16 Jul Understanding Scoliosis and Goals of Care
Scoliosis is more than a crooked spine on a set of x-rays. Each patient is a person, with a life and a family that has supported them on their search for help. The disease of scoliosis has a way of emotionally and/or physically victimizing each patient. Scoliosis is a disease that affects the patient physically, emotionally, and mentally, as well as placing enormous emotional strain on the family as a whole.
Scoliosis is defined by a one dimensional measurement on x-ray called a Cobb angle. A measurement of 10 degrees or higher is classified as scoliosis. The current medical model is observation between 10 and 25 degrees x-ray every 4-6 months with the hope it does not get worse. Like most problems in our lives when you ignore them they get worse. Once the scoliosis is 25 degrees a rigid brace with the primary goal only to stabilize the progression is prescribed. It is usually worn 23 hours a day. Once the scoliosis has reached 40 degrees the recommendation for scoliosis surgery is recommended.
The current model does not always take into consideration: symptoms, function, and structure when making the clinical decisions for deciding treatments. Scoliosis surgery- like all surgeries should be the last option with a goal to improve the health of the patient. A 2013 scoliosis study in a highly respectable research journal concluded that scoliosis surgery was mostly a cosmetic procedure and had minimal improvement on health factors. “Surgeons and patients should be aware of the limited evidence for improvements in domains other than self-image after surgery.”
What is the effect of surgery on the quality of life of the adolescent with adolescent idiopathic scoliosis? A review and statistical analysis of the literature
Scoliosis is more than a Cobb angle. Scoliosis is a disease of the neuromuscular skeletal system. It is not a bone condition. It is a 3 dimensional, abnormal spinal position composed of compression, translation, lateral flexion, and rotation.The quantification of the condition based on one radiographic measurement describing one dimension of the spine and to select a procedure as invasive as spinal surgery does not make logical sense.
Approximately 80% of scoliosis cases are defined as idiopathic which means unknown cause. The unique thing about most idiopathic scoliosis cases is the spinal structure is not abnormal. The bones are not abnormally shaped. The system in charge of keeping the spine upright and straight relative to gravity is malfunctioning.
Idiopathic scoliosis in a nutshell is the brain misinterpretation of the body relative to gravity. It is holding the spine in an abnormal position but does not realize it. The origin of the condition appears to be not in the spine but in the brain. Posture and spinal position is controlled by the brain through involuntary postural reflexes. This is the reason you cannot correct your posture by just standing up straight. When you stop thinking about it you go right back to your original abnormal posture.
The truth about bracing as a treatment for scoliosis is that bracing will not correct scoliosis. Braced or not, there is little difference in the end result. Many patients who wear a brace continue to get worse. Some cases are more genetically inclined to progress.
Scoliosis can continue to get worse even after spinal fusion. Research studies have found over 20% of patients require more than one operation and 40% of patients are legally disabled 16 years after the procedure. Surgery does not cure the disease of scoliosis, but rather replaces one deformity (a flexible, curved spine) with another (a straighter, fused rigid spine).
The goal of our care is to help the patient improve symptomatically, functionally and structurally and provide the patient with tools to combat their condition with less dependence on doctors.
The focus of our scoliosis treatment program is reduction and stabilization of the scoliosis without bracing or surgery. The goal of our Scoliosis treatments’ is to rehabilitate the neuromuscular system which controls posture and spinal position. This program can restore hope, strength, and spirit.
Call Today to schedule your complimentary case overview and detailed explanation of the treatment.
Best in health,
Dr. Mark N. Berry, D.C.
Dr. Rodolfo Alfonso, D.C.
Sunset Chiropractic & Wellness
8585 Sunset Dr.
Miami, FL 33143