Sunday, 25 January 2015

Carbon back rods for scoliosis - ORLANDO

Scoliosis affects six million Americans and there is no cure. For more serious cases, patients may require surgery to fuse the spine. The surgical materials doctors use are generally not a problem for patients, but a new solution for an unexpected complication helped save one boys life.

Daniel Stephen's parents call him their miracle. Doctors said he wouldn't live past the first night.
“He was not pink like a typical newborn baby who takes that gasp,” said Dawn Stephens, Daniel's mother.
Daniel had major health problems, including early onset scoliosis. His spine was curved into his ribcage, squashing his lungs.
Surgeons implanted a VEPTR, or a vertical, expanding, prosthetic titanium rib, which doesn't usually cause any problems.
“He was scratching his head, his chest, he had belly pain,” Jonathan Phillips, M.D., Pediatric Orthopedic Surgeon at Arnold Palmer Hospital for Children in Orlando, told Ivanhoe.
Turns out, Daniel is allergic to mostly all metals used to treat scoliosis. So Dr. Phillips had an idea: to trick Daniel's immune system they removed the titanium rods and masked the metal by spraying it with carbon. Daniel's symptoms disappeared.
That's why the teen says he calls his doctor his hero.
“He's fought for Daniel, he's thought way outside the box, it's inspiring and it gives us hope, hope for another day,” Dawn Stephens told Ivanhoe.
Meanwhile, one of Daniel's biggest wishes…
“To reach five feet,” Daniel said, “so I can drive go-carts.”
Daniel has been allergy-free for the past four years. Doctor Phillip's carbon-coated rods research was recently published in Spine Deformity, The Official Journal of The Scoliosis Research Society.
Contributors to this news report include: Cyndy McGrath, Supervising Producer; Katie Coronado, Field Producer; Kim Coley, News Assistant; Jamie Koczan, Videographer/Editor.
METAL ALLERGIES: The most common types of metal found in implants are chromium, nickel, cobalt, titanium and molybdenum; sometimes a prosthetic joint will contain one or more of these metal types. Nickel is the most common metal allergy, with up to 17 percent of women and 3 percent of men having it. In some people, the metal in the implant causes a reaction in the immune system when it comes in contact with body fluids. When blood circulates with the trace amounts of metal and reaches the skin, it causes a skin rash, called dermatitis; other symptoms include hives, blisters, and swelling of the skin tissue. The worst of this reaction usually occurs near the implant site. For patients with a titanium allergy, symptoms can range from a skin rash to pain and fatigue. So far, a blood test called the MELISA (memory lymphocyte immunostimulation assay) test is the only scientifically-proven way to diagnose a titanium allergy and its severity. There is also a blood test developed at National Jewish Health in Denver that can diagnose nickel allergies. Both tests see if a person's white blood cells react to the metal.

CARBON-COATING: Jonathan Phillips, M.D. Pediatric Orthopedic Surgeon at Arnold Palmer Hospital in Orlando, had been working with his young scoliosis patient, Daniel Stephens, for about a decade, trying to figure out how to work around an allergy to the metal implants keeping his spine straight. Through a combination of discussions with engineers from NASA and Synthesis, makers of the original VEPTR rods, Dr. Phillips learned that he could plasma-spray the titanium rods with carbon. Phillips told Ivanhoe, “carbon is an extremely inert substance and is very, very kind to the body.” Plasma spraying is the process of spraying molten/heat-softened material onto a surface to provide a coating. The material in powder form, in this case, carbon, is injected into an extremely high temperature plasma flame. This accelerates it to a high velocity impacting the desired surface and then cools to form a coating.(Sources: http://www.spine-deformity.org/article/S2212-134X(13)00131-7/abstract,http://www.gordonengland.co.uk/ps.htm)


Geo Morales
(321) 841-5766

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Jonathan Phillips, M.D., Pediatric Orthopedic Surgeon at Arnold Palmer Hospital for Children in Orlando, talks about modifying titanium back rods with carbon to help a child stand taller.

Interview conducted by Ivanhoe Broadcast News in June 2014.

If you could start by telling us a little bit about Daniel's story in a summary.

