Baby boomers and scoliosis: Osteoporosis is risk factor

For many adults, the word scoliosis conjures up childhood memories of lining up in gym class for an examination by the school nurse. But scoliosis isn't just a pediatric condition. Curvature of the spine can develop in adults too, and the osteoporosis that can accompany menopause is a risk factor. Mayo Clinic orthopedic surgeon Paul Huddleston, M.D., explains how scoliosis develops, prevention and treatment options and a trend he is seeing in Baby Boomer women.

What is scoliosis?

Scoliosis is a misshaping of the spine as seen from the front — where the spine seems shifted right or left — or from a side view, where the spine is bent too far forward or backward, or a combination of the two. It doesn't always cause pain: Schools started screening in elementary school or junior high in part because many children and their parents didn't know the children had it, Dr. Huddleston says.

"The range of symptoms can be from asymptomatic, or no symptoms, to completely debilitating, depending on the patient, magnitude of the deformity and where the bend or special shape occurs," Dr. Huddleston says.

What causes scoliosis in children?

It can be a change during the growth process in the womb, in which a growth plate in the spine closes prematurely or there is an extra piece. In older children and adolescents, the scoliosis likely is genetic, but that hasn't been completely defined, Dr. Huddleston says. In other cases, diseases such as cerebral palsy, muscular dystrophy and the connective tissue disorder Marfan syndrome can predispose a child to scoliosis.

"The most common type is the 'We don't know why' variety called idiopathic scoliosis," Dr. Huddleston says.

What causes scoliosis in adults?

Adults who had spine curvature as children can develop severe arthritis in the spine next to their old curves. In other cases, osteoporosis, or weakening of the bones, can develop as a complication of menopause or medications as people age, even causing fractures. Forms of arthritis in which joints in the back wear out can also let the spine sag into a bad position, Dr. Huddleston says.

How is scoliosis affecting Baby Boomers?

Baby Boomers have a much better understanding of adult scoliosis and are more aggressive in seeking treatment than previous generations have been, Dr. Huddleston says. The number of older adults seeing him to ask about corrective surgery for scoliosis has easily doubled within the past five years, and women of Baby Boomer age are driving that trend.

"I think a lot of it is our appreciation and desire for a higher quality of life in the later stages of life. They say '60 is the new 50' or '50 is the new 40.' I think we want to be more active. We're educated about the possibilities and we demand that quality of life," Dr. Huddleston says. "And women are demanding to stay active, to have good bone health and to address any perceived deficiencies that the special shape of the spine as it becomes scoliotic has placed upon them."

Some mention that they want to avoid becoming the stereotypical hunched-over "little old lady" with a cane, he adds.

How is scoliosis treated?

"We try to minimize the initial treatment and maximize the patient's function. We try to empower them to stay as active as possible," Dr. Huddleston says. That can mean physical therapy, and in adults, medication to treat osteoporosis and osteoarthritis.

If that doesn't work, spinal surgery may be considered.

"We think of surgery really as an end-stage treatment," Dr. Huddleston says. "We are trying to balance the patient's suffering versus intervening too soon. We don't want to put a very large, potentially painful procedure in front of some of these more basic foundation treatments, but we don't want people to suffer, either."

In principle, surgery is the same in adults as in children: treating the spinal deformity. But because of the influence of age on healing and bone quality, adult scoliosis surgery "really is a different experience," Dr. Huddleston says, adding that Baby Boomers are benefiting from a much better understanding of that by physicians.

Not all patients are good candidates for scoliosis surgery. For those who are, successful surgery improves their ability to move, reduces pain and can improve their self-image.

Physical therapy is critical before and after surgery to build flexibility, strength and stamina.

"In fact, I would say without reservation that the surgery alone without the appropriate preoperative physical therapy and bone preparation and postoperative physical therapy will not be successful," Dr. Huddleston says. "We can change the structure of the patient, the way you look inside, but we can't make you move. The analogy would be, we can straighten the frame, but we're not the motor."

Can adults prevent scoliosis?

Make sure to get enough calcium and vitamin D to help prevent osteoporosis, and seek treatment if you have osteoporosis. Women should take steps to preserve their bone health before menopause, Dr. Huddleston says.

