Dealing with scoliosis

                                       
                            Before Surgery




                                                After Surgery

Dealing with scoliosis - before

Scoliosis is a medical condition of which, in 90 percent of cases, the cause is unknown . Scoliosis can happen to anyone, including toddlers.
 
According to Dr. Luthfi Gatam SpOT, an orthopedic specialist who practices at the Ramsay Spine Center at Premier Bintaro Hospital, the name scoliosis is derived from the word "scolios", which means crooked. It is a medical condition in which a person’s spine is curved and, when viewed from behind, tends to curve to the right or left.
 
"Generally, the spine curves to the left side of the body,” said Luthfi.
 
There are many types of scoliosis. Idiopathic scoliosis is the most common type. Luthfi said that “idiopathic” was derived from the words “idiot” and “pathic” and had no known etiology.
 
Luthfi stressed that scoliosis is not a disease, but a descriptive term. All spines have curves. Some curvatures in the neck, upper trunk and lower trunk are normal. Humans need these curves to help the upper body maintain proper balance and alignment over the pelvis.
 
However, when there are abnormal side-to-side curves in the spinal column, the condition is called scoliosis. And the problem with scoliosis is that it can progress. Data shows that 10 percent of people with scoliosis are experiencing an advancement in the condition.
 
People with idiopathic scoliosis can actually carry out normal daily activities. They do not experience significant abnormalities. But if their scoliosis progresses, they can suffer from impaired function.
 
“People with scoliosis experience pain in their back, waist and neck. And there is the possibility of impaired lung function and breathing disorders. Impaired heart function and digestion can also occur,” explained Luthfi.
 
Over time, the spinal curvature may get worse. Some patients will not even be able to chew or digest properly.
 
“When that happens, the progression of the scoliosis must be stopped as it can be fatal.”
 
There is non-surgical treatment as well as surgical options available to stop the scoliosis from progressing, as well as to balance the body, to correct the posture and to improve the quality of life of patients. Non-surgical treatment usually consists of swimming, stretching, physiotherapy and dorsal exercise. This is effective to strengthen the muscles.
 
“But this treatment is only for patients with a spinal curvature of under 20 degrees,” said Luthfi. “Patients with a spinal curvature of 20 to 40 degrees should use a neck and body brace to correct or restrain the progress of the scoliosis. For a spinal curvature that exceeds 40 degrees, the right medical treatment would be surgery.”
 
Luthfi explained that surgery can stop the progress of scoliosis, as well as correct the crooked bones. These days, scoliosis patients in Indonesia can also easily access medical help as Premier Bintaro Hospital now has a spinal center.
 
The Ramsay Spine Center provides facilities and services to solve all types of spinal problems in an integrated and comprehensive way. At the Ramsay Spine Center, spinal problems are handled by a team of doctors from various specialized fields, such as orthopedic spine specialists, neurologists, neurophysiology specialists, medical rehabilitation specialists and radiology specialists.

 
For more information, please contact the Ramsay Spine Center, Premier Bintaro Hospital on +62 21 2762 5500 Ext. 3338 (Dani) or visit www.ramsayspinecenter.com 

Source: The Jakarata Post , 22nd Dec 2014

Scoliosis in Kids

When a muscle on one side of the spine is tight and in spasm, it can severely pull on the spine, breaking the previous equilibrium.


The spine is the body’s backbone, and it is made up of vertebrae. The word scoliosis (say: sko-lee-OH-sis) comes from a Greek word meaning crooked. It is, in essence, a musculoskeletal disorder (in layman terms, injuries or pain in the body’s muscular and skeletal framework) in which there is a sideways curvature of the spine, or backbone.  There are two types of scoliosis:


l Nonstructural (functional) scoliosis:is a normal spine that simply appears curved. This is a temporary curve, changing with the progress of time. Underlying conditions such as uneven leg lengths, postural problems, and muscular imbalances can result in back spasms and direct trauma to the spine, which lead to Scoliosis. Neither the vertebrae nor the spinal bones are affected.


l Structural scoliosis: is much more serious as compared to its nonstructural counterpart and develops as a result of unequal growth of the two sides of the vertebrae (spinal bones). Structural scoliosis involves both a side-to-side curve and also a twist or rotation in the spine.


What Causes Scoliosis?


This disorder mainly affects young children who are more susceptible to the deformity as the bones in their spine are less mature and stable. There are certain cases where there is no identifiable reason patient stands but disappears when the patient lies down or bends forward are normally functional, and spinal curves that are evident when a patient stands but persist when he lies down or bends (in any direction) are normally structural.


 X-ray evaluation:


If scoliosis is suspected, a simple x-ray of the spine can be taken to confirm whether there is an abnormal curve present or not.