Dr. Phillips: Absolutely. I've known Daniel more than a decade now. I think I first met him when he was about 3 or 4 years old and came to me, the family moved to this part of the world and at that time he already had a very significant spinal curvature, a really bad scoliosis. The big question at that point was how we were going to treat it. Usually in very little kids we try to avoid surgery, but occasionally when the scoliosis is very bad, we have to start doing surgical procedures when these children are 4 or 5 years old. That's what ended up being the case with Daniel. We tried bracing and that was futile. We couldn't get that to work, so we eventually adopted a surgical method of treating the spinal curvature. The thing we were most concerned about was not just the gravity, the magnitude of his spinal curvature, but in addition, the fact that it was causing some compression of his ribcage and therefore squashing his lungs effectively. His respiratory function was becoming worse and worse with every passing year. And that's really what the very frightening aspect of his case was.

When his mother explained to you that there was a major reaction in his body what was your first thought? Did you think it was an allergic reaction?

Dr. Phillips: Well let's back up and talk about how we first addressed this. There are various ways you can do the surgery. There are various different devices, but the one that we thought was most appropriate, is called a VEPTR. That's a vertical expanding prosthetic titanium rib. The titanium is important because it's generally a very inert metal and doesn't usually cause any reaction. We eventually took him to the operating room, put in two of these artificial ribs, these distraction devices to support his spine and straighten it out, and everything went well for 2 or 3 weeks. Then he started to become unwell and we thought he had an infection, just on the right side. We took the right rod out and he seemed to improve transiently, but his mom told me on several clinic visits after that that he was still having very strange symptoms. He had eczema. He was scratching his head and his chest. 

He had belly pain. He had wheezing. He had an upset stomach, a very, very strange constellation of symptoms, so I was scratching my head very actively at this stage. I didn't really have any idea what was going on because this was not an infection. He didn't have a fever. His white blood cell count wasn't abnormally high, but there was something very strange going on. And then in one of his office visits, I looked at him, looked at him scratching and had this I guess “eureka moment,” an epiphany. I said “Oh my goodness, this little lad is allergic to the metal I put in his body. Then I had to start doing some research because titanium allergy is not supposed to occur. I went to the literature to see what was being published. I discovered that there is more in Google than there is in scientific literature unfortunately and some of it wasn't a very high quality, but certainly in the dental literature there was good evidence that titanium allergy, an allergy to this very, very, gentle noble metal did exist. Then the question is what on earth could we do? Well the first thing of course was to relieve his symptoms and to that end, we took out the other rod. Within probably a week or two all the scratching, the itching, the chest pain, the wheezing, the belly pain; all went away, that kind of proved, that indeed that might have been the case. But as a consequence of removing the struts that were supporting his spine, his scoliosis collapsed like a deck of cards and his lungs became even more compressed. 

We were up against a really big problem. We had to confirm this notion of titanium allergy so the first thing we did from the laboratory standpoint was to take some blood and send it off to a couple of places; one in the United States and there's one other place in Europe. We chose the lab in the United States to confirm the metal allergy. Because this time was so unique and so rare, we had to reconfirm this theory. And it turned out that he was allergic to a lot of different metals, titanium, miobium, niobium, zinc, everything. Even iron which of course is a major component of stainless steel and that was a big problem. Having confirmed that his T-cells, one of the two types of cells involved in the body's immunity, did not like titanium and all these other metals, the question is well, can we sneak around this and use a different metal. A few months later, I plucked up courage to use a stainless steel rod as a test metal and implanted it underneath his forearm skin as an ultimate allergy test and within a week or so, he was doing exactly the same thing, scratching, itching, whatever. We took it out; it went away.

 His symptoms resolved. He was all better. And now, we had a real problem. Because I confirmed anything with titanium, anything with steel and all these different metals we use in orthopedics, have got lots of different irons in them; they have trace elements of nickel, even things like copper, tiny amounts of that; we really were up a gum tree because there was no way we could use any traditional orthopedic metals to treat his scoliosis. In the meantime, his respiratory function was getting worse and his scoliosis was getting worse and worse. His spine was becoming more and more crooked.