"You can ask the question: Is my bone health what it should be or what I expect it to be? That involves seeing your health care provider, getting screened, and then taking action to prevent softening of the bone," he says. "Because once the bones start to break with the osteoporosis, you can't undo that fracture, and you've really lost that opportunity to stay in that good space."



Source : Insight News , 3rd Nov 2014

MEDICREA receives FDA clearance for world’s first patient-specific spinal osteosynthesis rod

The MEDICREA Group (Alternext Paris: FR0004178572 - ALMED), a company that specializes in the development of personalized implants produced for a patient’s specific need in the treatment of spinal pathologies, today announced the company has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for UNiD^TM, the world’s first patient-specific spinal osteosynthesis rod.

The technology will be premiered at the 2014 North American Spine Society (NASS) Annual Meeting taking place on November 12-15 in San Francisco, CA at booth #2231. The first U.S. patient underwent surgery to have personalized UNiD^TM rods implanted earlier today in New York.

“MEDICREA’s groundbreaking UNiD^TM patient-specific rods include the most current clinical data and software development along with the latest in personalized production and industrialization to revolutionize how spine surgery is performed. UNiD^TM rods provide surgeons a very precise surgical method, supporting better patient care and improved economic outcomes”.

UNiD^TM features a user-friendly software tool to help surgeons preoperatively plan their surgery and order customized, industrially-produced rods to fit the specific spinal alignment needed for each individual patient. UNiD^TM eliminates the need to manually contour a rod during surgery, providing surgeons with a precisely aligned rod prior to surgery and reducing the amount of time patients spend in the operating room, which directly impacts infection rate and quality of recovery.

“Understanding and restoring sagittal alignment is key towards providing better patient outcomes and preventing the need for reoperations, a major factor in rising health care costs. By providing rod customization, UNiD^TM allows surgeons to precisely execute their preoperative plan and frees them from the antiquated technique of freehand bending, ensuring individual patients receive the most accurate and effective treatment. Having a more precise, personalized rod ready before even stepping foot in the operating room is a game-changer for spine surgery,” said Frank J. Schwab, MD, a renowned orthopedic surgeon and spinal deformity expert, who performed the first customized UNiD^TM rod surgery in the U.S. today.

The UNiD^TM rod system, which has been successfully implanted in over 100 patients in Europe offers a real-time support team, the UNiD^TM Lab, that provides a seamless process by which surgeons preoperatively analyze, design and order the patient-specific rod. The UNiD^TM plug in, proprietary to MEDICREA, is embedded into the Surgimap software, and provides surgeons a quick and efficient option for ordering patient-specific rods. After the planning process is complete, the order is transferred to the UNiD^TM Lab, which processes the request and industrially produces and labels the rod specifically for the patient.

“When we created Surgimap in 2008 our primary goal was to provide a research tool for surgeons to plan, measure and review their results,” said Virginie Lafage, PhD, Co-Founder of NEMARIS. “As we collected data we noticed a startling trend: 62 percent of patient remained sagittally malaligned after surgery . This was occurring not because of a lack of skills, but because surgeons have not had the best tools at their disposal. Our collaboration with MEDICREA is an important step forward for spine surgery. Combining our core competency, our software platform, with MEDICREA’s hardware solution was necessary to bring a cutting-edge solution to surgeons and the patients they treat. It would not have been possible without such collaboration.”

The UNiD^TM customized rod offers numerous benefits to surgeons and patients undergoing spine surgery.

• The primary benefit of UNiD^TM is it allows surgeons to plan and then execute their operating strategy without compromises or approximation errors.

Until now, surgeons had no alternative but to use a bending device, known as a French bender, supplied in all instrument kits to bend the rods manually. This manual rod-contouring process involves estimating the curve in a very empirical manner using pre-operative X-rays displayed on a wall in the operating room. Significant error and variability exist with that approach. With UNiD^TM, surgeons can now be certain of implanting spinal fusion rods that are precisely adapted to the patient because UNiD^TM rods are personalized and accurately curved using a design established by the surgeon during the pre-operative planning phase with the Surgimap / UNiD™ software. 

Additional advantages of UNiD^TM include: 

• Surgeons can improve their success rate in terms of global sagittal patient alignment.

With the free UNiD^TM application in the Surgimap software, spine surgeons have access to the most recent scientific data available on the parameters necessary to determine and restore sagittal alignment for each patient. 