Scoliotic Spine

Your physiotherapist addresses, more specifically, muscle imbalance, which has a major role in bringing about functional scoliosis. This asymmetry, if not treated, will affectyour posture, your appearance and cause you tremendous pain. Tight or spastic muscles, if severe enough, can result in your spine bending as the muscles in the back and pelvis are attached to your spine. Normally, the muscles on both sides of your spine are in balance with one another, pulling your spine in their respective directions, equally – much like two equally matched teams locked in a perpetual tug-of-war. When a muscle on one side of the spine is tight and in spasm, it can severely pull on the spine, breaking the previous equilibrium. Your physiotherapist may use exercises to help relax the tight muscles, thus allowing the spine to return to its natural curvature.

These exercises simply strengthen the core and back muscles of your body. They are safe and will not cause your scoliosis to worsen in any way. The aim of this exercise is to strengthen your back muscles and in effect help to reduce future spinal issues.


Another form of exercise that can be undertaken by the physiotherapist for your benefit is Pilates. This exercise form is specifically designed to improve back health.Lastly, maintaining a good posture is just as important Dr Anjana Laungani Consultant Physiotherapist & Rehab Specialist.

Source: Free Press Journal , 21st Dec 2014

Treating adolescent idiopathic scoliosis

Adolescent idiopathic scoliosis is one of the most frequently occurring spinal deformities. In adolescents, it can cause various problems related to growth and adversely impact their studies.





There are various ways to adequately treat adolescent idiopathic scoliosis. Among the many methods of treatment, some are based on scientific evidence while others are not.

Patients need to carefully examine the various types of treatment available in order to receive the safest and most effective.



Causes


Adolescent idiopathic scoliosis occurs between the ages of 10 and 18. The cause of this disease is not as clearly defined as that of other forms of scoliosis, but hormone imbalances, asymmetric growth and muscle imbalances are presumed to be possible reasons.


In terms of hereditary factors, about 30 percent of patients have a previous family history. Many researchers have found some correlation with hereditary causes. However, they have not yet found any direct correlations.


There is a laboratory in the United States that analyzes the genetic factors of adolescent idiopathic scoliosis. Based on 53 different genetic markers and measurements of current angle of spinal deformity, the lab predicts a future curve progression of scoliosis called a "ScoliScore."


The screening test is being developed for commercialization. However, the cost is still very high, and there need to be further verifications of its reliability.



Symptoms
Adolescent idiopathic scoliosis generally does not cause any pain or other neurological symptoms.


Most back pain has no relation to scoliosis. In most cases, patients visit the hospital once they realize the abnormality of their spinal shape, uneven shoulder height, uneven protrusion of their back or an uneven waist line making the patient feel like one leg is longer than the other.



Treatments


There is still some debate as to which treatment is the best for the scoliosis, but the most widespread treatment is wearing a brace or undergoing surgery. If the angle of deformity is less than 25 degree, the progression should be carefully followed by regular examinations and evaluations.


In Korea, many centers promote their ability to correct the scoliosis. While it is true that scoliosis or the imbalances causing temporary pain can be eased by manipulation physiotherapy, there is insufficient evidence that treatments through chiropractic, physiotherapy and yoga can actually correct scoliosis.


These treatments do not correct the scoliosis, but they do help the condition by strengthening the spinal muscles and relieving the pain. Thus, a patient with weak spinal muscles or pain can expect improvement by combining treatment with a rehabilitation program.


If a patient is still growing and has a 25-to-40-degree deformity, wearing a brace is highly recommended, not to correct the scoliosis but to prevent the scoliosis from worsening. If the angle of deformity is greater than 45 degree, then surgical methods such as spinal fusion are necessary.


The writer is director of the spine center at Bumin Hospital Seoul in Gangseo District. He was included in the 2014 edition of "Marquis Who's Who."


Source: Korea Times, 21st Dec 2014

Youngsters who have undergone surgery to correct curvature of the spine gather to celebrate success stories

Young people helped at James Cook University Hospital in Middlesbrough included 14-year-old Jodie Parke

Jodie Parke, who featured in the DVD about the operation

Youngsters who have undergone surgery to correct curvature of the spine gathered to celebrate their success stories.

In 2010, the scoliosis service at James Cook University Hospital in Middlesbrough was boosted with the appointment of two consultant spine surgeons.

And to mark the success of the past four years, staff invited dozens of young people whom the unit has helped.

They included 14-year-old Jodie Parke who had surgery to correct an abnormal curvature in November.

She only became aware of a problem in May when her mum Julia Parke noticed her right shoulder blade was more prominent than her left.

A trip to the doctor’s and subsequent referral to a specialist confirmed Jodie had developed teenage scoliosis.

“At first we thought we were being over-cautious,” said her mum.

“She had never had any problems before this, she’s very sporty and loves cricket and football.”

Jodie travelled from her home in Scarborough for the surgery performed by consultant spine surgeon Waleed Hekal. It involved the insertion of two metal rods in her spine and 17 pins.