And finally, what did you decide that made the difference?
Dr. Phillips: Well, it wasn't a final decision. It was a process of elimination, in many ways. When you make decisions in your life and when you come up with ideas, it isn't necessarily a single notion, but you draw from all your life experiences; you look at all of the different things that you've done; the boats you've built; the cars you fixed and that kind of stuff and in concert with talking with some engineers out at Cape Canaveral, NASA and talking with the engineers of the company Synthes that makes this VEPTR, in Switzerland, one of their engineers came over to talk to me, and then talking with the engineers from a company here in the United States, we kind of came up with a theory. What I needed to do was bamboozle Daniel's immune system by convincing his T-cells that there was no metal inside him. And we had to sort of sneak down the back stairs in a way. I thought well, we could make the actual device out of a ceramic which has been done for many years in orthopedics, but looking at the engineering challenges with that, it might not have been feasible because ceramic is very brittle and the first time he falls off his bicycle or whatever, he would potentially break. I said, okay, well if I can't make it out of ceramic, maybe we can make it out of carbon fiber. I've always enjoyed working in that medium, but then to mix carbon fiber, you have to put it in a gel of epoxy which is very, very unfriendly to the human body, so that wasn't a good idea. I thought, is there any way we can spray paint the titanium rods? I'm thinking, let's go to the hardware store and find something – well that's not going to work because those kinds of chemicals are very irritative too. I say, well how can we get carbon and wrap it around this rod because carbon is an extremely inert substance and is very, very kind to the body. Then one of the engineers said well, why don't you plasma spray the titanium with carbon. I said “What? You can do that?” And the combination of all of these kinds of different ideas came to fruition. We took some of the rods and these are actually a couple that I bent many years ago to suit Daniel's spine and these are usually a gold color and this is one of the ones that we sent to a company in Michigan and they plasma sprayed it with carbon and that's what it looked like and these are Daniel's custom made implants to fix his spine. When we had these all prepared, we took him back to the operating room, re-implanted these, expanded his spine and gave him better capacity for breathing and that was I think 7 or 8 years ago and he has never looked back since.

Source: 8newsnow, 21st Jan 2015

Dr. Mohammad Diab, patient creating app to help spinal condition sufferers

Mohammad Diab, MD, and his longtime patient, Carol Tran, are working together to design an app that helps sufferers of scoliosis parse through some of the more difficult aspects of pre- and post operation life, reports KTVU news.
Ms. Tran, 23, has had severe scoliosis since she was 11 years old and explained that she met Dr. Diab through her condition.

Dr. Diab had performed a second spinal fusion surgery on Ms. Tran when a first surgery had failed to correct the irregular curvature of her spine.

That surgery — the second — was successful and Ms. Tran was able to join her high school's swim team and even complete undergraduate school at Harvard.

Now, the app the pair are crafting includes a checklists on how to prepare for surgery. Ms. Tran said she hopes it will be the most all-inclusive resources available for scoliosis sufferers.

Dr. Diab, Chief of Pediatric Orthopedic Surgery at University of California San Francisco's Medical Center, said it's been rewarding to have treated treating Ms. Tran as a child and watching her recover and turn into an advocate for scoliosis.

Ms. Tran is working as an intern for Dr. Diab and plans to attend medical school in the fall.