• Surgeons can save time and be more efficient in the operating room.

By eliminating the manual bending of rods during surgery, surgeons can significantly reduce operating time. This is an additional benefit, since infection rates and the quality of a patient’s recovery are directly linked to the duration of the surgical procedure. As soon as the surgeon validates the rod’s design in the UNiD^TM application, MEDICREA precisely manufactures the implantable rod and delivers it within 5 working days. 

• Surgeons can reduce the risk of spinal implant failure.

The UNiD^TM rods, customized for each patient, are pre-contoured using a controllable and reproducible industrial process. This eliminates the intraoperative use of a bending device, which creates indentations, or notches, in the rod. Such notches are an acknowledged cause of rods breaking postoperatively, which can occur in patients – especially adults with severe spinal deformities

“MEDICREA’s groundbreaking UNiD^TM patient-specific rods include the most current clinical data and software development along with the latest in personalized production and industrialization to revolutionize how spine surgery is performed. UNiD^TM rods provide surgeons a very precise surgical method, supporting better patient care and improved economic outcomes,” said Denys Sournac, Founder, CEO and Chairman of MEDICREA and added “FDA approval of UNiD^TM is a major milestone for MEDICREA. We started working closely with the FDA nearly 2 years ago on that strategic approval and this newly obtained clearance marks the culmination of years of research and surgery planning to bring a patient-specific spine implant to market, as well as the beginning of a new exciting era in spine surgery.”

UNiD^TM patient-specific rods are universal implants available in two alloys (Titanium TA6V ELI/Cobalt Chromium) and two diameters (5.5 mm/6 mm), that match global standards. UNiD^TM naturally fits into the PASS LP^® thoraco-lumbar fixation system, present in a worldwide market segment estimated at $3.6 billion. The PASS LP^® system is already used by numerous spine surgeons in 35 countries, and notably in the United States where this product accounts for the majority of MEDICREA USA Corporation’s sales. MEDICREA’s customized spine implant platform also includes the UNiDTM anterior lumbar interbody fusion (ALIF) spine cages created with a 3-D printer. With the support of specific software and advanced imaging, the UNiD^TM ALIF customized cages made of Poly Ether Ketone Ketone (PEKK) exactly reproduce the anatomic details of a patient’s vertebral endplates. The world’s first spinal fusion surgery using the UNiD™ ALIF customized 3-D printed spine cages was performed on May 28, 2014 in France.

UNiD is the first patient-specific device cleared to treat degenerative spine conditions including scoliosis and other type of deformities, which represent a $2 billion market opportunity in the U.S. alone. According to the National Scoliosis Foundation, an estimated six million people in the U.S. have scoliosis. Each year scoliosis patients make more than 600,000 visits to private physician offices, and an estimated 38,000 patients undergo spinal fusion surgery. Adult spinal deformity surgery is likely to increase in frequency with as much as 32 percent of the adult population suffering from scoliosis and a prevalence of 60 percent among the elderly. Hospital costs of adult spinal deformity surgery can exceed $100,000 per patient. Revisions and reoperations place a large financial burden on the health care system – increasing the average cost of adult spinal deformity surgery by more than 70 percent. The market for revision surgeries is growing at a significant rate because of the number of corrections performed with approximation errors and misalignment over the past 20 years.

MEDICREA will be hosting a symposium on November 12 from 6:00pm to 8:00pm at the Inter Continental San Francisco featuring guest speakers including Virginie Lafage PhD, Dr. Schwab and renowned San Francisco neurosurgeon Christopher Ames, MD. Topics to be discussed include integration of science into clinical practice, open procedures and osteotomy techniques in adult spinal deformity and the role of patient-specific implants into improving patient outcomes.


Source : News-Medical , 12th Nov 2014

Yoga for Kyphosis

Yoga is understood to relax your nerves by remedying posture and doing away with deleterious kyphosis.

Kyphosis, a back problem, not just hinders your look however also influences your physical health. As kyphosis can create a speculative impression amongst your peers, it’s a significant source of frustration. Your mood and your efficiency can also be influenced with such abnormality.

Not to stress, yoga is your best supporter if you’re coping with painful signs and symptoms of kyphosis. Yoga is a wonderful means to obtain additional mileage by fixing posture, sustaining a positive state of mind and improving your body’s internal energy.