The effects were instant.

“It will last for the rest of her life and other than check-ups she needs no further treatment,” said her mum.


“We couldn’t believe how straightforward it was and the care was fantastic. The whole system was like private healthcare.”


Yesterday’s event at the hospital gave patients like Jodie a chance to meet the team again and share their experiences.



 

Surgeon Waleed Hekal with Hannah Wintle and Lauren Wood

 

 

 

Specialist nurse Cheryl Honeyman said: “The difference successful scoliosis surgery makes on a young person’s life is huge.


“I’ve seen patients change from shy, introverted, unhappy people to confident, outgoing, positive role models for others.


“The team we have here at South Tees has achieved outstanding results, with almost full correction of spinal curves up to 110 degrees, recovery as comfortable as possible and positive experiences of surgery and hospitalisation.”

A demonstration was shown on how the operation works

The cause of scoliosis is often not identified but some cases are caused by other medical conditions, including cerebral palsy and muscular dystrophy.

Treatment is not always necessary for very young children with scoliosis because the condition often corrects itself as the child grows.

However, in older children and adults, it is unlikely that scoliosis will improve without treatment and in some cases the curvature may get progressively worse.


Source:  Gazettlive, 23rd Dec 2014

 

 

 

6 points on intraoperative traction during pediatric scoliosis surgery

A study published in Spinal Deformity examined intraoperative traction in pediatric scoliosis surgery to determine whether there are benefits for use.

The researchers examined the MEDLINE and EMBASE tools for studies on intraoperative skeletal traction for scoliosis correction. There were nine papers included in the study with six being retrospective case control, one being a case report and two being retrospective case series. Here are six findings from the report:

1. There were seven studies showing the positive impact of intraoperative skeletal traction on diverse outcomes measures. These outcomes measures include:

• Pelvic obliquity correction
• Cobb angle
• Axial plane deformity

2. The intraoperative skeletal traction also precluded the need for an anterior release before posterior instrumentation for large curves.

3. There was only one paper reporting postoperative traction-related complications. The complication was anterosuperior iliac spine pressure sores.

4. There was one paper reporting intraoperative traction could evoke neuro monitoring signal changes for many patients who undergo surgery for adult idiopathic scoliosis.

5. Surgeons responded to these changes by decreasing or removing weight intraoperatively.

6. None of the patients reported postoperative neurologic deficits.

“Isolated intraoperative skeletal traction may be a low-morbidity adjunct to facilitate scoliosis surgery,” concluded the study authors. However, there is also a need for additional studies to compare outcomes for scoliosis surgery with or without intraoperative skeletal traction.


Source: Becker's Spine, 23rd Dec 2014

Teenager hopes to become taller after scoliosis surgery

Christmas came early for Mariah Jones, the 16-year-old point guard for the Natchitoches Central basketball team, who recently underwent scoliosis surgery at Shriners Hospitals for Children-Shreveport.

Christmas came early for Mariah Jones, the 16-year-old point guard for the Natchitoches Central basketball team, who recently underwent scoliosis surgery at Shriners Hospitals for Children-Shreveport.

Mariah Jones, left, and her mother, Tracy, prepare to leave the Shriner’s Hospital for Children-Shreveport recently following Mariah’s scoliosis surgery.


Her request of Santa was simple: "I'm hoping the surgery makes me a little taller. And I hope I can get back to playing soon."

At 5-foot-1 and with the wisp of a willow tree, Jones is a bundle of energy that even major surgery has trouble slowing down. Just three days past her operation, the teenager already was talking about getting back on the basketball court, something that's not likely to happen this season.

"Mariah's so pushy. She asked the doctor this morning before she left, 'Hey, can I go with the team on the bus to a game after Christmas?'" said her mother, Tracy Jones.

Twice as common in girls as in boys, scoliosis is an abnormal curvature of the spine. It can develop at any age, but usually occurs after the age of 10 and can be treated with observation, bracing or surgery depending on the severity of the curve and the risk of it getting worse, according to MedicineNet.com.

Mariah's grandmother began noticing her "walking crooked" during the summer, and she began having severe pain after practices not long afterward. Jones went for a consult in August and the scoliosis diagnosis was confirmed in September.

The Jones family hoped to stall surgery until after basketball season, since Mariah had won the starting position as a sophomore on what has traditionally been a very strong high school basketball team. But the pain made that impossible.

"At first there was no pain, but it increased as the months passed. Like after practice I would be slouched over and there was a lot of pain," said Mariah, who received daily treatments in her mid-back area from the trainer. "The freeze was like Icy Hot, it would kind of numb it for awhile."

Tracy Jones took her daughter back for another check-up, and the doctor said the curvature had progressed by about 8 percent.

"They said there would be more pain, and falling on the court would add more to it. And they said it was pushing on my organs," Mariah said.