Source: Beckers Spine, 20th Jan 2015

Girl’s Spinal Deformity Cured Through Surgery - MUMBAI

A seven-year-old girl suffering from Scoliosis has successfully undergone corrective surgery at a hospital here.
Scoliosis is a medical condition in which the spinal axis has a three-dimensional deviation.
Pinki was born with a deformed spine which made her life difficult and also posed to her a risk of accidents and health complications.
According to medical experts, such misalignment requires six-seven surgeries on a progressive basis to keep correcting the spinal curvature and maintain spinal growth.
Worried about Pinki’s future, her parents took her to several hospitals. They were later suggested to consult Ashok Johari, a orthopedic surgeon who runs Children’s Orthopedic Centre in the city.
spinal surgery of the patientTaking cognizance of the spinal deformity, Johari used a revolutionary new surgical procedure named ‘MAGEC’ to treat Pinki. She underwent the surgery Dec 20 last year.
According to the new technique, magnetic rods are used to correct the grossly deformed spine of the patient.
Pinki was first such patient in western India to undergo this latest surgical procedure.
Johari said that through the use of ‘MAGEC’ technique, Pinki will not only get better but get freedom from six-seven subsequent surgeries that would have been needed in the conventional mode of surgery.
Under this technique, ‘MAGEC’ rods are used in spine surgeries but for a magnetic actuator. Once implanted, subsequent distraction (lengthening) can be managed from an external magnetic controller.
This controller can be used by the physician during routine visit. This exercise is completely pain free, does not require anesthesia or even a pain killer.
“Initially when Pinki was brought to the clinic, her scoliosis progressively increased. Such patients have to be treated early before the curve advances aggressively and is a threat to normal functioning of other organs,” Johari said in a statement. He has performed the same procedure on two other children with similar conditions.
He said that in the absence of ‘MAGEC’, the patients have to undergo six-seven surgeries.
“These surgeries carry a potential risk associated with anaesthesia, blood loss, infection and above all mental trauma to small child and parents,” he said.
“Pinki is perfectly fine now and her bone deformity has been cured,” he added.

Source: Bioscholar , 23rdJan 2015 

Saturday, 17 January 2015

Shankar's film 'I' ridiculing disability on pretext of creativity

Cinema and cricket captures the imagination in this country. Sadly, majority of cricket stadiums are not accessible and majority of the films ridicule disability. Cinema is also responsible for perpetuating stereotypes and more often than not people with disabilities are at the receiving end. Disability is portrayed as a negative character and there is hardly a Bollywood film where a person with disability himself has portrayed any significant character. Often, non-disabled portray disabled character without understanding the disability. If this was not sufficient, top directors dish out humiliating experiences in the form of creativity. The latest to join this infamous list is unfortunately, India’s most seasoned director.

The teaser of Tum todo na song in Shankar’s magnum opus ‘I’ begins on a promising note but gradually turns into disbelief for me and later unacceptable. The song portrays the beauty and the beast concept but what hurts me was the projection of werewolves as disabled beasts. The protagonist Vikram is portrayed as a werewolf and a grotesque avatar of Hunchback of Notre Dame. Standing behind him in the song are werewolves as the beasts with spinal curvatures and holding wooden crutches. As this dehumanizing song was not sufficient, the film has Vikram in another character Koonan where he is shown as pitiable and pathetic stereotype with huge growths on his face and scoliosis. Shankar, the director himself tweeted a photograph stating “With one of my favourite #I hunchback standees”.  ​Is Shankar n​ot aware that words and negative cinematic portrayal do have the power to hurt​?​

In the six months after Disney's Hunchback of Notre Dame was released in the UK, disabled people reported the word 'hunchback', which had gone out of use, was being used in a derogatory way towards them. The British Scoliosis Society wrote to the then Minister of Disabled People complaining that since the film came out there had been more than a hundred attacks on people with scoliosis.
Pepin le Bossu (767-811) had kyphosis since birth and medieval historians gave him the epithet “hunchback.” Many medieval people probably believed that physical deformation or disability was an outward manifestation of spiritual corruption, a position that was partially informed by passages from the Bible- disability is seen as a punishment from God (Chapter 9, Book of Leviticus, Chapter 21).
Richard III, who ruled England from 1483 to 1485, had adolescent idiopathic scoliosis. Shakespeare called him a ‘hunchback’ and described the king as a “poisonous bunch-backed toad” in his 1593 play. English poet Alexander Pope had a severe rachitic kyphoscoliosis along with tuberculosis of spine (later termed as Pott’s spine). His rival poets bullied him by calling “hump-backed toad.” 

The Disney Films unfortunately continued the tradition of reinforcing negative stereotypes of disability. In the 1998 animated ‘The Hunchback of Notre Dame’, Disney chose to have Esmeralda go off with the non-disabled Phoebus rather than the disabled, Quasimodo, who loves her. Similarly, in the earlier film “Beauty and the Beast”, in the climax the beast transforms back into a handsome human totally contradicting the film’s supposed message of “looks don’t matter.” The teaser of Tum todo na also shows the same.

The stereotypes about Quasimodo’s disability were reinforced again and again in subsequent filming of ‘The Hunchback of  Notre Dame’. In fact, the original title of the novel by Victor Hugo was Notre Dame de Paris. 

