This research article highlights the effectiveness of Spine Correction Center of the Rockies approach to scoliosis.
It should be noted that this is the most ever viewed article for this journal.
On September 14th, 2004, an article was published in BMC Musculoskeletal Disorders entitled, “Scoliosis treatment using a combination of manipulative and rehabilitative therapy,” by Mark Morningstar, D.C., Dennis Woggon, D.C., and Gary Lawrence, D.C. In this study, twenty-two scoliosis cases with Cobb angles ranging from 15 to 52 degrees were treated with an experimental rehabilitation protocol involving specific spinal adjustments, exercise therapy, and vibratory stimulation. Three subjects were dismissed from the study for non-compliance. After 4-6 weeks of treatment, the nineteen scoliosis patients who remained had experienced an average reduction in their Cobb angle of 62%. Individually, reduction varied from 8 to 33 degrees. None of the patients’ Cobb angles increased. The conclusion of the study was that these results warrant further testing of this new protocol. Since this study, we have attempted to understand exactly why such positive results were achieved, and our research has led us to the following theories:
- Scoliosis is caused by a dysponesis between the motor-sensory input/output from the upper trunk to the lower. This dysponesis is in turn caused by a unilateral impairment of the spino-cerebellar loop, which is located in the area between the atlas and the first cervical vertebra. Supporting this theory is the fact that 100% of scoliosis patients have a problem with proprioception (orientation of the body in time and space), and 100% of scoliosis patients have a loss of the cervical lordosis resulting in forward head posture. Scoliosis patients are often unable to touch their chins to their chests; this is due to a flexion mal-position of C0 and C1. Correcting this subluxation restores the neuro-musculoskeletal proprioceptive function to the patient. However, the postural aspect must still be corrected for the correction of the Cobb angle to progress.
- Exercise rehabilitation therapy is mandatory to reverse the scoliosis. Without patient compliance, no amount of care can help. It is necessary to retrain the postural muscles of the body. Vibratory stimulation overrides the body’s proprioceptive signals and mechanoreceptors, thus facilitating retraining of the postural muscles.
- Cobb angles over 30 degrees cannot be reduced in the same manner as Cobb angles under 30 degrees. The muscles contract more on the convexity of the curve, rather than the concavity, as is the case with angles under 30 degrees. Normal laws of biomechanics do not apply in patients with Cobb angles of more than 30 degrees! These theories have led to the composition of a treatment protocol for scoliosis patients that, so far, has had universal success in compliant patients. While surgery may be necessary in some cases, such as when the patient exhibits non-compliance with mandatory exercise rehabilitation protocols, this information should be encouraging to parents of children with scoliosis who are debating whether or not to schedule the Harrington rod implantation surgery for their son or daughter. We encourage you to delay the surgery until all other non-surgical options have been exhausted. Long-term ramifications of the Harrington surgery have been so unfavorable that the new recommendations are to remove the rods after four years.
- Little to nothing is known about how the build-up of scar tissue and the disruption of the spinal pathology will affect the patient in the future once the rods have been removed.
(right head tilt, left upper cervical angle, left lower cervical angle, right high shoulder, right dorsal-upper dorsal angle, right dorsal-lower dorsal & lumbo-dorsal angle, left lumbo-sacral angle, right hip anterior & superior, left hip posterior & inferior. Also forward head posture, superior optical orbits, left dominant eye)
Typical Scoliosis Posture
Recommendations for Scoliosis Treatment must include a component that is lacking.
One component that is universally lacking in nearly all forms of scoliosis treatment today: the effect of the cervical spine in determining spinal pathology, gait, stance, and overall posture. The head controls all components of the spine below it, much like how the engine controls the direction of a train. Without regard for which direction the locomotive is heading in, how is it possible to control the boxcars behind it? The very first aspect that must be addressed in scoliosis correction is the cervical spine; specifically, correcting the forward head posture by restoring the cervical lordosis and normal ranges of motion in the cervical spine, especially between the atlas and the first cervical vertebra. Precision x-rays are mandatory; a C0-C1 flexion malposition will manifest most readily with lateral cervical views in neutral, flexion, and extension. Follow-up x-rays should be performed roughly every three months as objective proof of improvement; should the patient’s progress plateau or regress, additional rehabilitation or alterations to the protocol may be required. Obviously thoracic and lumbar views are necessary to measure the Cobb angle. Balance and proprioception also play an important role in the rehabilitation of the scoliotic patient. A neurological short leg will always be found at first; this imbalance should be corrected with specific spinal adjustments. Once the patient is balanced, proprioceptive retraining exercises can be prescribed to maintain the correction.
One method of reducing forward head posture and retraining postural muscles is deceptively simple: by blocking the superior half of the lens on a pair of glasses, and instructing the patient to wear them for at least twenty minutes, the postural muscles of the neck are retrained to better hold the cervical lordosis in place. Various spinal weights may be placed on the head and/or hips to activate the weakened postural muscles. Also, whole-body vibration therapy (WBV) has been scientifically proven to be extremely effective at proprioceptive re-education. It is impossible and foolish to think of trying to “push” a scoliosis out of the spine! Most scoliosis braces are ineffective or even harmful because they do exactly this. A scoliotic spine must be visualized and corrected three-dimensionally; the lateral curve will not reduce until the spine has been de-compressed and de-rotated. Traction is far more effective because it is a subtler, gentler force, and one that is less readily resisted by the body. Dr. Clayton Stitzel has developed a scoliosis traction chair that incorporates cervical decompression with lateral thoracic and lumbar traction, and also addresses the rotational aspect of the scoliosis simultaneously. This passive exercise therapy can be performed by the patient at the clinic or at home.
- Idiopathic Scoliosis: long-term follow-up & prognosis in untreated patients J Bone Joint Surg Am 1981 Jun;63(5):702-12
- The estimated cost of school scoliosis screening Spine 2000 Sep 15;25(18):2387-91 Yawn & Yawn
- Radiologic findings and curve progression 22 years after treatment for AIS Spine 2001 Mar 1;26(5):516-25
- Corrosion of spinal implants retrieved from patients with scoliosis J Orthop Sci 2005;10(2):200-5
- The Effect of Scoliosis Fusion Surgery on Spinal Ranges of Motion: a Comparison of Fused & Nonfused Patients with Idiopathic Scoliosis Spine 2006;31(3):309-314
- The etiology of Adolescent Idiopathic Scoliosis Am J Orthop 2002 Jul;31(7):387-95
- Adolescent Idiopathic Scoliosis: the effect of brace treatment on the incidence of surgery Spine 2001 Jan 1;26(1):42-7
- Long-term results of quality of life in patients with idiopathic scoliosis after Harrington instrumentation and their relevance for expert evidence Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8
- The Search for Idiopathic Scoliosis Genes Spine 2006;31(6):679-81
- The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study Spine 1994 Jul 15;19(14):1573-81
- Long-term follow-up of patients with untreated scoliosis: a study of mortality, causes of death, and symptoms Spine 1992 Sep 17;(9):1091-6
- Back pain and disability after Harrington rod fusion to the lumbar spine for scoliosis Spine 1992 Aug 17;(8 Suppl):S249-53
- Results of surgical treatment of adults with idiopathic scoliosis J Bone Joint Surg Am 1987 Jun;69(5):667-75
- Thoracic Scoliosis and restricted neck motion: a new syndrome? Eur Spine J 1998;7:155-57.