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More than a Curve in you Spine

Causes of Scoliosis 


  • Upper Cervical Injury
  • Spinal Cord Tension 
  • Sensory Motor Dysfunction
  • Altered Spinal Biomechanics
  • Toxicity

SCOLIOSIS IN CHILDREN

Scoliosis is the most common spinal deformity in school-age children. (Chiro & Osteo. 2005)
The total number of scoliosis cases in the United States is estimated to be greater than 4 million. (National Scoliosis Foundation)
Each year, 442,900 office visits, 133,300 hospital visits, and 17,500 emergency room visits are made by children with scoliosis. (HCUP-AHRQ 2011)
Approximately 29,000 scoliosis surgeries are performed on adolescents every year in the United States. (WJO 2015)
The average cost of a hospital stay for a child with scoliosis is $92,000 – over five times the national average of $17,500. (HCUP-AHRQ 2011)
Spinal deformity in children and adolescents accounts for the largest share (48%) of all musculoskeletal deformity health care visits – over 857,280 each year. (HCUP-AHRQ 2011)

SCOLIOSIS IN ADULTS

Scoliosis in the adult has an impact that is similar to other common medical conditions including osteoarthritis, coronary artery disease, and chronic obstructive pulmonary disease. Overall, the burden of scoliosis on health-related quality of life is severe relative to other common medical conditions. With the aging demographic profile of the US, the burden of adult scoliosis is increasing and has a significant impact on the health of our population.
– Sigurd H. Berven MD, Matthew D. Hepler MD, Sylvia I. Watkins Castillo, PhD
Adults with scoliosis are more likely to require long-term care. (BAJB 2011)
Estimates of the direct costs of nonsurgical care in adult scoliosis (not including lost wages, time from work, cost of care providers, etc.) are estimated to be as high as $14,000 per year. (Spine 2010)
In 2011, 229,000 adults were hospitalized with scoliosis, at an approximate cost of $15.44 million. (BAJB 2011)
Scoliosis represents 20% of all spinal deformity cases in the United States, accounting for 1.2% of all hospital charges annually. (BAJB 2011)
The average hospital charge for an adult with scoliosis is approximately twice as high as the national average. (HCUP-AHRQ 2011)
74,000 emergency room visits are made each year by adults with scoliosis. (HCUP-AHRQ 2011)

INCIDENCE OF SCOLIOSIS AMONG VISION/HEARING-IMPAIRED POPULATIONS

Vision-impaired individuals have a 5 times greater incidence of scoliosis. (Visual deficiency and scoliosis, Spine 2001)

AVERAGE AGE OF SCOLIOSIS PROGRESSION

The average age of curve acceleration is 11.7 years of age. (Maturity assessment & curve progression in girls with IS, JBJS 2007)

UTILIZATION OF CHIROPRACTIC SERVICES FOR SCOLIOSIS

“An estimated 2.7 million patient visits are made to American chiropractors each year for scoliosis and scoliosis-related complaints.“  (Job analysis of chiropractic. 2000, National Board of Chiropractic Examiners)
Feise conducted a telephone survey to, “determine the clinical management approach of practicing chiropractors with regard to patients with adolescent idiopathic scoliosis.
114 chiropractors responded.  “In general, the respondents would provide 6 months of “intensive” chiropractic therapy, then follow the patient for 4 years (near skeletal maturity). Eighty-two percent of respondents named diversified technique as their primary adjustive treatment, 87% would use exercise, and 30% would use electric muscle stimulation as an adjunct to manual therapy.” (JMPT 2001)
“Full-spine chiropractic adjustments with heel lifts and lifestyle counseling are not effective in reducing the severity of scoliotic curves.” (Effect of Chiropractic intervention on small scoliotic curves in younger subjects:  A time-series cohort design.  JMPT 2001)

SCOLIOSIS AND COMMUNICATION WITH HEALTH PROFESSIONALS

Only 5% of those with scoliosis declared that they had opportunities to discuss their feelings with health professionals, while 90% of them declared that they wanted to have more opportunities to do this. (J Adv Nurs 2001)

