Scoliosis is a complex condition that's progressive in nature, making how it's responded to, in terms of treatment, particularly important. There are different scoliosis treatment methods that offer patients different potential outcomes, both surgical and nonsurgical treatment options.
The best scoliosis treatment impacts the condition, first and foremost, on a structural level. There are two main scoliosis treatment options: traditional and conservative. The former tends to funnel patients towards spinal fusion, while the latter offers a proactive nonsurgical response.
When it comes to treating scoliosis, the chosen treatment approach has far-reaching consequences, so I want patients, and their families, to be aware of all treatment options available to them.
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Scoliosis is a highly-prevalent spinal condition; according to the Scoliosis Research Society, current estimates put between 6 and 9 million people currently living with scoliosis in the United States alone.
In addition, scoliosis is the leading spinal condition among school-aged children.
Scoliosis is the development of an unnatural sideways spinal curve, with rotation, and a minimum Cobb angle of 10 degrees.
A patient's Cobb angle is taken during X-ray and tells me how far out of alignment an unnatural spinal curvature has forced the spine, and also classifies conditions in terms of severity:
As you can see from the wide range of Cobb angle measurements, scoliosis is a highly-variable condition, and in addition to ranging from mild to very severe, there are also different condition types a person can develop.
The most prevalent form of scoliosis is adolescent idiopathic scoliosis (AIS), diagnosed between the ages of 10 and 18, and idiopathic scoliosis is also the most common form to affect adults.
The idiopathic classification means not clearly associated with a single causative source; instead, it's thought to be multifactorial.
Approximately 80 percent of known diagnosed cases of scoliosis are classified as idiopathic, and the remaining 20 percent consists of types associated with known causes: neuromuscular scoliosis, congenital scoliosis, degenerative scoliosis, and traumatic scoliosis.
Part of the diagnostic process involves comprehensive assessment to further classify conditions based on key patient/condition variables, and these variables shape the design of effective treatment plans: patient age, curvature location, condition type (cause), and severity.
Patient age is important because it indicates whether a patient is likely to find their condition painful, and also tells me whether they are at risk for rapid-phase progression or not.
There are three main spinal sections, cervical, thoracic, and lumbar, and scoliosis can develop in any, but is most common in the thoracic spine; curvature location tells me where to concentrate my treatment efforts.
As mentioned, there are two main scoliosis treatment approaches for patients to choose between, traditional and conservative, so let's take a look at the main differences between the two.
Traditional scoliosis treatment has been in place for many years, but despite our growing understanding of the condition, it has changed little over those years.
Traditional scoliosis treatment is more reactive than proactive and offers a surgical treatment response.
Traditional treatment doesn't have a strategy for treating scoliosis while mild, and remember, as a progressive condition, scoliosis has it in its very nature to worsen over time, particularly if left untreated, or not treated proactively.
For patients with mild scoliosis on the path of traditional treatment, they are commonly told to simply watch and wait for signs of continued progression, and this monitoring is done through periodic assessments that check a patient's Cobb angle.
Periodic assessment intervals can range from every 3, 6, or even every 12 months (depending on the treatment provider).
While we don't fully understand what causes idiopathic scoliosis, we know how to treat it, and we know what triggers its progression: growth and development.
Remember, adolescent idiopathic scoliosis is the most prevalent form, and adolescents are at risk for rapid-phase progression because of the stage of puberty they are in, or are entering into.
So what happens if an adolescent with mild scoliosis is told to return for assessment in 3 months, during which time, they have a significant growth spurt that triggers significant progression?
Now, the condition is more complex to treat; while there are no treatment guarantees, with early intervention, there are fewer limits to what we can achieve.
Had proactive treatment been applied when the patient was first diagnosed, that progression might never have occurred, and valuable treatment time might not have been wasted.
Smaller curves are simpler to treat, more flexible and responsive to treatment, and it's best to start treatment before the body has had ample time to adjust to the unnatural spinal curve's presence.
Traditional treatment only applies bracing as actual treatment, prior to recommending spinal fusion when a patient crosses the surgical-level threshold at 40+ degrees and shows signs of continued progression.
Traditional bracing has also changed little over the years, and is associated with a number of shortfalls, mainly related to it only addressing the condition as 2-dimensional, and ignoring its rotational component.
Once a patient becomes a surgical candidate, spinal surgery is often presented as the best treatment option, but spinal fusion comes with a number of serious potential side effects, risks, and complications.
Many patients are also disappointed with the loss of spinal flexibility and range of motion they experience post-surgery; fortunately, there is a nonsurgical treatment option that preserves as much of the spine's natural function as possible.
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Conservative scoliosis treatment is also known as chiropractic treatment and/or functional treatment because preserving spinal function is a focus of treatment.
Here at the Scoliosis Reduction Center, I use a conservative treatment approach that integrates multiple condition-specific treatment disciplines so conditions are impacted on every level.
I believe in starting proactive treatment as close to the time of diagnosis as possible; this is to prevent increasing condition severity, escalating symptoms, and the need for invasive surgical intervention in the future.
As a progressive condition, where scoliosis is at the time of diagnosis is not indicative of where it will stay. Even mild scoliosis can progress and become moderate, severe, or very severe; only proactive treatment can counteract the condition's progressive nature.
Here at the Center, as a structural condition, I want to impact it on a structural level, first and foremost, and once I see structural results, I can shift the focus to increasing core strength so the spine's optimally supported by its surrounding muscles.
Through a series of chiropractic adjustments and techniques, I can work towards adjusting the position of the curve's most-tilted vertebrae, at its apex, back into alignment with the rest of the spine: addressing the condition's underlying structural nature,
I use a variety of different physical therapy methods and scoliosis exercises to impact the abdominal and back muscles so the spine is receiving optimal support, as well as addressing muscle pain and imbalance.
In addition, scoliosis-specific exercise treatment has been known to activate certain areas of the brain for improved brain-body communication, postural remodeling, and better body positioning.
To help augment corrective results achieved through other treatment disciplines, I apply ultra-corrective bracing, like the ScoliBrace, to push the spine into a corrective position, and modern corrective bracing represents the culmination of what we've learned about the condition, and bracing efficacy, over the years.
I also prescribe a series of custom scoliosis-specific exercises to help patients establish a home-rehabilitation program for further spinal stabilization and long-term sustainable results.
I want to spare patients the hardships associated with progression, increasing symptoms, and spinal surgery.
When it comes to treating an unnatural curvature of the spine, there are both surgical and nonsurgical treatment options for patients to consider.
While spinal fusion can help straighten a crooked spine, it can do so at the cost of the spine's overall strength, flexibility, function, and health, so for those choosing to forgo a surgical recommendation, there is an effective conservative nonoperative treatment option to consider.
Patients of the Center receive conservative treatment that combines multiple condition-specific treatment modalities and benefit from accessing multiple treatment disciplines under one roof.
I recommend that patients choose chiropractic treatment and use physical therapy, corrective bracing, and rehabilitation to impact the condition on a structural level and increase spinal support by strengthening abdominal muscles.
So when it comes to effective treatment for scoliosis curves, there are both surgical and nonsurgical options for patients, and their families, to consider, and patients need to be aware of the differences between the two, particularly in how they can affect spinal health and function.
