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To your health

Scoliosis -- Some hope?

06/01/2007 - Last month I was attending a class in which the main speakers were from Montreal, Canada. They were pediatric orthopedists who wanted to share a new bracing system for scoliosis and they were intrigued by the technique I use to analyze posture at my office.

(click for larger version)
First, let's define scoliosis. It is a curvature of the spine which, if not kept in check or corrected, can lead to some stressful times for all involved.

The common treatment for scoliosis has been either rigid bracing or the insertion of rods next to the spine. Unfortunately, the data for this shows that more than half of the conditions treated were worsened. My profession did not fair much better, however we saw mainly adults, which makes correction more difficult. Also, our program involves many exercises and a form of postural traction making compliance difficult for most people.

Scoliosis, once detected and allowed to progress, can affect the person psychologically, especially a child. Studies have shown that a child could have decreased test scores and/or become withdrawn from friends, especially when he/she starts this rigid bracing program. Long term effects include muscle and spine pain, difficulty breathing, and early degenerative joint disease of the spine.

Now, back to the orthopedists. They have developed a flexible bracing systmem that can be worn underneath clothes and allow the individual to participate in normal activities. They were interested in the technique I was taught and use in my office because of our understanding of posture and what we call "spinal coupling patterns". We were pleased because they realized our frustration with treating this problem, but we did not have the resources that were available to them to develop such a brace. They had spent over four million dollars just in the computer software and a few more in development of the brace. Now they want to evaluate effectiveness, hence the lecture to our group. They were impressed by our evaluation and analysis techniques for scoliosis as well as our determination of therapeutic exercises and order of these exercises. They were surprised that change could be effected, but recognized we needed more help.

Their brace is to be used 20 hours per day for a minimum of 18 months plus therapy. This is similar to orthodonture. (Price of the program is also similar.) Their strength in our weakness in developing a brace and our strength in their weakness in understanding coupling patterns was a neat marriage. However, they wanted us to use their brace and use the solftware so data could be collected. They wanted different doctors around the country using this, but the training in the use of the brace is a little pricey for the doctor. The problem is meeting the criteria for patients that qualify for doctors to train on. They don't understand that we do not have large population in our town from which to draw, the same being true for our entire state.

I visited with a school principal who informed me that they have not done screenings in a couple of years so his nurse evaluates only if she observes a child looking odd in his/her posture. This is a problem so I will send letters to pediatricians and orthopedists to see if they might be interested in helping me get the necessary patients to undergo the training. The developers have strict guidelines for patients to qualify for usage of the brace and they have not developed the criteria for adults. So this may be a more involved process than even I can imagine. But it will be worth a try. So, for now, parents please check your child by having him/her bend over to touch his/her toes. If you see unevenness in the shoulder blades or the spine appears to bend off to the side, please get him/her checked by a chiropractor, pediatrician, or physical therapist.

I'm taking the summer off. See ya next fall.

Marc Delgadillo is a chiropractor practicing in Casper.

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