EMOTIONAL EFFECTS OF SCOLIOSIS

Scoliosis patients have been shown to be 40% more likely to have suicidal thoughts (Payne et al, Spine 1997)
A study by Shang et al found that patients with severe AIS were more likely to have psychological problems that affected their quality of life than patients with medium or mild AIS. (Analysis of psychological characteristics in adolescent idiopathic scoliosis. Chinese Journal of Spine and Spinal Cord. 2009)
Payne et al surveyed 685 patients with AIS (269 males and 416 females, aged 12–18 years). Scoliosis patients had more frequent suicidal thoughts, more concern about abnormal body development, and a greater worry and concern about peer relations. (Payne et al, Spine 1997)
“For both sexes, the predominant clinical symptom of AIS appears to be the negative effect that the spinal deformity exerts on perceived self-image and appearance.” (Perceived self-image in adolescent idiopathic scoliosis: an integrative review of the literature. Rev. esc. Enferm. 2014)

SCOLIOSIS AND PAIN

In one study, 63% of children with scoliosis reported pain – a number almost twice as high as the number reported by those who did not have scoliosis (“The pain drawing in AIS.” Proceedings of the Scoliosis Research Society, 36th Annual Meeting. 2001.).
Twice as many people with scoliosis report continuous pain as non-scoliosis patients, and 73% of people with scoliosis report experiencing back pain in the past year compared to only 28% of people without scoliosis. (“The Ste-Justine AIS Scoliosis Cohort Study,” Mayo et al 1994, Spine 19:1573)
23% of people with scoliosis reported their pain level as horrible, excruciating, or distressing, compared to just 1.4% of people without scoliosis.
The incidence of low back pain is almost twice as high in people living with scoliosis as those without. (“The Ste-Justine AIS Scoliosis Cohort Study,” Mayo et al 1994, Spine 19:1573)

All of the above is from the Clear Institute
 2017 Mar;54:143-149. doi: 10.1016/j.jbtep.2016.07.015. Epub 2016 Jul 30.

Upright posture improves affect and fatigue in people with depressive symptoms.

https://www.ncbi.nlm.nih.gov/pubmed/27494342/

  • "CONCLUSIONS: This preliminary study suggests that adopting an upright posture may increase positive affect, reduce fatigue, and decrease self-focus in people with mild-to-moderate depression. Future research should investigate postural manipulations over a longer time period and in samples with clinically diagnosed depression."
 2015 Jun;34(6):632-41. doi: 10.1037/hea0000146. Epub 2014 Sep 15.

Do slumped and upright postures affect stress responses? A randomized trial.

  • CONCLUSIONS:
    • "Adopting an upright seated posture in the face of stress can maintain self-esteem, reduce negative mood, and increase positive mood compared to a slumped posture. Furthermore, sitting upright increases rate of speech and reduces self-focus. Sitting upright may be a simple behavioral strategy to help build resilience to stress. The research is consistent with embodied cognition theories that muscular and autonomic states influence emotional responding." 
    • https://www.ncbi.nlm.nih.gov/pubmed/25222091

Biomechanics of the Cervical Spinal Cord

Relief of Contact Pressure on and Overstretching of the Spinal Cord


 http://journals.sagepub.com/doi/abs/10.1177/028418516600400602

  • Loss of cervical curve and stretch the cervical spinal cord 7.2cm longitudinally.  Adding stress and tension to the entire system. Spinal cord, nerve roots, cerebellum, brain stem. 
 1999 Jul-Aug;22(6):399-410.

A review of biomechanics of the central nervous system--Part III: spinal cord stresses from postural loads and their neurologic effects.



  • Results{"Spinal postures will often deform the neural elements within the spinal canal. Spinal postures can be broken down into four types of loading: axial, pure bending, torsion, and transverse, which cause normal and shear stresses and strains in the neural tissues and blood vessels. Prolonged stresses and strains in the neural elements cause a multitude of disease processes.

    CONCLUSION:

    Four types of postural loads create a variety of stresses and strains in the neural tissue, depending on the exact magnitude and direction of the forces. Transverse loading is the most complex load. The stresses and strains in the neural elements and vascular supply are directly related to the function of the sensory, motor, and autonomic nervous systems. The literature indicates that prolonged loading of the neural tissue may lead to a wide variety of degenerative disorders or symptoms. The most offensive postural loading of the central nervous system and related structures occurs in any procedure or position requiring spinal flexion. Thus flexion traction, rehabilitation positions, exercises, spinal manipulation, and surgical fusions in any position other than lordosis for the cervical and lumbar spines should be questioned."


