Every case of scoliosis is unique, with each patient producing their own unique set of symptoms and condition characteristics, which is why effective scoliosis treatment has to be highly specific and customized. It’s important for patients, and their families, to fully understand all the treatment options available to them so they can make an informed decision and aren’t funneled in a certain direction.
Different scoliosis treatment approaches offer patients different potential outcomes. There are two main scoliosis treatment approaches: conservative and traditional. The former is chiropractic-centered and strives to avoid surgery, while the latter can funnel patients towards a spinal-fusion recommendation.
To fully understand the different potential treatment outcomes, let’s start by exploring the two main approaches to scoliosis treatment.
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The treatment approach I offer patients of the Scoliosis Reduction Center can go by different names: conservative, chiropractic centered, and/or functional.
This approach applies proactive treatment as close to the time of diagnosis as possible. As we know that scoliosis is progressive, meaning it’s in its nature to worsen over time, without proactive treatment, an abnormal spinal curvature that could have been treated and addressed early on, can progress unimpeded, leading to increased symptoms and the need for more-invasive forms of treatment.
Here at the Center, I don’t believe in watching and waiting to see if a progressive condition is going to progress; to me, this is wasting valuable treatment time.
After all, there is no harm in working towards reducing a mild curve to smaller, but there is harm associated with letting an abnormal spinal curvature increase in size and become more severe.
While early detection and proactive treatment can’t guarantee treatment success (nothing can do that), it most certainly increases the chances of a positive outcome.
Diagnosing and treating an abnormal spinal curvature while it is still small means it has not yet experienced significant progression, has more spinal flexibility (progression can make the spine rigid and inflexible), and the body has not had ample time to adjust to its presence.
Particularly in the condition’s most-prevalent form, adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18, being proactive is a key component of treatment efficacy.
AIS patients are at risk for rapid-phase progression; this is because growth is the condition’s number-one progressive trigger, and we know that adolescents are entering into, or are in, the stage of puberty characterized by rapid and unpredictable growth spurts.
With any patient that carries a high risk of progression, staying ahead of that condition’s progressive line is crucial in order to counteract its tendency to worsen over time, at varying rates.
While providing the spine with optimal support, stabilization, and working towards a curvature reduction on a structural level is always a priority, in AIS patients with high progressive rates, sometimes treatment focuses on holding their scoliotic curves where they are throughout puberty, and once skeletal maturity has been reached and the big trigger for progression is removed, working more intensely towards a significant curvature reduction.
The point is, every case is different and depending on patient age, condition type, severity, and curvature location, treatment plans have to be crafted and customized in a way that addresses each of these important and patient-specific variables.
Here at the Center, I use multiple scoliosis-specific treatment disciplines to achieve the best possible results as the very nature of the condition necessitates a customized and integrative approach: chiropractic care, in-office therapy, custom-prescribed home exercises, and super-corrective bracing.
It’s important to understand that a conservative chiropractic-centered approach applies a more natural form of treatment that addresses the condition’s true 3-dimensional nature for corrective results.
After all, scoliosis isn’t just an abnormal sideways spinal curvature of a certain degree, it also has a rotational component, meaning the curve doesn’t just bend from side to side, but also twists from front to back.
If a treatment plan doesn’t account for the condition’s rotational component and only addresses the curvature on 2 dimensions, its efficacy is limited; here at the Center, I address and treat the condition’s underlying structural nature in all dimensions for corrective results.
Now that we have discussed the approach I offer patients of the Scoliosis Reduction Center, let’s move onto the traditional approach to scoliosis treatment, and how they differ.
Under the umbrella of traditional treatment for scoliosis, patients diagnosed with mild scoliosis are often told to watch and wait; this means monitoring for progression by returning to the doctor for periodic exams and X-rays.
The length of intervals between check ups will depend on the doctor, but tend to range from every 3, 6, or even 12 months. As mentioned, in AIS, rapid and unpredictable growth spurts are common, so what happens if between checkups, a patient has a huge growth spurt and progresses significantly?
What this means is the condition has been allowed to progress unimpeded, with no proactive treatment efforts having been made to counteract the condition’s progressive nature.
This also means that more invasive treatment is now needed to impact the curvature, whereas had proactive treatment been applied earlier, the condition might not have progressed to that point.
