Different Scoliosis diagnoses
Scoliosis comes in many forms, most being idiopathic and developed during adolescence. When defining a treatment option, one must first understand the condition being treated. Usually, most scoliosis conditions are identified by a lateral curvature of the spine, meaning when viewed from the front or back, the spine is not straight. As a clinician, there are several questions that must follow in order to properly define what the condition is currently, previously, and what it will likely do in the future for both short and long-term.
If a child has scoliosis, the most important aspect is to determine if they have reached or begun their pubertal growth spurt, which lasts approximately 30 months. Secondly, you’ll want to know what the current x-ray measurement is. There is a tremendous difference between an 11-year-old female with a 30 degree scoliosis, versus a 15-year-old with a 30 degree scoliosis. The 11-year-old is just entering the rapid progression phase, and is highly likely to get significantly worse by age 15, even when bracing is performed. The 15-year-old on the other hand, by age 20, is unlikely to get worse, and if they do, will not be by much.
What are the expectations?
So what are the expectations of the 11-year-old versus the 15-year-old with a 30 degree scoliosis when starting the bootcamp program? The 11-year-old will have an expectation of avoiding a surgical threshold of 50 degrees, whereas the 15-year-old's expectations will be to reduce and stabilize the scoliosis. Both cases will get initial reduction. However the 11-year-old's spine is expected to get worse; in a sense swimming upstream against a very large current called genetic predisposition.
When trying to create new muscle memory, the 11-year-old may in fact slow or even halt progression by reducing the existing curvature during latent, non-progressive periods. As the spine enters a progression period, it is progressing from a lower starting point than the initial 30 degrees. If the patient were to progress during a growth spurt from 30 degrees, it might add 10 degrees making it a 40 degree curvature. During the bootcamp process however, the 11-year-old's scoliosis might be reduced to 15 degrees. Now if the child enters that same growth spurt, progression might add 10 degrees, totaling a measurement of 25.
The problem with managing expectations is that we don’t know not knowing the genetic predisposition unless a scoliscore™ genetic test is performed in the early stages. The example above is only relevant to a child who has a high risk of curve progression. Otherwise, treating the 11 year old will have the same effect as the 15 year old because progression momentum is lower, and therefore, sustained reduction would be achieved sooner.
The scoliosis bootcamp™ program has had success significantly reducing the curvature of the spine in pre-growth children aged 8-10 for females, and 9-11 for males; even for those with a high genetic predisposition.
Every patient who engages in a scoliosis bootcamp™ program will have to have a detailed consultation with their provider to properly mange expectations so as not to set the bar initially too high or low. The program has the best potential when a thorough analysis of progression risk has been performed.
Featured images:
- License: Royalty Free or iStock source: http://www.corbisimages.com/stock-photo/royalty-free/42-31108560/scoliosis-of-the-spine?popup=1
Written by Dr. Brian T Dovorany, developer of the TorsoTrainer™ and Scoliosis Cantilever™ designed to reduce and stabilize idiopathic scoliosis through autonomic muscle recruitment.
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