Kyphosis Leading to Abnormality

Kyphosis is an unusual back posture defined by extreme rounding of the thoracic spine (portion in between the upper and middle back). A popular train of thought is that osteoporosis, degenerative conditions, and vitamin D insufficiency can result in Kyphosis. However, a carefree way of living with inadequate posture is precisely the reason why you observe an excessive curve in your back.

Kyphosis restricts body movement and obstructs normal breathing that can disrupt everyday performance. Excessive hunchback ruins your cosmetic appearance too and keeps you feeling “less than” your colleagues. Furthermore, kyphosis results in loss of balance and boosts possibilities of falling, trouble resting and consistent backaches.

Yoga for Kyphosis

Your back activities don’t stream rather as smoothly as they should when you’ve an extreme curve. Because the back is the main supporter of the body, it’s extremely important to ensure its curve and function for all the actions it’s to carry out. The general policy is to keep moving to preserve spine alignment. 

A research study examining the impacts of yoga among women with hyperkyphosis revealed that yoga is safe, appropriate and can improve posture. A pilot research study published in the American Journal of Public Wellness stated that: females with hyperkyphosis who were provided hatha yoga experienced positive physical and mental effects. Ladies who’d practiced hatha yoga, a mix of breathing and motion, showed an enhanced postural awareness and a more elongated spine. Females revealed a better sense of well-being, a feeling of relaxation and a tranquil frame of mind.

Each yoga pose has an objective to accomplish a particular target. As yoga positions are approached with a calm and meditative state of mind, the body can accomplish a guaranteed objective. So yoga in a detailed way can assist handle the physical and mental issues of kyphosis.

Benefits of Yoga to Correct Kyphosis

• A body-mind combination of yoga handle the physical and psychological health and corrects lifestyle associated physical problems.
  
• Strengthening and stretching exercises correct underlying muscular and bio mechanical problems that trigger kyphosis.
  
• Increased strength and versatility of underlying muscles assist to enhance the back positioning that enhances your back.
  
• Experience a liberty in body language that you never pictured previously.
  
• Yoga makes you content to live on the edge of your potential. Provide you a fresh start and fix your poor posture.

Yoga poses for Kyphosis

Yoga postures beneficial in reducing excessive rounding of the thoracic spine are:

• Bridge pose (Setu Bandasana)
  
• Locust pose (Salabhasana)
  
• Cobra pose (Bhujangasana)
  
• Mountain pose (Tadasana)

Ensure your yoga trainer is educated enough to recommend you appropriate positions for fixing Kyphosis. Practice those that work best for you and take pleasure in a graceful and healthy life.


Source : Yoga Divinity , 31st Oct 2014

Yoga For Fighters – Kyphosis

                               BIG UP YER CHEST!!!

Something guys don’t normally have a problem with, biggin up their chests!!

Haha I’m just jesting you buttercups!! But all jokes aside…

This is a regular complaint for those fighters that have a strong guarded stance and a gruelling training schedule.

Kyphosis can be a postural or genetic deformity of the thoracic vertebrae.

Either way, it can be corrected or improved by exercises which increases postural awareness, corrects alignment and increases mobility and strength to the area.

I must also state that there are varying degrees of kyphosis, some of which will need medical attention and supervision. For those with a lesser degree, yoga can help.

It is basically the hunching forward of the shoulders, that leaves an accentuated curve to the upper back and neck, which can cause pain and stiffness. This pain and stiffness can lead to a worsening of the condition, due to the compensation of a particular weakness.

The chest and neck starts to feel like its closing into yourself. Not only does this lead to bad posture and loss of flexibility in the area, breathing can be effected by less space for the lungs to expand with a closed chest.

Its easy to see how this has happened, because your training consists of using this defence stance in particular for a long period of training to guard your own body as defence.

Guess its time to BIG UP DA CHEST, for real!!

If you don’t counter balance this posture, your muscles will grow and become strong to this shape which causes future postural problems and a lack of flexibility and mobility to the upper back, amongst other problems including shoulders, neck, core and breathing.

To counterbalance the guarded stance and correct kyphosis, any posture that squeezes the shoulder blades together, extends the cervical backwards, raises the chest and increases length between the navel and rib cage should be practiced regularly.