The Hunchback part was added when the book was translated into English. Shankar continued to use the derogatory term in his interviews and on social media. In contrast, Oddsocks Productions, a British theatre company dropped the word “hunchback” from its stage adaptation of the classic novel and named it The Bellringer of Notre Dame. The difference was that these people consulted disability advisors and then dropped the word. I doubt if Shankar had approached anyone from disability sector.
That reminds me of Shankar’s previous classic Nayak featuring my favourite Anil Kapoor. In one of the scenes, a crawling disabled youth honours Anil Kapoor with a garland and requests to stand for elections saying, “My country has become lame like me. Make it walk.” That scene struck very well in the context of the film and even the protagonist Anil Kapoor vows to fight the elections in the film. On the contrary, it reinforced the stereotype that disabled people cannot contribute to growth. Does “Make it walk” means that a disabled person cannot contribute to nation building?

The negative images of disability in these media, although false, have become so familiar that people believe they show the reality of disabled people's lives. The non-disabled audience accepts unquestioningly these false images because it is more comfortable to do so than to face their deep-seated fear of difference. Jenny Morris argues in Pride Against Prejudice, “If we do not 'appear' as real people, with the need for love, affection, friendship and the right to a good quality of life, how can non-disabled people give any meaning to our lives?" 

Anyone can, at any time, become disabled, or develop a physical or mental impairment. Vikram, who is playing the character having spinal curvature, met his wife for the first time when he was in crutches, following three years of his hospital stay. The film makers and the actors should be aware of the sensitive issue since ignorance is no excuse. There is an awful stigma attached to scoliosis and it can lead to bullying, discrimination and adverse psychological problems.

Medical impairments like congenital porphyria (photosensitivity, reddish teeth, & psychosis), hypertrichosis (excessive facial growth), scoliosis/kyphosis/lordosis (curvature of spine), ​and ​Pott’s spine (tuberculosis of spine leading to bony deformity) may lead to some of the features traditionally associated with werewolves. The derogatory hunchback word has become so thoroughly associated with evil characters that it is totally unacceptable. Spinal curvature is the preferred terminology if you ask us, the people with disabilities.

Developmental disorders, degenerative diseases like arthritis, osteoporosis, compression fractures all these can lead to spinal curvature which can happen to anyone. Disability is diversity. Just like the DNA of the crew members of film ‘I’ is not same similarly anybody in ​this world can have a posterior convex angulation (kyphosis), anterior convex angulation (lordosis) or lateral curvature (scoliosis) of spine. Being a doctor with disability, I know and would like to tell all that a small degree of both kyphotic and lordotic curvature is considered ‘normal’. Not only disabled but elderly people also and people in plasters use crutches (Vikram used too) so it was dehumanizing to equate assistive device with beasts in the song.

My initial reaction was disbelief that the world renowned director has portrayed disabled in such a spirit. My knee jerk reaction was 3 tweets to him and in one of those I said that I am proud to use crutch and NOT ashamed of knowing people having kyphosis or scoliosis. No wonder the great director blocked me on Twitter.

The Cinematograph Act, 1952 under section 5B(2) states that the "Central Board of Film Certification shall ensure that scenes showing abuse or ridicule of physically and mentally handicapped persons [2(iii)b) and scenes that may have the effect of de-sensitising or de-humanising people are not shown [2(iv)]."

Can a person with spinal curvature or a person using crutch see this film in a cinema hall? Will he not be ridiculed as we all know how disabled are treated in our country? As feared, even media has started using the derogatory hunchback word popularized by Shankar.Creativity doesn’t give anyone be it Shankar or Weta Digital any right to ridicule disability. I appeal to directors to refrain from depicting us as objects of curiosity. Make us ordinary. Our impairments should not be ridiculed or made the butt of jokes.

The opening song in Disney movie asks listeners to judge for themselves “who is the monster, who is the man.” Same can be asked from Shankar. No doubt he has captured our imaginations with his previous films. But here, his filming of the song Tum todo na reminds me of another song ‘Dil mera churaya kyun, jab ye dil todna hi tha’.