 2014 Nov-Dec;21(6):519-24. doi: 10.1002/cpp.1890. Epub 2014 Feb 27.

Sitting posture makes a difference-embodiment effects on depressive memory bias.

"The findings indicate that relatively minor changes in the motoric system can affect one of the best-documented cognitive biases in depression."
  • https://www.ncbi.nlm.nih.gov/pubmed/24577937

Analysis of the cranio-cervical curvatures in subjects with migraine with and without neck pain

http://www.physiotherapyjournal.com/article/S0031-9406(17)30026-3/abstract
  • "Results
    • Subjects with migraine reported a longer history of neck pain symptoms, and higher pain intensity and neck-pain-related disability than controls (P < 0.01). Patients exhibited a smaller anterior translation distance (mean difference: 4.9 mm, 95% confidence interval 1.8 to 8.8; P < 0.001) and hyoid triangle (difference: 3.0 mm, 95% confidence interval 1.0 to 5.0; P = 0.02) than healthy controls. When the presence or the absence of neck pain was included in the analysis, the differences did not change. Differences in anterior translation and hyoid triangle distances were considered clinically relevant for subjects with migraine suffering from neck pain.
  • Conclusion
    • Subjects with migraine exhibited straightening of cervical lordosis curvature. The presence of neck pain did not influence head posture in subjects with and without migraine."



Postural Consequences of Cervical Sagittal Imbalance - A Novel Laboratory Model




 2013 Jul;68(7):869-75. doi: 10.1093/gerona/gls253. Epub 2013 Jan 28.

Spinal posture in the sagittal plane is associated with future dependence in activities of daily living: a community-based cohort study of older adults in Japan.  


 2005 Mar;16(3):273-9. Epub 2004 Jul 2.

Trunk deformity is associated with a reduction in outdoor activities of daily living and life satisfaction in community-dwelling older people.

Who says you need to be in pain to have degeneration? 

 

Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.


Review article

Brinjikji W, et al. AJNR Am J Neuroradiol. 2015.
  • "CONCLUSIONS: Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age.'
  • "The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age."
  • https://www.ncbi.nlm.nih.gov/m/pubmed/25430861/



 2016 Oct;25(4):494-499. Epub 2016 May 20.

Global sagittal axis: a step toward full-body assessment of sagittal plane deformity in the human body.




Demonstration of central conduction time and neuroplastic changes after cervical lordosis rehabilitation in asymptomatic subjects: a randomized, placebo-controlled trial

https://www.nature.com/articles/s41598-021-94548-z?utm_sq=gv1k0jbyqz&fbclid=IwAR0Z3xhKmqPA4iqgrnhFCd62jqxanWAQSyPXYhFi_Q6n_gLDRBg2INwUSDA

A randomized controlled study was conducted to evaluate the effect of rehabilitation of the cervical sagittal configuration on sensorimotor integration and central conduction time in an asymptomatic population. Eighty (32 female) participants with radiographic cervical hypolordosis and anterior head translation posture were randomly assigned to either a control or an experimental group. The experimental group received the Denneroll cervical traction while the control group received a placebo treatment. Interventions were applied 3 × per week for 10 weeks. Outcome measures included radiographic measured anterior head translation distance, cervical lordosis (posterior bodies of C2–C7), central somatosensory conduction time (latency) (N13–N20), and amplitudes of potentials for spinal N13, brainstem P14, parietal N20 and P27, and frontal N30. Outcomes were obtained at: baseline, after 10 weeks of intervention, and at 3 months follow up. After 10 weeks and 3-months, between-group analyses revealed statistically significant differences between the groups for the following measured variables: lordosis C2–C7, anterior head translation, amplitudes of spinal N13, brainstem P14, parietal N20 and P27, frontal N30 potentials (P < 0.001), and conduction time N13–N20 (P = 0.004). Significant correlation between the sagittal alignment and measured variables were found (P < 0.005). These findings indicate restoration of cervical sagittal alignment has a direct influence on the central conduction time in an asymptomatic population.




 1999 Jul-Aug;22(6):399-410.

A review of biomechanics of the central nervous system--Part III: spinal cord stresses from postural loads and their neurologic effects.