Here is a simple yoga posture that you can perform on a regular basis to help. I would recommend everyday, maybe twice a day, or at a minimum, every time you train. Just a few in and outs is fine.

USTRASANA – CAMEL POSE

Start off standing on the knees with the toes tucked under (feet and knees are no more than hip width apart) and head looking straight ahead. Please note, this image shows the feet relaxed, as a beginner, start with the toes tucked under.

Hands are at the chest in prayer position, with attention to shoulders being away from the ears.

Keep the hips and thighs in line with the knees, Inhale then start to stretch the lower back and drop the head behind by extending the neck backwards.

Bring the right hand by your side, then behind to the right ankle, then place the left hand by the side, and behind to the left ankle.

Keep pushing the hips forward so the hips, thighs and knees stay in line. This will also increase the back and quads stretch.

Focus on squeezing the shoulder blades together, and the length between the navel and ribcage which opens the chest and allows maximum lung capacity.

Also you will notice, as the head is dropped behind, the neck is stretched in the opposite direction to that of a guarded stance.

Keep relaxed and concentrate on deep breathing, longer exhales to ease tension and allow maximum stretching.

Breathe deeply and hold this posture for as long as possible, at least a few breaths to start with.

To return to an upright position, simply inhale, release the hands and bring them back into prayer position at the chest and look straight ahead.

Repeat a few times.

You may get light headed if you are a beginner, because of the dropping of the head backwards. If this is the case, you can rest your forehead to the floor whilst sitting on the heels in between posture.

Limited Flexibility Option

If you have difficulty reaching the ankles you can alternate single hands to the ankles to start with.

Start off with the right hand to the right ankle, squeeze the shoulder blades together, bring the left and as far back towards the left ankle as you can.

Then Inhale and come up, repeat to the left side.

Finish by sitting on the heels, with the forehead to the floor.

Very Limited Flexibility Option

If you still can’t reach either ankle, work on a simple movement of shifting the weight back and forwards whilst your hands are in prayer position to the chest. This will increase combined strength and flexibility to the abdominals and back.

Start off with hands in prayer to the chest.

Inhale shift the weight back, hold for a few breathes.

To come out, inhale, shift the weight forward and on the exhale, release the hands from prayer position to your side.

Finish by sitting on the heels, with the forehead to the floor.

Then repeat.

Things to remember whilst in posture:-

• Squeeze the shoulder blades together.
  
• Keep the shoulders away from the ears to lengthen the cervical
  .
• Allow the head to drop behind, don’t strain the neck by looking up.
  
• Shift the weight shifting forward in the hips by pushing forward in the thighs, to stretch the quads and extend lower back stretch.
  
• Keep hips and knees in line.
  
• Lengthen the space between the navel and rib cage by lifting the chest.
  
• Breathe deeply for better stretching.
  
• Come out when you feel you need to.

I would also recommend you combine this posture with Upward Facing Dog and Downward Facing Dog Pose for maximum benefit. These are included in my blog, YouTube tutorials and Yoga For Fighter e-book.

If you haven’t downloaded it yet, DO IT!!

I have been asked if there will be a Yoga For Fighters Part 2… yes there will be!!

Your never too big to get biggin, with chest expansion yoga exercises!! Start today!

Peace Out

Jo xx



Source : Jo Prakash Yoga

T1 pelvic angle correlated with health-related QoL in patients with spinal deformity

Researchers found that, in patients with adult spinal deformity, the T1 pelvic angle can be useful as a preoperative planning tool, with a target T1 pelvic angle of less than 14°. 

In a multicenter, prospective study, researchers included 559 patients with adult spinal deformity, an age older than 18 and either a coronal Cobb angle of 20° or greater, a sagittal vertical axis of 5 cm or greater, a pelvic tilt of 25° or greater, or a thoracic kyphosis of 60° or greater for analysis.

The researchers collected data from standardized health-related quality-of-life questionnaires, in addition to clinical, demographic and radiographic information for all patients at baseline.

T1 pelvic angle was found to correlate with the sagittal vertical axis, pelvic incidence minus lumbar lordosis and pelvic tilt.

Upon categorizing the patients by increasing T1 pelvic tilt (ie, <10°, 10° to 20°, 21° to 30°, and >30°), the researchers found a significant and progressive worsening of health-related quality of life.