The disabled character Quasimodo originates from Latin words "quasi" and "modo" also mean "almost" and "the standard measure" respectively. As such, Quasimodo is "almost the standard measure" of a human being. The measure should be empathy and compassion (as shown by Quasimodo’s love for Esmeralda) and not disability. The use of crutches to equate beasts with disable was totally unwarranted.

I take pride in using crutches & will continue to use them.
I accept disability as diversity.
I respect people with spinal curvatures.  
I wish 'I' a good business.
I plead film reviewers not to use 'hunchback word' while reporting about 'I'.
I may not watch 'I' but I assure Shankar to watch his future films if they are non-discriminatory.
I expect more sensitivity from Indian cinema on disability issues.
I further hope that Indian cinema wont feign disability and use people with disabilities to showcase their experiences.

Dr Satendra Singh
(A doctor with disability at UCMS & GTB Hospital, Delhi and founder of a group 'Infinite Ability' promoting creativity and disability. I use crutches and not ashamed of that.)

Source: The Enablist, 13th Jan 2015

Sunday, 11 January 2015

Doing Simple Yoga Pose Short-Term Reduces Adolescent Scoliosis Curves By Almost Half

For adolescent girls and adults diagnosed with scoliosis severe enough to need treatment -- especially young girls, whose scoliosis of unknown origin (IAS) is by far the most common form of scoliosis -- treatment options are heartbreaking. Actually, there are 38,000 scoliosis surgeries annually in the USA costing approximately $7.1 billion.

When their bodies are changing and their peer group is becoming all-important, these young girls are put in disagreeable braces or subjected to surgery. Untreated scoliosis can progress at 7 percent per year, and result in disability and life-threatening health risks.

Bracing, the most conservative treatment, consists of confining body orthotics worn up to 23 hours a day. In addition, one of the most popular bracing methods calls for patients to exercise in two-hour sessions three times per week for three to four months. Patients are then advised to continue exercises for half an hour a day as long as they live.The bracing is unwieldy and lengthy exercising is socially awkward, emotionally painful and physically difficult. European studies find a profound drop in self-esteem and a dramatic rise in depressive symptoms accompany bracing.
Medical Yoga

Medical yoga has been so effective for so many different ailments that I decided to try it for scoliosis. Experience had already shown that patients can't or don't want to spend hours or a lot of money. I looked for a relatively simple pose that could be applied to scoliosis, done in a brief time, at home after minimal instruction.
Since scoliosis is an asymmetrical condition, I thought about poses that could be done asymmetrically, on one side only. It made sense that strengthening the muscles on the weak (bulging) side of the curve would make those muscles powerful enough to pull the spine into a straighter position. The Side Plank (Vasisthasana) could make the relevant spinal muscles stronger for the primary curves I focused on initially when Ibegan a clinical trial.
My first patient, the one who inspired the clinical trial, was an older woman brought to me by her yoga-teaching daughter. Her curve was 108 degrees, and was affecting her breathing and cardiac function to the extent that she could not have surgery. I told her we could try using yoga which might slow down or maybe even halt the progression of the curve. It never occurred to me then that we could reverse the curve.
Immediate Encouraging Results

After the first X-ray, she returned to my office, where she learned Vasisthasana rather quickly, though she had not done much yoga before. At that time she committed to doing the pose up to six times week for about a minute or a minute and a half a day. Helped and encouraged by her yoga teacher daughter, she religiously did the pose every single day. After about a year and a half I said, "maybe I'm kidding myself, but you actually seem straighter." The repeat X-ray was 64 degrees -- a reduction of almost 60 percent!

This woman is emblematic of the results of my clinical study, which showed that Vasisthasana, a basic yoga pose, done for an average of only 1.5 minutes a day, six days a week for an average of 6.8 months, reduced idiopathic scoliosis curves for adolescent and adult patients an average of 32 percent. The 25-participant trial was evaluator-blinded, X-ray based and used the standard Cobb method for measuring results. Among 19 compliant patients who did the yoga more than three times a week, the improvement was 40 percent. In the group of compliant patients, adolescents improved 49.6 percent -- almost half; adults improved 38.4 percent. All patients did the side plank (Vasisthasana) yoga pose, and all patients did it on one side only -- the convex side of the lumbar curve.