"RESULTS:

Spinal postures will often deform the neural elements within the spinal canal. Spinal postures can be broken down into four types of loading: axial, pure bending, torsion, and transverse, which cause normal and shear stresses and strains in the neural tissues and blood vessels. Prolonged stresses and strains in the neural elements cause a multitude of disease processes.

CONCLUSION:

Four types of postural loads create a variety of stresses and strains in the neural tissue, depending on the exact magnitude and direction of the forces. Transverse loading is the most complex load. The stresses and strains in the neural elements and vascular supply are directly related to the function of the sensory, motor, and autonomic nervous systems. The literature indicates that prolonged loading of the neural tissue may lead to a wide variety of degenerative disorders or symptoms. The most offensive postural loading of the central nervous system and related structures occurs in any procedure or position requiring spinal flexion. Thus flexion traction, rehabilitation positions, exercises, spinal manipulation, and surgical fusions in any position other than lordosis for the cervical and lumbar spines should be questioned."

 1999 Jun;22(5):322-32.

A review of biomechanics of the central nervous system--part II: spinal cord strains from postural loads.


"RESULTS:

All spinal postures will deform the neural elements within the spinal canal. Flexion causes the largest canal length changes and, hence, the largest nervous system deformations. Neural tissue strains depend on the spinal level, the spinal movement generated, and the sequence of movements when more than one spinal area is moved.

CONCLUSIONS:

Rotations of the global postural components (head, thoracic cage, pelvis, and legs) cause stresses and strains in the central nervous system and peripheral nervous system. Translations of the skull, thorax, and pelvis, as well as combined postural loads, need to be studied for their effects on the spinal canal and neural tissue deformations. Flexion of any part of the spinal column may generate axial tension in the entire cord and nerve roots. Slight extension is the preferred position of the spine as far as reducing the magnitude of mechanical stresses and strains in the central nervous system is concerned."

 1999 May;22(4):227-34.

A review of biomechanics of the central nervous system--Part I: spinal canal deformations resulting from changes in posture.


"RESULTS:

All spinal postures will deform the spinal canal. Flexion causes a small increase in canal diameter and volume as the vertebral lamina are separated. Extension causes a small decrease in canal diameter and volume as the vertebral lamina are approximated. Lateral bending and axial rotation cause insignificant changes in spinal canal diameter and volume in cases without stenosis.

CONCLUSIONS:

Rotations of the global postural components, head, thoracic cage, and pelvis cause changes in the diameter of the spinal canal and intervertebral foramen. These changes are generally a reduction of less than 1.5 mm in extension, compared with a small increase in flexion of approximately 1 mm. These small changes do not account for the clinical observation of patients having increased neurologic signs and symptoms in flexion."




. Jan-Mar 2019;10(1):19-23.
 doi: 10.4103/jcvjs.JCVJS_17_19.

Is cervical instability the cause of lumbar canal stenosis?





 2016 Mar;24(3):436-46. doi: 10.3171/2015.5.SPINE14989. Epub 2015 Nov 13.

Role of pelvic translation and lower-extremity compensation to maintain gravity line position in spinal deformity.

https://www.ncbi.nlm.nih.gov/pubmed/26565764


 2014 Oct 1;96(19):1631-40. doi: 10.2106/JBJS.M.01459.

TheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life.



 2016 Oct 20;7:93. eCollection 2016.

Predictive parameters for the antecedent development of hip pathology associated with long segment fusions to the pelvis for the treatment of adult spinal deformity.

https://www.ncbi.nlm.nih.gov/pubmed/27857857

 2005 Dec;14(10):925-48. Epub 2005 Nov 18.

The adult scoliosis.

https://www.ncbi.nlm.nih.gov/pubmed/16328223



 2016 Jun 13:1-9. [Epub ahead of print]

Efficacy of corrective spinal orthoses on gait and energy consumption in scoliosissubjects: a literature review.

https://www.ncbi.nlm.nih.gov/pubmed/27295454


 2009 Apr;18(4):512-21. doi: 10.1007/s00586-009-0899-7. Epub 2009 Feb 18.

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis.

https://www.ncbi.nlm.nih.gov/pubmed/19224255

 2010;158:101-6.