The researchers also found that the T1 pelvic angle and sagittal vertical axis correlated with Oswestry Disability Index (ODI), Scoliosis Research Society (SRS)-22 and SF-36 scores.

Results of a linear regression analysis demonstrated that a T1 pelvic angle of 20° corresponded to severe disability, or an ODI of more than 40, and the meaningful change in T1 pelvic angle corresponding to one minimal clinically important difference was 4.1° on the ODI, according to the researchers.


Source : Healio , 31st Oct 2014

Author Jakia Cheatham's Book Offers Hope to Young People Dealing with Scoliosis : USA

Tate Publishing is happy to announce negotiations with Jakia Cheatham on her personal story detailing her personal battle with Scoliosis

_______________________________________________

This is not the end of the world, Yes you have a condition but don’t let it control you.

— Jakia Cheatham, Author of My Scoliosis

-Tate Publishing is excited to be negotiating a publishing contract with Jakia Cheatham and they hope to have this project included in their 2015 line. “We would be honored to have Jakia as an author with us; what an inspiring young lady with a beautiful spirit. We look so forward to a successful venture and helping her to spread awareness about Scoliosis and help other teens just like her,” said Trinity Tate, owner at Tate Publishing and the acquisitions editor for the book.

If published by Tate Publishing and Enterprises, the book will be available upon its release through bookstores nationwide, from the publisher at www.tatepublishing.com/bookstore, or by visiting barnesandnoble.com or amazon.com.

For more information or interview requests please contact Michelle Whitman, publicist, at (405) 458-5642 or send an email to michelle@keymgc.com.Michelle Whitman
Key Marketing Group
405-458-5642



Source : EINNews , 29th October 2014

Dream fulfilled for pageant winner

When Keisha Corbeil was diagnosed at age 11 with scoliosis, the thought of becoming a pageant winner seemed an impossibility.

Keisha Corbeil was crowned Miss Teen Ontario North earlier this month and has qualified to compete a national pageant next summer

But after having an operation to correct her spine, she fulfilled her dream and was crowned Miss Teen Ontario North.

“It feels unbelievable,” she said. “I look at my crown and I think my dream has come true. I didn’t see myself doing pageants like this. It was really just last year that I learned there were pageants in Northern Ontario and that they were nothing like the pageants you see on TV. I became passionate about it really quickly.”

The 16-year-old Grade 11 École secondaire catholique Thériault student took home the prestigious title during the Miss Jr. and Miss Teen Ontario North Canada regional pageant held in Cochrane in October. Seventeen girls and their families travelled from all across the North to participate in the pageant. The girls went head-to-head in various categories and activities from giving a speech to performing a talent.

Corbeil said she still can’t believe that she was crowned.

“I couldn’t even think. They put the crown on my head and my eyes would get watery,” she said. “It was my third pageant and the first time I didn’t really think I would be crowned. It wasn’t my goal. I just wanted the whole experience and then I learned from it. The second pageant I got runner up. I told myself that this time

I’m really prepared for it.”

Corbeil said she drew inspiration from her experience with having scoliosis.

Most spines are in a straight line but Corbeil’s was angled at nearly 70 degrees. A few years later, her spine curved even more and she needed surgery. This required her to fly to Ottawa in order for the operation to happen in 2011. Received two titanium rods that were fused into her spine. The procedure corrected the spine but kept her from being able to bend her back.

To prepare for the pageant, Corbeil practised her walk, got sponsors, wrote her speech and worked on her talent, which was dancing. She said she incorporated her story of having scoliosis into the performance.

She said that the pageants she participates in aren’t like the ones seen on television where the highest points are attributed to beauty.

The crown means that Corbeil will be going to a national pageant competition next summer. She said she is excited to participate in the pageant and has already started doing research on it.

She added that anyone who is interested in participating in a pageant should give it a try.

“Don’t doubt yourself,” she said. “Don’t tell yourself you’re not pretty enough for that. That’s something I thought about. It doesn’t matter what you look like. Nothing matters. It’s about your personality. You have to go in and give it 100% and truly be yourself.”

She added that she’s taking donations for families in need until Christmas and will be partnering up with the Schumacher Lions Club. Donations can be anything from toys to clothes.

Those wishing to help out can contact Corbeil on Facebook or through email kc16@outlook.com. 



Source  : timminspress , 28th oct 2014