Other research besides this small medical yoga trial has been done, of course. One method found improvements with 15 hours a week of exercises, but it measured the spinal twist that results from advancing scoliosis, not the curve. I believe the curve is what needs to be treated, that it comes first and causes the twist. Other popular methods do not use the Cobb scale (the standard) for measuring sclerotic curves, or they recommend yoga or other exercises but have no scientific evidence that they work.
More Research Is Needed
Scoliosis is not necessarily simple. Many patients also have "S" shaped curves, and curves appear in different spinal locations. I am beginning to work with those other curves in addition to the primary curve that Vasisthasana reduces. The Half-Moon Pose, Ardha Chandrasana, appears to help with some curves higher up in the rib-bearing vertebrae.

There are still many unanswered questions about Vasisthasana and other specific yoga poses for scoliosis. Does the curve keep reducing at the same rate? Are there even better poses? Can yoga prevent scoliosis? More research is needed. But yoga -- free, with "side-effects" such as better posture, enhanced self-esteem and elevated consciousness, can be done without cost, at home, producing results in a brief time -- certainly provides hope.

Source: Huffington Post , 5th Jan 2015

7 things to know about radiation exposure during scoliosis surgery

A new prospective study on radiation exposure during spine surgery for scoliosis correction shows exposure is within the recommended safe limits. The study is published in The Spine Journal.
Study authors examined exposure with an electronic dosimeter attached over the thyroid guard and thermoluminescent dosimeter ring on both of the surgeon's hands. Patient monitoring used a dose area product measurement tool and calculations were done with the Monte Carlo


The researchers found:

1. Average eye dose per procedures for one of the surgeons was 0.8 μSv. The other surgeon reported an average of 1.3 μSv.

2. The first surgeon reported an average thyroid does of 1.4 μSv while the second surgeon reported a does of 1.2 μSv.

3. Doses recorded for the surgeon on the same side of the patient as the X-ray tube were significantly higher than the surgeon on the far side of the X-ray.

4. The average dose area product per procedure was 91.2 cGycm2.

5. The average radiation dose for the patient was 252.9 μSv.

6. There was an increased cancer risk for patients about 0.001 percent. For surgeons, the risk of cancer went up 0.0005 percent for each year of exposure.

7. The researchers concluded that "both surgeons received total radiation dose less than 1 percent of the recommended dose limit per year and therefore the total radiation exposure by both surgeons and patients was well within the recommended safe limits."

Source: Beckers Spine Review, 8th Jan 2015

Dancer with scoliosis selected for world’s most prestigious ballet competition

Mosman Ballerina, Naomi Sano, 15, has been selected for the international Prix de Laussan
Mosman Ballerina, Naomi Sano, 15, has been selected for the international Prix de Laussane competition.

IDENTICAL twins and ballet dancers Naomi and Arisa Sano of Mosman have spent two years in back braces, but it has not dented their spirit and courage.
Now Naomi has been selected for the world’s most prestigious ballet competition — a remarkable achievement for a ballerina who, like her twin, suffers from scoliosis or curvature of the spine.
Naomi will leave for Switzerland in February to compete in the Prix de Lausanne, which opens doors to international scholarships and ballet companies.
“Arisa is pleased for Naomi. They are very supportive of each other,” said their mother Tomoko Sano.

Arisa and Naomi Sano performing at the Mosman Dance Academy annual concert called Cirque

Arisa and Naomi Sano performing at the Mosman Dance Academy annual concert called Cirque de la Danse in 2013.

The twins have taken ballet lessons since they were five years old.
The twins have taken ballet lessons since they were five years old.
The 15-year-olds were only allowed to remove the back braces for two hours a day, which they devoted only to ballet practice.
The braces were finally removed last July but Arisa will be unable to audition in Switzerland as she fights through further treatment for her scoliosis.

