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Early Stage Scoliosis Intervention - Baltimore Sun talk forum
Here is a summation of my call to action
The current system of scoliosis detection, evaluation, early intervention, treatment schedule, and treatment methods need to be completely over-hauled from the ground up.
The current system is too patch-worked and broken to be fixed
..
It needs to be replaced .
Adams positions (the bending over and looking for rib cage asymmetry test) isnt sensitive enough to detect scoliosis in its early stages
..it is often referred to as the too late test.
The use of a $40 scoliometer would dramatically increase the accuracy and early stage detection of the condition, yet it is rarely used.
Cobbs angle was developed in 1948 by Dr.
Cobb (modest fellow) and is a completely obsolete system of analysis.
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 cobbs angle as the sole system of analysis 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 a scam.
It was accepted entirely on one article in 1977, by one doctor who openly admits the numbers are arbitrary and based on a cost based analysis to fit a particular healthcare system.
It is not based off science, and more importantly, not based off the patients best interests.
Observation only is not treatment
..it is simply doing nothing
..an aggressive, non-invasive early stage scoliosis intervention program should be employed during this time.
An adolescent childs best hope of beating scoliosis is reduction and stabilization of the curvature while it is still flexible and before it gets a biomechanical advantage.
Spinal bracing should be abolished.
It has no clinical value and only serves to psychologically scar our children whom already have enough hurdles to overcome.
Scoliosis is a 3 dimensional deformity of the spine and some of the latest CT in brace imaging indicates rigid bracing increases the rotation component
..especially the rib cage rotation.
Surgical intervention for scoliosis 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 dont even ask.
The orthopedic doctor should make this very clear when discussing the procedure, but they dont have an obligation to do so.
Every patient must be their own advocate
.and that goes for every healthcare procedure.
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 and borderline unethical.
Just my opinion and I know many of you will disagree.
You are free to do so.
Im not claiming a conspiracy theory in respect to the orthopedic community, but what real motivation would an orthopedic surgeon have to create a non-surgical solution?
Every doctor (even me) is bias towards their treatment option, but asking the orthopedic community to re-work the entire problem is likely to receive a disingenuous effort due to financial conflicts of interest alone.
Once again, I would like to apologize for hard feelings, anxiety, and anger I may cause in this post, but I still believe the ends justify the means.
I hope some of you can come to the realization that the current system of scoliosis treatment is broken and it needs to be fixed if we are truly going to offer a solution filled with hope to future scoliosis sufferers.
Most of you will dismiss all of this and move on with your lives
..a small number of you will not
.those for whom this has lit a passion and desire for change in your soul, please know that you are not alone.
We can unite and put forth one voice.
It all begins with the creation of an Early Stage Scoliosis Intervention program (aggressive, non-invasive active rehabilitation based treatment program for all spinal curvatures as soon as they are detected) is where it can and should all start.
I am confident it can and will significantly reduced the number of scoliosis patients whom reach the imaginary bracing, and therefore, surgical thresholds.
This is the form in which hope will take shape and change will take hold.
This is the only realistic hope for a cure in the foreseeable future in opinion.
www.fixscoliosis.com has an entire section dedicated to E-SMART (Early Stage Management Rehabilitative Treatment).
It is not a technique or treatment method.
It is a meeting place where all ideas and treatment methods are openly welcome for discussion.
Ideas are shared and debated.
Solutions are found and implemented.
It is where a revolution will be born and will take shape.
Please join us."
Revolutions are rarely televised, which is to say, occurring out in plain view.
They begin in chat rooms and support groups.
The people have the power to demand change, but they need to have the political will to do it first
.and that requires outrage
..where is the OUTRAGE
Demand better for these kids!
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My daughter was diagnosed at ~11 years old by the bend-over-and-look test at school.
She was recommended to an orthopedist.
He prescribed a brace, which she wore pretty much every waking moment when not in school or doing sports.
She wore it for ~2-3 years and has been perfectly happy, tall, and well adjusted for 7 years or so since.
It was a Godsend to have the screening done at school and to have a device like the brace.
We were very pleased.
YMMV.
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Quote: : My daughter was diagnosed at ~11 years old by the bend-over-and-look test at school.
She was recommended to an orthopedist.
He prescribed a brace, which she wore pretty much every waking moment when not in school or doing sports.
She wore it for ~2-3 years and has been perfectly happy, tall, and well adjusted for 7 years or so since.
It was a Godsend to have the screening done at school and to have a device like the brace.
We were very pleased.
YMMV.
Hi Frobby,
I am thrilled to hear your daughter's case turned out well, but the back brace probably had little or nothing to do with it she most likely just got lucky in terms of curve progression.
See the results of the 2007 study published in SPINE comparing bracing vs.
Observation (doing nothing) this included 18 separate studies!
A 2007 study published in SPINE by Drs.
Dolan and Weinstein concluded that observation only or bracing showed no clear advantage of either approach.
Furthermore one can not recommend one approach over another to prevent surgery.
They gave the recommendation for bracing a grade "D" relative to observation only because of "troublingly inconsistent or inconclusive studies on any level."
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Most ortho's tell patients that their spinal curvature won't progress once they reach skeletal maturity that is actually flat out incorrect and it has been incorrect for a long time.
The average curve progression post skeletal maturity averages 1-3 degrees a year.
While the rapid progression of curvatures generally only occurs pre-skeletal maturity and post menopause, it is a myth that scoliosis curvatures do not progress post skeletal maturity.
Early Stage Scoliosis Intervention still gives every scoliosis patient the best opportunity to treat their spinal curvatures now and for the future.
DON'T WAIT TO START TREATMENT!
Spinal bracing has no long-term effect and is no better than doing nothing.
The CLEAR Institute is a non-profit organization and the only one to offer an non-bracing early stage scoliosis intervention treatment option.
Natural History of Progressive Adult Scoliosis
Catherine Marty-Poumarat, MD;
Luciana Scattin, MD;
Michele Marpeau, MD;
Christian Garreau de Loubresse, MD;
Philippe Aegerter, MD, PhD
Spine.
2007;32(11):1227-1234.
©2007 Lippincott Williams & Wilkins
It has been known since 1969 that scoliosis can continue to progress during adulthood after skeletal maturity.
The study population consisted of 51 patients, 3 males and 48 females, with a mean age at the time of the first radiograph of 37 years (range 17-60) and at the time of the last radiograph of 64 years (range 44-80).
The mean duration of the natural history was 27 years (range 9-53).
All but 8 of the patients reported low back pain, 22 reported nerve root pain, and 4 were pain-free.
The various topographies were 30 single major curves (19 lumbar and 11 thoracolumbar), 18 double curves (double thoracic and lumbar), and 3 triple curves
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What if the Cobb angle (and spinal deformity) is really just a "symptom" of the unseen neurological condition that is outwardly and physically manifested as scoliosis?
It is kind of like watching the wind out a window.
You can't see the wind, but you can see the effects of the wind on the trees, grass, ect....What if the same is true with scoliosis?...you can't see the neurological condition, but you can see it's effects on the spine.
So bracing and surgery would only be treating the symptom, not the condition itself.
Deep huh?
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