Gait in adolescent idiopathic scoliosis. Kinematics, electromyographic and energy cost 


https://www.ncbi.nlm.nih.gov/pubmed/20543408

Abstract
Introduction: Adolescent idiopathic scoliosis (AIS) can affect spine mobility and gait mechanisms. Nowadays little is known about the effects of scoliosis on gait. Objectives: To evaluate the effects of untreated scoliosis on gait. Materials and Methods: Fifty-four females (13 healthy girls and 41 AIS with thoracolumbar/lumbar curve) were assessed by gait analysis. Xrays allowed classifying AIS patients into three groups, depending on the scoliosis severity. Gait analysis included synchronous bilateral kinematic and electromyographic (EMG) measurements, assessment of external (Wext), internal (Wint), total mechanical work (Wtot), oxygen consumption (V& O2), energy cost (C) and muscular efficiency (Wtot/C). Results: Shoulder, pelvis and hip motions were significantly reduced in all AIS patients. The reduced motion correlated with decreased Wtot. V& O2 and C were increased by 30 %. Muscle efficiency was decreased by 29 %. Increased C correlated with prolonged timing activity of lumbo-pelvic muscles (LPMTA). Discussion: Reduction of Wtot can be explained by decrease of external work. Increase of V& O2 and energy cost could be due to bilateral increase of LPMTA. Conclusion: Similar gait alterations were observed in all AIS patients, whatever the severity of the scoliosis. The observed alterations may be considered as the manifestation of an underlying neuromuscular disease or as a consequence of the stiffening effect of scoliosis. The observed “careful walking” strategy could also be a compensatory mechanism to minimize energy expenditure.

 2010 Jul;19(7):1179-88. doi: 10.1007/s00586-010-1292-2. Epub 2010 Feb 11.

Gait in thoracolumbar/lumbar adolescent idiopathic scoliosis: effect of surgery on gait mechanisms.

https://www.ncbi.nlm.nih.gov/pubmed/20148341


1) Increased Thoracic Kyphosis Increases Early Mortality:
This research study demonstrates the correlation of hyperkyphotic spinal posture as a predictor of early mortality in older men and women. Kado et al. (2005) evaluated the link between hyperkyphosis of the thoracic spine and early mortality among community dwelling, elderly men and women. If hyperkyphosis is related to early mortality, presumably proper posture is related to increased longevity. Posture Experts have sound evidence of why educating their patients of proper postural hygiene to prevent postural degeneration if of utmost importance.
Kado, D., Huang, M., Barrett-Connor, E., & Greendale, G. (2005) Hyperkyphotic Posture and Poor Physical Functional Ability in Older Community-Dwelling Men and Women: The Rancho Bernardo Study. Journals of Gerontology: Biological Sciences, 60(5), 633-637.
2) Hyperkyphosis in Thoracic Spine Predicts Mortality in Women:
Hyperkyphosis of the thoracic spine in women predicts mortality, independent of the presence of vertebral osteoporosis. The authors of this study concluded that the presence of an increased kyphosis in elderly women showed a 1.14-fold increased risk for death.
The presence of a hyperkyphotic spinal presentation was directly related to increased mortality, independent of other variables such as spinal osteoporosis. Therefore, women who take preventative actions to have good posture, without a “Granny’s Hump” presentation, are more likely to live longer. Educating your patients of the importance of postural hygiene can add quantity and quality to the years of their life.
Kado, D. et al. (2009) Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women. Annals of Internal Medicine 150:681-687.
3) Hyperkyphosis Increases Risk for Fracture, Early Mortality, and Impairs Quality of Life:
The authors of this article reviewed the prevalence and natural history of hyperkyphosis, along with associated health implications if left untreated. They concluded that hyperkyphosis has many associated health complications, including increased risk for fracture and mortality, and is associated with impaired physical performance, health, and quality of life. Women with hyperkyphosis report more physical difficulty, more adaptations to their lives, and greater generalized fears than women without hyperkyphosis.
Katzman et al. (2010) Age-Related Hyperkyphosis: Its Causes, Consequences, and Management. Journal of Orthopedic and Sports Physical Therapy, 40(6) 352-360.

http://americanpostureinstitute.com/the-killer-impact-of-hyperkyphosis-3-must-read-research-articles-2/

 2016 Jun;32(3):316-23. doi: 10.1123/jab.2015-0246. Epub 2015 Dec 22.

Postural Balance Parameters as Objective Surgical Assessments in Low Back Disorders: A Systematic Review.

https://www.ncbi.nlm.nih.gov/pubmed/26695763

 2013 Nov;5(11):957-63. doi: 10.1016/j.pmrj.2013.05.015.

Neuromuscular scoliosis.

https://www.ncbi.nlm.nih.gov/pubmed/24247014

Neuromuscular Scoliosis: Causes of Deformity and Principles for Evaluation and Management


 2005 Sep;16(9):1024-35. Epub 2005 Feb 23.

Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period.


