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Observation, Bracing and Surgery

Observation

The "watch and wait" method has been traditionally recommended for scoliosis curvatures between 0-25 degrees. This strategy involves monitoring the progression of the scoliosis from the point of detection up until the scoliosis curvature reaches 25 degrees or the child reaches skeletal maturity. Most doctors think that after skeletal maturity has been reached the curvature will not get worse, but this is far from the truth. In fact more than two-thirds (68%) of scoliosis curvatures will continue to worsen following skeletal maturity according to Weinstein et al. in "Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients," Journal of Bone Joint Surgery Am. 63:702-712, 1981.

It is much easier to reduce a smaller scoliosis curvature versus a larger scoliosis curvature with our scoliosis reduction method following the CLEAR protocol.

Bracing

Bracing is regularly recommended for scoliosis curvatures between 25-45 degrees. The supposed logic of using a brace is to prevent the scoliosis curvature from progressing. In fact, bracing often fails to arrest curvature progression, much less reduce it. In addition, bracing places substantial limitations upon a number of physical activities. Moreover, in order for the brace to have a chance of preventing the scoliosis curvature from progressing, it must be worn as tightly as possible for a long period of time each day, frequently as many as 23 hours. This can be quite difficult at times, especially during the hot humid summer, not to mention that the bulkiness and awkward-looking shape of a brace makes it noticeable when the person wearing it is out in public. In addition, bracing can often cause a decrease in lung function, rib deformity, skin irritation, and weakening of muscles.

Despite all of these serious drawbacks, bracing continues to be the most common treatment method recommended - this even though recent scientific studies question the effectiveness of braces, whether soft or rigid. In some cases, the forced correction of a brace actually causes an increase in a patient's rib deformity, commonly known as a rib hump. Even if a brace is successful and does not increase the deformity, all benefit is lost once the brace is removed. A 2007 article appearing in the journal Spine gave bracing an overall grade of a “D” for its ability to halt curve progression. Both patients and researchers have seems to agree that we need a better system for treating scoliosis. Now there is a better system!

Surgery

Surgery is traditionally recommended for scoliosis curvatures above 40-45 degrees. However, many long-term studies indicate poor treatment outcomes for surgically-treated patients, and some studies even recommend a second surgery for complete removal of the hardware implanted by the surgery after bony fusion has taken place. Research indicates that surgical intervention, while possibly necessary at times for very large spinal curvatures, is primarily a cosmetic procedure which ultimately leaves the complex condition of scoliosis untreated. The surgical procedure simply transforms the spinal deformity into a permanent spinal dysfunction that often results in chronic pain, disfigurement, and even long-term disability. While scoliosis surgery has improved over the past several decades, choosing surgery is never easy, and many patients find that the risks and poor treatment outcomes make this a last resort.

Before considering surgery, it's extremely important to consult with a CLEAR Intensive Care Certified doctor to know all your options. Why? Because once the surgery is performed, there is no turning back. A well-trained CLEAR Intensive Care Certified doctor will dedicate himself/herself to finding the best possible solution for your specific scoliosis curvature.

Regular Chiropractic Spinal Adjustment

Regular chiropractic spinal adjustments can help with temporarily reducing pain caused by scoliosis, such as pain in the lower back, mid-back, neck, and shoulders. However, research has shown that regular chiropractic spinal adjustment will not reduce scoliosis curvatures.

At Bones and Beyond, Dr. Hugh Van Kieu, DC, IDE is CLEAR Intensive Care Certified and will use his knowledge and skills to best help you with your scoliosis condition.




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