The end goal of traditional scoliosis treatment is not correction, but stopping progression, and while controlling progression is an important aspect of any effective treatment plan, it’s different from having it as the primary goal of treatment.
In the conservative approach, working towards a curvature reduction on a structural level and providing the spine with optimal support and stabilization means that correction is the primary goal of treatment.
In traditional treatment, it’s not until a condition has progressed into the moderate severity classification that any form of treatment is actually applied, in the form of traditional scoliosis bracing.
If traditional scoliosis bracing proves ineffective at stopping/slowing progression and a patient continues to progress into the severe and very-severe classification, spinal-fusion surgery is commonly recommended as the best option.
Before moving on to discuss spinal fusion as a treatment option for scoliosis, let’s first talk about scoliosis bracing as a facet of scoliosis treatment.
As mentioned, different scoliosis treatment approaches offer different potential results, and this is driven by their end goals and how treatment is applied.
Bracing as a scoliosis treatment option has been in place since the condition’s early days, but not all braces are created equal, and different braces, just like different treatment approaches, produce different results.
In a modern, conservative, and chiropractic-centered approach, the modern corrective ScoliBrace is commonly the brace of choice for achieving corrective results; in a traditional approach, a traditional brace, such as the Boston brace, is the most commonly used type of brace.
So what’s the difference? The modern ScoliBrace works towards corrective results, while the Boston brace has stopping/slowing progression as its treatment goal, and stopping a condition from getting worse is not the same as working towards corrective results on a structural level.
One of the biggest differences in brace efficacy is how they are designed. The ScoliBrace is designed in a way that addresses the condition’s 3-dimensional nature, so it works by impacting the spine on all dimensions, whereas the Boston only addresses the spine in 2 dimensions, which limits its efficacy, and has little effect on reducing the abnormal spinal curvature.
In addition, the way these braces work towards reaching their end goals can impact the spine very differently.
The ScoliBrace works by pushing the spine into a corrective position via its over-corrective design that works towards positioning the spine in an opposite mirror image of the scoliotic curve.
In many cases, repositioning the spine in this manner works to reduce the abnormal spinal curve and improves condition-related postural deviation such as uneven shoulders, rib arches, and the body’s overall symmetry.
In addition to addressing the condition’s true 3-dimensional nature and pushing the spine into a corrective position, the way it’s designed and customized to fit each patient is another important variable that increases its efficacy.
As a modern over-corrective brace, the ScoliBrace represents the culmination of what we have learned about bracing as a scoliosis treatment option, plus the condition itself, over the years. One of the important findings is that regardless of how effective a brace can be, if it’s not worn properly as prescribed, it becomes ineffective.
Traditional braces are not custom-fitted to the same extent that modern braces are. While fitting the Boston does involve taking some measurements for the best possible fit, these traditional braces are mass-produced and better suited to a certain body type.
The result is that many patients have found the Boston brace to be uncomfortable, bulky, difficult to get on and off, and embarrassing to wear, especially to adolescents who represent the main age group diagnosed with the condition.
The ScoliBrace acknowledged and addressed the compliance challenge with scoliosis bracing by using state-of-the-art imaging software (BraceScan), X-rays images and postural photos to ensure that every brace is bespoke to its wearer.
As the ScoliBrace is designed to be integrated more comfortably into patients’ lives, patients are more likely to wear it as prescribed, and when part of a proactive treatment plan combining corrective bracing with other effective scoliosis-specific treatment disciplines, the ScoliBrace can help reduce curvatures, pain, improve posture, and the body’s overall aesthetic appearance.
Not only can compliance be an issue with the Boston brace, it’s important for patients to understand that even in the best-case scenarios where the brace stops or slows progression, but the way that result is achieved can also impact the spine’s overall health and function.
As the Boston brace only treats the condition as 2-dimensional, it works towards its goal of controlling progression by squeezing the spine from the sides using strategically-placed pads known as a three-point pressure system; however, squeezing the spine in this manner for long periods of time (the Boston is commonly prescribed for full-time wear) can lead to a weaker spine, weaker muscles surrounding the spine, meaning less spinal support, and can cause an increase in condition-related postural deviation such as exaggerated rib arches.