Gait Cycle Evaluation as a Component of Chiropractic Care


Position of the major curve influences asymmetrical trunk kinematics during gait in adolescent idiopathic scoliosis



Breast Cancer Mortality After Diagnostic Radiography: Findings From the U.S. Scoliosis Cohort Study


. 2016; 6(7): e011812.
Published online 2016 Jul 8. doi:  10.1136/bmjopen-2016-011812
PMCID: PMC4947809

Your spine, for their Pocket


  • Spicy!! 
  • 500,000 Americans undergo spinal surgery EVERY YEAR. BILLIONS OF DOLLARS
  • Companies are trying to win over surgeons to use their products. Massive incentives. Massive increase in the prices of hardware/proceedures 
    • A single screw could cost $1,000
    • Spinal Device market has DOUBLED in only 3 years. 
  • About 100 device companies, many have some level of doctor ownership.
  • Companies actually recruit surgeons who have a high surgery rate. 



Why Corrective Chiropractic Care?

1. The nervous system controls all function, health, and healing.1

"2. Proper spinal alignment is crucial for protection and optimal function of the nervous system and therefore of the mind and body.
a. The spine should be straight from the front and curved from the side in order to keep pressure off the spinal cord and nerves.58,59,60,61
b. Harrison et al has done a tremendous amount of research on the importance of the ideal spine with a lateral neck curve being 42.5 degrees and the lateral curve in the low back being 35 degrees while standing. 58,59,60,61
3. When normal spinal alignment is lost, a condition called subluxation exists.
a. Subluxation causes a reduction in cerebrospinal fluid flow, degeneration of the discs, vertebra, and nerves. Subluxation leads to a reduction in the nerve communication to the organs, muscles and tissues of the body and over time causes early death.3,4,5
b. As the spine shifts out of place, bones are adaptively molded to resist the chronic stressors that losing proper alignment creates. As the vertebra degenerate, so do the spinal cord and nerves. 19,21,25,27,28,29, 65,66
c. Loss of neck or low back lordosis predisposes the spine to accelerated degenerative changes over time. There are almost immediate physiological effects of changes in alignment on weight bearing bones.30
d. A reversal of the cervical curve results in demyelination of the nerve fibers in the funiculi and neuronal loss in the anterior horn due to chronic compression of the spinal cord. 19,21,25,27,28,29, 65,66
e. Delayed paralysis is sometimes seen following the development of a reversed cervical curve.19
f. Loss of the cervical curve predicts mortality in men and women, especially heart and lung conditions.22
g. Shrinking 3cm or more (due to poor posture and/or degeneration) puts you at 64% greater risk of coronary heart disease.23,24
h. The physical complications of scoliosis, spinal alignment abnormalities or subluxation can range on a continuum from being symptom free, to pain or soreness and even organ dysfunction/serious illness.4,5,10,11,14
i. 68% of adults have scoliosis (abnormal curvature of the spine), many of which develop in childhood.6
j. 60% of patients with scoliosis may die from complications of the heart and lungs.4,5,10,11,14
k. Other ailments linked to alignment abnormalities include (not limited to): headaches, chronic fatigue, joint pain, difficulty sleeping, loss of concentration and depression. 3,8
l. The cost of bracing or spinal surgery often ranges from $10,000 to well over $200,000 and may require follow-up surgeries that pose serious risks and complications.10
m. Life expectancy of many people with scoliosis is an average of 14 years shorter than those with a properly aligned spine.5
i. For comparison, the average life expectancy loss for a cancer patient is 15.5 years.7
n. Dr. Henry Windsor performed autopsies that determined there was a 96% correlation between damaged/degenerated vertebra and disease of the organ associated with the nerve of that spinal level.12
i. There was a 100% correlation between minor curvatures of the spine and disease of the associated internal organs. 12
o. Immobilization of a joint (subluxation) that remains there for more than 10-15 days begin to degenerate. Movement needs to be restored before degeneration and further damage occurs.13