Jasmin Bobyk, holding seven-week-old Scarlett Mcdougall, with Naomi (left), Arisa Sano an
Jasmin Bobyk, holding seven-week-old Scarlett Mcdougall, with Naomi (left), Arisa Sano and toher young dancers at Mosman Dance Academy.
Since they started ballet at five years old, the twins have lit up the stage in front of thousands at competitions like the Sydney Eisteddfod/
Naomi said she was passionate about ballet and the scoliosis only made her more determined.
“It’s just this feeling inside when I dance,” she said.
Fortunately for the girls, doctors have approved of ballet as one of the best medicines for scoliosis, particularly as an aid for posture.
Cooper Gridland Hayes, 17, of Cammeray has also been selected for the Prix de Lausanne.
Naomi will leave for Switzerland in February to compete in the Prix de Lausanne.
Naomi will leave for Switzerland in February to compete in the Prix de Lausanne.

Source: Daily Telegraph, 9th Jan 2015

Doctor links scoliosis, brain chemical imbalances

A curvature of the spine, called scoliosis, affects approximately 3-5 percent of the adolescent population in the United States. It has long been thought of as purely an orthopedic disorder, until now.
A new study published this month in the journal Alternative & Integrative Medicine shows that adolescent children with idiopathic scoliosis obtain better correction when treatment of certain brain chemical imbalances is combined with rehabilitation treatment.
According to the study’s lead researcher, Dr. Mark Morningstar, DC, PhD, of the ScoliSMART Clinic — Michigan. “We’re beginning to realize that scoliosis is more of a neurological and hormonal condition that results in the spine curvature called scoliosis, rather than scoliosis simply being a mus culoskeletal problem with genetic factors.”
In the study, a group of children participated in a proprietary scoliosis exercise program for two weeks. Another group participated in the same program, but additionally received amino acid therapy to address a pattern of brain chemical imbalances — called neurotransmitters.
When both groups followed up at six months, the group who received the brain chemical treatment maintained their scoliosis treatment results far better than the exercise-only group.
“Very little is understood at this point in time as to why some children do very well with exercise-based scoliosis treatment, while others fail all forms of scoliosis treatment, including bracing and surgery.
“Our hope is that we can find the missing pieces in how scoliosis develops, how it progresses rapidly in some children, and not at all in others. Identifying these hidden factors in scoliosis development will help lead us into the future of scoliosis treatment….prevention,” said Morningstar.
Neurotransmitter testing involves a urine test that is covered by most insurances. Anyone wishing to be tested, or have their child tested, can visit www.treatingscoliosis.com and request a free test kit to be sent directly to them. For more information on the study, contact Mark Morningstar, DC, PhD, 810-694- 3576 or online: www.treatingscoliosis.com/ . 

Source: Grand Black View, 8th Jan 2015

6 key notes on pulmonary function after spinal deformity surgery

study recently published in The Journal of Bone and Joint Surgery examines pulmonary function after spinal deformity surgery in the adult population.
The researchers examined 164 patients who underwent surgical treatment at a single institution. The patients were followed for at least two years and the procedure was primary surgery for 100 of the patients.

The posterior-only surgical approach was used for 77 percent of the patients. Here are six key findings from the study.

1. A significant change in the major thoracic Cobb angle occurred in all patients. The average changes were:

• Thoracic Cobb angle: 47.4 degrees to 24.9 degrees
• Sagittal Cobb angle: 35.5 degrees to 30 degrees

2. There was a significant decline in absolute and percent-predicted pulmonary function values. The percent-predicted FEV1 decreased 5.3 percent and the percent-predicted forced vital capacity decreased 5.7 percent.

3. There was a clinically-significant decline — 10 percent or more in percent-predicted FEV1 — for around 27 percent of the patients.

4. Ten percent of the patients reported pulmonary impairment preoperatively and 14 percent reported pulmonary impairment after surgery. This change was not significant, and the patients with preoperative pulmonary impairment showed significant improvement in the absolute and percent-predicted FEV1 after surgery as compared to those without preoperative impairment.

5. The patients undergoing revision surgery had similar postoperative percent-predicted results to the patients undergoing primary surgery. But, revision surgeries were more often associated with a significant decline in pulmonary function.

6. The researchers found no difference in pulmonary function between patients who had posterior-only surgery and those who underwent the anterior/combined anterior-posterior procedures. There were also similar results when comparing by upper-instrumented vertebra.

Source: Becker's Spine Review, 9th Jan 2015