Patients who have worn the Boston brace have also experienced additional issues with:
The bottom line is that while the Boston brace can impact scoliosis in terms of controlling its progression, it has little ability to actually correct an abnormal spinal curvature.
In addition, the way it works by squeezing the spine from the sides can lead to other issues that can make compliance a challenge, limit its effectiveness, and lead to a weaker and less-functional spine.
Now that we have addressed the main differences between modern and traditional scoliosis braces as a scoliosis treatment option, let’s talk about spinal fusion as a form of scoliosis treatment.
Commonly referred to as scoliosis surgery, the actual procedure is called spinal fusion, and it involves fusing the most-tilted vertebrae (bones of the spine) at the apex of the curvature into one solid bone to eliminate further progression; what that also does, however, is eliminate movement in the fused section of the spine.
While there are different types of spinal fusion, generally, a fused spine is held in place by rods that are attached to the spine with screws.
Now, depending on the location of the curvature, and how many vertebrae are involved, this can lead to a significant decrease in spinal flexibility: a result that many patients are disappointed with.
In addition, spinal fusion is a costly, lengthy, and invasive procedure, and once a spine is fused, there is no un-fusing it, and if the surgery is unsuccessful, there is no recourse other than subsequent surgeries.
While every surgical procedure comes with its share of potential risks and side effects, for spinal fusion, the list can include nerve damage, adverse reaction to the hardware used, infection, blood loss, and more.
In addition, living with a fused spine can also come with its share of challenges including mobility restrictions, risk of hardware failure, and increased pain post-surgery. Many patients also talk about the psychological effects of living with a fused spine and being fearful of taking part in certain activities that used to give them pleasure, and the fear of trying new things due to living with a fused spine that’s more prone to injury.
There is also a gap in the research on the long-term effects of living with a fused spine and the longevity of hardware used 10, 20, 30+ years down the road.
So in a best-case scenario where spinal fusion is successful in terms of stopping further progression, which it can be, what type of cost does that form of treatment come with? For some, the cost is high: impacting mobility, spinal function, and overall quality of life.
Thankfully, there are more scoliosis treatment options available than ever before, but in order for patients to benefit from these modern approaches to scoliosis treatment, they have to be aware of how they are applied and what they offer.
The bottom line is that whether a conservative or traditional approach is chosen, doctors and surgeons have their patients’ best interests at heart, but no treatment results can ever be guaranteed, and when it comes to deciding what a patient’s best option is, knowledge is power.
With multiple treatment options available that offer such different outcomes, patients have to advocate for themselves in ensuring they have explored, and fully understood, how different treatment options are applied, the approach they are using, and their potential outcomes.
Here at the Scoliosis Reduction Center, managing progression is an important component of our treatment plans, but it’s not our end goal: achieving a curvature reduction and providing the spine with optimal support and stabilization is. Once those things are achieved, progression is also impacted as the condition’s underlying 3-dimensional structural nature has been addressed.
As the spine’s natural curvatures give it added strength, flexibility, and facilitate its ability to evenly distribute mechanical stress, my goal is to return the scoliotic spine to as healthy and natural a state as possible, which is why conservative treatment strives to achieve corrective results without surgery; a spine that’s artificially held in place by rods and screws is not going to be as healthy and functional as a spine that has achieved a curvature reduction on a structural level through proactive treatment that simultaneously works on improving the spine’s support and stabilization.
While the traditional approach has been in place for hundreds of years, its end goal is not correction, but rather stopping progression, which can be a positive thing, but in order to truly achieve corrective treatment results, an approach has to address the condition’s 3-dimensional nature by treating the entire spine in all dimensions.
In addition, the traditional approach that can funnel patients towards scoliosis surgery involves a lot of passivity in terms of watching and waiting for a condition to progress, rather than starting proactive treatment as close to the time of diagnosis as possible; by doing so, many of the hardships associated with progressing in severity and the need for invasive treatment can be avoided.
As I want each and every patient to make the most informed decision possible when it comes to how to treat their scoliosis, I spend a lot of time explaining the pros and cons of the different treatment options with patients and their families.
For patients who want to try a more natural and less-invasive approach to scoliosis treatment, or have chosen to forego a surgical recommendation, there is another choice available, and the Scoliosis Reduction Center’s results speak for themselves.