p. Subluxation may occur without symptoms and changes the neurological communication between the brain and the body. Detecting and removing subluxations requires a trained chiropractor. Prevention of subluxations requires regular spinal care. 14
q. Subluxation often causes a fight or flight (increased sympathetic) response in the body. 15
i. This means that often blood pressure becomes increased, heart rate increased, LDL cholesterol go up, insulin and glucose rise as a result of subluxation. Often the immune system becomes negatively altered because of the physiological effects of subluxations which chronically may lead to cancer, colds, influenza and infections. 15
ii. Proprioception is diminished with subluxation, which is recognized by the body as a stressor putting the body into chronic adaptive physiology. 15
iii. Subluxation often decreases serotonin, and can lead to anxiety and depression.15
r. Atlas inversion or loss of proper positioning between atlas and occiput was found in all 50 cases of SIDS studies in 1991, and in 10 out of 11 cases in 1979, the 11th had upper cervical damage. 32,33
4. Ways to tell if there is a loss of normal spinal alignment or subluxation
a. Spinal palpation, postural evaluation and range of motion are often helpful ways to determine if subluxation is present.
b. X-rays allow the chiropractor to see exactly where subluxation is occurring, a good idea of how long it’s been there, the extent of damage to your spine and the proper adjusting angles to correct the subluxation . 58,59,60,61
c. Safety of x-rays
i. We are exposed to radiation on a daily basis due to naturally occurring background radiation from the earth, radon gas, electronics, air travel, cosmic rays and our food. 62,63,64
ii. Radiation doses from a spinal x-ray series is equivalent to a few weeks of natural background radiation. 62,63,64
iii. This dose is considered negligible to very low risk range for individuals of all ages.62,63,64
5. Corrective chiropractic care re-aligns the spine, creates motion in immobilized joints, and allows the nervous system to more effectively communicate with every cell tissue and organ in the body which is essential for optimal health!
a. Chiropractic patients have a 200% greater immune competence than people who do not receive regular chiropractic care, and 400% greater than people with cancer or other serious disease.16
b. Among 120 atopic dermatitis patients, 88% showed improvements with daily chiropractic adjustments.17
c. In a study of 5607 adult patients under chiropractic care, non-musculoskeletal improvements included: allergies, breathing, circulation, digestion, asthma, hearing, ringing in ears and heart function. 18
i. The longer individuals were under chiropractic care, the more positive changes they experienced.18
d. Patients who receive chiropractic maintenance care spend only 31% of the national average on healthcare! (69% savings).67 The March 4th 2013 issue of Time Magazine stated that the current annual healthcare spending in the U.S. is over $8,200 per person per year.---- Now $9,200
i. People under chiropractic care had 50% less medical provider visits. 67
ii. Their health habits were radically better than overall populations. 67
iii. Chiropractic patients had 60% fewer hospital admissions, 62% less surgeries, 85% less pharmaceutical costs.67Currently, 70% of Americans are on at least one prescription drug. 50% on multiple
e. With proper alignment of the spine, it is impossible to have a herniated disc or spinal stenosis. 26
f. Chiropractic is often beneficial for breathing problems such as asthma. Studies have shown that chiropractic adjustments have a positive effect on forced vital capacity, respiratory rate and forced expiatory volume.34,35,36
g. Spinal adjustments have a positive effect on heart rate, diastolic blood pressure, systolic blood pressure, and increased blood flow within the vessels of the body. 37,38,39,40,41,42,43,44,45,46,47,48,49,50
h. Chiropractic care improves immune many system functions.51,52,53,54,55,56,57 "


Understanding the role of the immune system in adolescent idiopathic scoliosis: Immunometabolic CONnections to Scoliosis (ICONS) study protocol

