Questions and Answers about Scoliosis in Rogers AR
Q: What causes Scoliosis?
To answer this question we must first explain the biomechanics of the human spine. Normally the human spine, when looking from the front, should be straight. However, when you look at it from the side there should be three normal curves; a front curve (lordosis) in the neck and low back and a reversed curve (kyphosis) in the mid back. These curves give the spine strength, stability, and flexibility. These are biomechanical structures that make the spine so as adaptable as it is. The curves also allow the spinal cord (which is encased in the spine) to fit comfortably. When these curves are lost, tension is put on the spinal cord resulting into a variety of symptoms. The most common symptom is neck and back pain due to the pressure that is placed on the spinal cord and associated nerve roots.
A scoliosis is a spine that has lost the normal biomechanical curves. The lateral curves that are developed are compensating for the loss of the normal curves of the spine. These curves also take pressure off of the spinal cord and associated nerve roots. The loss of curves normally begins at the neck. When this occurs the normal forward curve (lordosis) eventually will result into a loss of curve (hypolordosis) or complete reversal of the forward curve (kyphosis) and will result in an increase of the forward head posture. The loss of curve in the neck will also result into buckling of the spine and eventual loss of the remaining curves. The end result is a scoliosis that will continue to progress until proper biomechanics are introduced to the spine. Like a basket full of organges, in order to put apples in this basket you must first take out some of the oranges. There is only so much room for the spine. By creating the normal curves, the abnormal curves will have a place to go.
Q. Why the need for early stage scoliosis intervention?
Scoliosis is a progressive disease and when left untreated a scoliosis can progress to a point where severe symptoms can affect the patient’s life. One study suggests that if a scoliosis is left untreated it can reduce the life expectancy as much as 14 years! (J bone surg am 1981 Jun; 63(5): 702-712). According to emedicine.com, scoliosis when left untreated can produce cosmetic deformities, pain, headaches, digestive problems, low back and leg pain, as well as severe restriction to the patient’s capacity to work. With curves that are larger than 60°, cardiovascular compromise is very common. The mainstream model of scoliosis care gives you the option of observation, bracing and eventually surgery. The methods available are either lacking in results, invasive, leave the patient with long-term pain or impairment or all of the above. The best treatment is early stage scoliosis intervention. This form of care is painless and can prevent you or your loved one from care that is unnecessary treatments. After all, we want you to know there is hope!
Q. My medical doctor said my scoliosis is small, should I get treatment?
The loss of sagittal curves are a progressive system. As the loss of the normal, sagittal curves begins, gravity and repetitive poor postures will further this process. As this occurs, more and more tension is put on the spinal cord. This will result in buckling of the spine and inducing the abnormal, lateral curves. Once a curve to the side exists in a spine, the weight of the body segments superior to that curve in upright positions of the upper torso creates a lateral bending moment that tends to increase or drive further progression. (Ruber, et al. Trunk Muscle myoelctric activities in idiopathic scoliosis. Spine 8:447-456, 1983). The greatest predictor of long-term curve progression is the initial cobb magnitude. (Tan KJ, et al. Curve progression in idiopathic scoliosis/ follow-up study to skeletal maturity. Spine 2009 Apr 1; 34(7): 687-700). After all the easiest way to manage a scoliosis is managing it while during its early stages before the scoliosis has a chance to progress.
Q. What are the risks my scoliosis will progress?
Even mild cases of scoliosis (20° and below) have a risk of progression as much as 22%. Curves that are allowed to go above 20° have an elevated risk of progression of 68%. When a scoliosis reaches 30° or more the risk of progression is more than certain as this risk factor can reach as high as 90%. Managing a scoliosis before it has the chance to reach to reach 25° has the best possible outcome as we are able to help develop stability within an unstable spine. However if a scoliosis has reached above 25° there is still a good prognosis for advanced cases of scoliosis.
Q. I am an adult, will my scoliosis continue to progress?
Even after skeletal maturity, scoliosis will continue to progress in the later years of adult hood. This is more true when the scoliosis has reached 30° (Bollini G, et al. Idiopathic Scoliosis: Evaluation of the results. Bull Acad Natl med. 1999; 183(4): 747-767). Adults have been successfully treated without braces or surgery.
Q. Why are pre and post X-rays necessary and are they safe?
X-rays are necessary as they allow the doctor to measure as well as quantify the results of your treatment. While each scoliosis patient may have similar curves they differ just as much as having a finger print. While they appear similar the small details make all the difference. This is more true in scoliosis as treatment protocols may require alterations with the data gathered from the precision X-rays.
In regards to X-ray safety, a study published in August of 2000 studied the outcome of radiographic exposure of children with significantly increased their risk of radiation induced carcinogenesis or hereditary defects. A retrospective study between 1980-1993 at the Shriners Hospital in Spokane, WA looked at the total radiation in children with idiopathic scoliosis, hip dysplasia or leg-length discrepancy. The group’s risks for developing leukemia, breast cancer or a heritable defect, respectively, were .8%, 2.1% and 3.0% higher than baseline risks. The use of serial radiographs during the treatment of idiopathic scoliosis appears relatively safe and the increased risk of carcinogenesis or hereditary defects in these patients are minimal (Bone CM, Hsieh GH. The risk of carcinogenesis from radiographs to pediatric orthopaedic patients. J Pediatr Orthop. 2000; 20(2):251-4).
When taking a precision x-ray - that is, one not to rule out fractures or abnormalities, but rather to measure the position of the spinal units - positioning matters more than one might think. Even a slight rotation off from center will skew the results and show an inaccurate image. For this reason, we must be very concerned about how the x-rays were taken. They must allow an objective outcome assessment. X-rays from other sources oftentimes can be unreliable if they are shot at different angles or focal distances, which prevent comparison between films.
Q. What makes our treatment different than other alternative treatments?
Traditional medical science views the spine as a bridge connecting the head to the pelvis. If a bridge begins to collapse, the correct approach is to try to hold it together by fusing its structure. Chiropractors, however, view the spine as an engine. If the engine in your car starts to run funny, and you fuse the cylinders together, this might not solve the problem. Motion is essential for proper functioning of the spine and the associated soft tissue components. The reason your spine buckles as the curve in your neck disappears has to do with physics. When you carry your groceries in to your house from your car, you carry the bags close to your body. Increasing the distance between your body and the bags of groceries causes an increase in the apparent weight of your burden. In the same way, holding your head forward puts a greater stress upon your spine. In fact, for every inch the head moves forward from your center of gravity, the apparent weight of your head increases by 10 pounds!One of the easiest ways for the body to adapt to this increased load is to add another curve into the spine. If you are holding a heavy weight in your hand and flex your wrist forward, your elbow will swing out to the side to make it easier for your muscles to support the weight. With our alternative scoliosis treatment, you can correct the scoliosis without bracing!
There are different reasons why the curve in the neck disappears. Sometimes it is a motor vehicle crash, or an incident of trauma. More often, however, it may develop slowly, over time, as we live day-to-day. Studying in school, working at a computer, or focusing on a project on our workbench often requires that we hold our head downwards and forwards for long periods of time. Eventually, this causes the spine to slip, bit by bit, until the muscles become tight and strong. The body then begins to use these stronger muscles more than the weaker ones, reinforcing the change in posture. With the loss of the curve in your neck, the nerves that travel from the brain to every single cell in our body begin to suffer.
In order to make you better we must fix the problem. Not make the current problem worse. By correcting the biomechanical deficiencies correcting a scoliosis can be done without the need of orthopedic braces or surgery.
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