A Brief History of Scoliosis Treatment

Dr. Clayton J. Stitzel, 1-866-627-3009, drstitzel@clear-institute.org,

http://www.treatingscoliosis.com/

SCOLIOSIS:

National Scoliosis Foundation

“The effects: Reduced life expectancy. It can stunt height growth and decrease pulmonary function. It’s associated with headaches, shortness of breath, digestive problems, chronic disease, and hip, knee and leg pain.”

History:Hippocrates described Scoliosis around 400 BC.

Galen coined the term Scoliosis in 131 – 201 A.D.

The 1st metal brace was developed under Ambroise Pare in 1575.

In 1876, it became possible to quantify the angle of deformation.

The etiology of scoliosis remains unknown in 80% of cases.

An enlargement of one of the panels shown in Fig. 13 demonstrating treatment of a spine injury. The typical treatment consisted of using gravity and extension of the spine to treat a curvature.

Courtesy of the British Museum, Sloane Manuscript Collection. Manuscript No. 1977.

An early printed example of the treatment of spine injuries in a work by Avicenna. Illustrated here are some of the examples of spine stabilization.

From Avicenna: Liber Canonis, De Medicinis Cordialibus, et Cantica. Basel: Per Joannes Heruagios, 1556.

Illustration showing the Hippocratic treatment of spine injuries—the rack system and the technique of using gravity to straighten the spine.

Reprinted from Hippocrates: The Genuine Works of Hippocrates (translated by Adams F). London: Sydenham Society, 1844, Vol 2, pp 117–118.

Illustration showing the use of a rack to straighten the spine. From an early manuscript (attributed to Serefeddin Sabuncuoglu, ca. early 18th century) on the subject of Avicenna and the treatment of spine injuries. In the author's personal collection.

The modern Era Until curvatures progress to 25° or more, physicians

prescribe “observation only.”

At 25°, bracing has been used to stabilize progression, and its efficacy continues to be examined.

Spinal fusion is recommended for skeletally immature patients when curvatures progress to 40° - 45° and for mature patients with curvatures > 50°.

• Incidence of Curvature Progression in Idiopathic Scoliosis Patients Treated With Scoliosis Inpatient Rehabilitation”, Hans-Rudolf Weiss, Pediatric Rehabilitation, 2003, Vol. 6, No 1, 23-30

Bracing

• 44% of bracing attempts are considered failures

– do not stop the progression

• Less than 30°, there were no significant differences between braced and non-braced patients– Typically brace is prescribed when scoliosis is <20°

• 60% felt bracing handicapped their lives• 14% considered bracing left a psychological scar

SURGERY

• Scoliosis fusion surgery– Average pre operative curve = 72°– Average post operative curve = 44°

Posterior Spinal Fusion and Instrumentation

Scoliosis surgery

Harrington Rods

Are They Cured?• Unfortunately, most patients return for 2nd, 3rd, and 4th

surgeries• Rod maintenance• Side effects

– Inflexibility– LBP– Headache

• “40% of operated treated patients with idiopathic scoliosis were legally defined as severely handicapped persons” (4)

4 Gotze C, Slomka A, Gotze HG, Potzl W, Liljenqvist U, Steinbeck J. Long-term results of 4 Gotze C, Slomka A, Gotze HG, Potzl W, Liljenqvist U, Steinbeck J. Long-term results of quality of life in patients with idiopathic scoliosis after Harrington instrmentation and quality of life in patients with idiopathic scoliosis after Harrington instrmentation and their relevance for expert evidence. Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8their relevance for expert evidence. Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8Dr. Clayton J. Stitzel, 1-866-627-3009,

drstitzel@clear-institute.org, http://www.treatingscoliosis.com/

The Future Scoliosis Treatment?

• Non-invasive• Early Stage Scoliosis Intervention• Rehabilitation based• Re-trains the brain’s involuntary postural

control centers.• 3-D Auto correction that eliminates deformity.

Pre Treatment Post Treatment

Treatment (Mix, Fix, Set)

• Scoliosis Chiropractic Care– Warm-up (Mix)– Adjustment (Fix)– Rehabilitation (Set)

• Maybe a little chocolate therapy

• Wobble chair• Cervical Traction• Core Stimulation

(ligaments) & Muscle Stimulation

Warm up (MIX)

Adjustments (FIX)

• #1 PRIORITY: Restore cervical lordosis

• Adjust Anterior & Posterior Hip

Rehabilitation (SET)

• Proprioceptive neuromuscular re-education &

rehabilitation• Head weights• Hip weights• Tight rope

exercise

• Websites on scoliosis

–www.clear-institute.org/freeinfo–www.fixscoliosis.com–www.scoliosis-world.com

Resources for parents and kids

A Brief History of Scoliosis Treatment

Health & Medicine

Transcript of A Brief History of Scoliosis Treatment

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