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947809/
"The nervous system: As patients with several neurological syndromes have scoliosis, there has been significant focus on defining neurological factors contributing to AIS. In addition, defects in central control and processing of information have been proposed to be associated with AIS, although their role in the development and propagation of AIS remains under investigation.
  • Anatomical abnormalities involving spine, midbrain, pons, medulla, vestibular and hindbrain regions have been reported in AIS. Differences in brain volume, internal capsule and corpus callosum were also reported. How these differences drive AIS is a mystery.
    Neurophysiological mechanisms have also been reported in AIS, including abnormal proprioception, oculovestibular dysfunction, lateral gaze palsy, dynamic balance problems, postural imbalance and somatosensory disequilibrium. There have also been reports of enhanced electromyographic activity of the convex side of the spine.
    These phenomena led to the hypothesis that a combination of abnormal spinal growth patterns and neuromuscular and tissue remodelling is implicated in AIS. Posture is determined by sensory input from visual, vestibular and proprioception neural pathways, coupled with motor output. As a first step, postural disequilibrium due to defects in the neuromuscular system leads to the development of small spinal curves. With ongoing spinal growth, a second step involves biomechanical and neurological factors that drive the progression of the curve. With the establishment of scoliosis, secondary geometric and morphological changes emerge" 

Patient-Reported Side Effects Immediately after Chiropractic Scoliosis Treatment: A Cross-Sectional Survey Utilizing a Practice-Based Research Network

Joshua Woggon & Dennis A. Woggon
Annals of Vertebral Subluxation Research ~ March 20, 2017 ~ Pages 47-54

https://vertebralsubluxation.sharepoint.com/Pages/2017_1474_Woggons_scoliosis.aspx

Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series

https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-5-32
  • "After 4–6 weeks of treatment, the treatment group averaged a 17° reduction in their Cobb angle measurements. None of the patients' Cobb angles increased."


Costs

 2014 Oct 1;14(10):2326-33. doi: 10.1016/j.spinee.2014.01.032. Epub 2014 Jan 24.

Total hospital costs of surgical treatment for adult spinal deformity: an extended follow-up study

  • "Patients were predominantly women (n=415 or 86%) with an average age of 48 (18-82) years and an average follow-up of 4.8 (2-8) years. Total hospital costs averaged $120,394, with primary surgery averaging $103,143 and total readmission costs averaging $67,262 per patient with a readmission (n=130 or 27% of all patients)." 
 2011 Jan-Feb;31(1 Suppl):S77-80. doi: 10.1097/BPO.0b013e3181f73bfd.

"Does the outcome of adolescent idiopathic scoliosis surgery justify the rising cost of the procedures?".

 2013 Feb;7(1):57-62. doi: 10.1007/s11832-012-0466-3. Epub 2012 Dec 5.

A brief overview of 100 years of history of surgical treatment for adolescent idiopathic scoliosis.

https://www.ncbi.nlm.nih.gov/pubmed/24432060


Wobble Chair
 2016 Apr 11;49(6):939-45. doi: 10.1016/j.jbiomech.2016.01.042. Epub 2016 Feb 11.

Active-passive biodynamics of the human trunk when seated on a wobble chair.




Bracing 

Cochrane Review 

  • Due to the important clinical differences among the studies, it was not possible to perform a meta-analysis. Two studies showed that bracing did not change QoL during treatment (low quality), and QoL, back pain, and psychological and cosmetic issues in the long term (16 years) (very low quality). All included papers consistently showed that bracing prevented curve progression (secondary outcome). However, due to the strength of evidence (from low to very low quality), further research is very likely to have an impact on our confidence in the estimate of effect. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children. This challenge may prevent us from seeing increases in the quality of the evidence over time.
  • "There is very low quality evidence from two prospective cohort studies with a control group that rigid bracing increases the success rate (curves not evolving to 50° or above) at two years’ follow-up"
  • "Results of the secondary outcomes showed that there was low quality evidence that rigid bracing compared with observation significantly increased the success rate in 20° to 40° curves at two years’ follow-up"
  • "There was very low quality evidence from one small RCT (111 participants) that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation"
  • " There was very low quality evidence from a subgroup of 77 adolescents from one prospective cohort study showing that QoL, back pain, psychological, and cosmetic issues did not differ significantly between rigid bracing and observation in the long term (16 years)"

Other sources


Yoga for Scoliosis 
http://yogaforscoliosis.com/



MRI study of Egyptian lumbar lordosis 

http://www.nytimes.com/health/guides/disease/scoliosis/prognosis.html

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