It needs to be replaced.......and here is how and why.

~ "The too late test" (the bending over and looking for rib cage asymmetry test) isn't sensitive enough to detect scoliosis in its early stages....it is usually referred to as Adam's positions in the medical books.
~ Cobb's angle was developed in 1948 and is a completely obsolete system of analysis.  It is nothing more than a measurement of lateral bending in the spine, which is one of the least important treatment outcomes of scoliosis treatment.  Attempting to describe a condition as complex as scoliosis purely by the means radiographic lateral flexion is the equivalent to attempting to describe all the features of your new luxury car by only its color. I feel that the continued use of cobb's angle as the sole system of idiopathic scoliosis analysis in the United States is the single greatest obstacle blocking further understanding of the true nature of scoliosis. There is so much more to this condition than just a cobb angle.

~ The current treatment schedule for scoliosis (10 degree diagnosis, 25 degree bracing, 40 degree surgery) is obselete. It was accepted entirely on one article in 1977, by one doctor who openly admits the numbers are arbitrary. It is not based off science or the patient's best interests.

~ "Watch and wait" (Observation) is not scoliosis treatment.....it is simply doing nothing and hoping the problem doesn't get worse (denile isn't just a river in Africa you know)....an aggressive, non-invasive early stage scoliosis intervention program should be employed during this time. An adolescent child's best hope of beating scoliosis is reduction and stabilization of the curvature while it is still flexible and before it gets a biomechanical advantage.  Any medical professional whom doesn't instill a frank sense of urgency in a parent's mind when their child is diagnosed with scoliosis is doing them a dis-service.

~ Scoliosis brace treatment should be discontinued. It has no clinical value and only serves to psychologically scar our children whom already have enough hurdles to overcome.  Newer research now suggests that long-term spinal immobilization from bracing may actually increase the amount of permanent spinal deformity.

~ Scoliosis surgery has been proven and accepted to provide NO clinical value to the patient in terms of organic health measures (pulmonary function, cardiac output, elimination of pain, ect). The research on this is clear, the vast majority of orthopedic doctors agree on the subject, and may patients assume it is "medically necessary" and don't even ask. Given the high rate of complications, long recovery, and poor long-term outcomes. I feel asking a desperate parent and/or patient to trade deformity for dysfunction is unfair.

Now here is the good news.....

We are entering a golden age in Adolescent Idiopathic Scoliosis (AIS) treatment, yet most people and doctors don't see it yet.

The development of new prognostic technologies like the Scoliscore genetic testing and the much anticipated Scoliosis blood test are going to be a significant boosts to the field of scoliosis treatment, but only if we scurry to close the ever growing divide between the rapid advanacement of prognositic scoliosis technology and treatment protocols that are able to take advantage of the opportunity this technology creates.  The new mantra of scoliosis treatment will be....."stay ahead of the curve".

Bracing is intended to halt the progression of spinal curvatures (which research is showing it doesn't really do anyway), not prevent them, or reduce them. It is not, and will not take advantage of the prognostic technology currently being developed and will gradually be phased out due in favor of pro-active, rehab based treatment approaches.

Scoliosis surgery is never the preferred treatment choice due to the invasive nature of the procedure and poor long-term outcomes.  Recent research on spinal fusions in younger patients are showing very poor long term results. Preventative spinal fusion for scoliosis should not, become the path paved by scoliosis prognostic technology.

So what technologies are currently being developed for AIS that will allow us to close the gap between prognostic tests that tell us the worse is coming?

A general picture of adolescent idiopathic scoliosis is emerging and it seems to be breaking down into a multi-factorial equation that looks something like this.

Genetic pre-disposition + Environmental Factors = Adolscent Idiopathic Scoliosis (AIS)

Therefore.... the only possible way and treatment technology that could take full advantage of the new AIS prognostic testing abilities would be one that focuses on the reduction/elimination of the Evironmental Factors (Bio-mechanical, Bio-Chemical, and Activity related) that co-create the condition.

In the future, Early Stage Scoliosis Intervention will be defined as a partnership btw prognostic testing technologies and "pro-active", environmental factor reducing treatment approaches while "after-the-fact" treatment approaches like bracing and surgery will disappear into the past.

The CLEAR Institute approach to scoliosis treatment is currently the only scoliosis treatment attempting to alter the natural course of the condition and prevent scoliosis through environmental factor reduction.

Treat the cause, NOT just the curve.

Scoliosis spine treatment: Don't let a lifetime be defined by scoliosis

1.    

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

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

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

Observation Only or the “watch & wait” stage
Once an individual has been diagnosed with scoliosis, no treatment is initially prescribed, and no action is immediately taken, until the Cobb angle has progressed to 25 degrees.  At this point, bracing is typically prescribed. This period, which is termed "watch & wait," consists only of regular visits to an orthopedic.

Scoliosis brace treatment (Generally recommended for curvatures 25 degrees and larger)
If there ever was a time when a patient could benefit most greatly from chiropractic, therapeutic exercise, or non-surgical intervention, it would undoubtedly be during the mild stages of the disease - before the muscles & tissues of the body have been deformed by months or even years of compensating for the abnormal twisting & bending of the spine.
Bracing dates back to approximately 650 AD, when Paul of Aegina suggested bandaging scoliosis patients with wooden strips. The first metal brace was developed by Ambroise Pare in the 16th century. Today, there is a bewildering assortment of braces in use, ranging from the venerable and bulky Milwaukee brace, to the traditional TLSO braces such as the Boston and the Wilmington brace. There are "part-time" braces, designed to be worn at night: the Providence brace, and the Charleston brace. There are also "dynamic corrective braces" (SpinCor) which may use soft, elastic materials and claim to be able to do more than simply stabilize the progression of scoliosis.

This dizzying variety is further complicated by the fact that not every doctor prescribes the braces to be used in the same manner, and not every patient may follow their doctor's recommendations to the same extent. As a result, research is often conflicting in regard to the true effectiveness of bracing in scoliosis treatment. Some studies have shown very little difference between patients who wore the brace for the prescribed time.  In every case, all corrective benefit is lost very quickly once the patient stops wearing the brace.

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