Doctors decided she needed the surgery as soon as possible, which put the family in a tough spot with the heart of the basketball season and the Christmas holidays approaching. Added to it was the effort Mariah put in to earn a starting position on the Lady Chiefs' squad.

Her request of Santa was simple: "I'm hoping the surgery makes me a little taller. And I hope I can get back to playing soon."

At 5-foot-1 and with the wisp of a willow tree, Jones is a bundle of energy that even major surgery has trouble slowing down. Just three days past her operation, the teenager already was talking about getting back on the basketball court, something that's not likely to happen this season.

"Mariah's so pushy. She asked the doctor this morning before she left, 'Hey, can I go with the team on the bus to a game after Christmas?'" said her mother, Tracy Jones.

Twice as common in girls as in boys, scoliosis is an abnormal curvature of the spine. It can develop at any age, but usually occurs after the age of 10 and can be treated with observation, bracing or surgery depending on the severity of the curve and the risk of it getting worse, according to MedicineNet.com.

Mariah's grandmother began noticing her "walking crooked" during the summer, and she began having severe pain after practices not long afterward. Jones went for a consult in August and the scoliosis diagnosis was confirmed in September.

The Jones family hoped to stall surgery until after basketball season, since Mariah had won the starting position as a sophomore on what has traditionally been a very strong high school basketball team. But the pain made that impossible.

"At first there was no pain, but it increased as the months passed. Like after practice I would be slouched over and there was a lot of pain," said Mariah, who received daily treatments in her mid-back area from the trainer. "The freeze was like Icy Hot, it would kind of numb it for awhile."

Tracy Jones took her daughter back for another check-up, and the doctor said the curvature had progressed by about 8 percent.

"They said there would be more pain, and falling on the court would add more to it. And they said it was pushing on my organs," Mariah said.

Doctors decided she needed the surgery as soon as possible, which put the family in a tough spot with the heart of the basketball season and the Christmas holidays approaching. Added to it was the effort Mariah put in to earn a starting position on the Lady Chiefs' squad.



Source: Shrevportimes, 25th Dec 2014

Scoliosis Expert Dr. Kevin Lau on Managing Spinal Well-Being

With professional training from United States of America and Australia, combined with a lifetime of practicing natural and preventive medicine, Dr. Kevin Lau advocates comprehensive natural solutions for treating scoliosis, promoting the merits of non-surgical treatment as the first resort.

He has been honored with the "Best Healthcare Provider Award" from the Straits Times.

His book Your Plan for Natural Scoliosis Prevention and Treatment is a best-seller on Amazon.com, and the series is rounded off with Your Natural Scoliosis Treatment Journal and Your Scoliosis Treatment Cookbook. For parents-to-be, there is also An Essential Guide for Scoliosis and a Healthy Pregnancy, a path-breaking and pioneering compilation of practical knowledge on how to handle conception and pregnancy in scoliosis.

Finally there is also The Complete Scoliosis Surgery Handbook for Patients, a wealth of information and a handy resource for those wanting to understand more about invasive procedures.

Under Dr. Lau's approach of Health in Your Hands, patients are encouraged, guided and advised to treat and prevent scoliosis through diet, exercise to improving daily living habits. Integrating technology into his healthcare practice, he also offers a comprehensive The Scoliosis Exercises for Prevention and Correction DVD as well as ScolioTrack, a top-ranking app on iTunes and Google Play (under Android for Medical Apps) as well as Scoliometer, an app to keep track of spinal deformity and progress monitoring.

We speak to Dr. Lau as he launches his newest book, Your Scoliosis Treatment Cookbook, and find out about his unique methods and how his patients and readers come from far and wide through his innovative use of new media channels.

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Describe scoliosis in layman’s terms for us, if you will…


In basic terms, scoliosis is the curvature of the spine, however it’s more than just a "sideways bend" of the spine.

There’s many ways people develop this condition such as congenital scoliosis - which people are born with, and there's the idiopathic scoliosis - which people develop in their adolescence.

Does this second group of individuals develop scoliosis as a result of their lifestyles? Through exercise, sports, improper posture, etc?


By and large, the condition still has an unknown cause, and therein the "idiopathic" (i.e., unknown pathogenesis or apparently spontaneous origin). But there are clues to suggest that genes are involved as well as hormonal and growth factors as well.

And it kicks in during adolescence?

Yes, during the growth spurts. So one of the ideas I brought through in my very first book, was that nutrition plays an important part of this condition. It goes into the field of epigenetics, which is understanding that while people are genetically predisposed to certain conditions, it doesn’t mean that it is a life sentence for them.

So the way they eat, and their lifestyles, can turn genes "on" and "off".

The conventional way of treating scoliosis these days is just via bracing or surgery, which is just pushing the deformity.

Whereas I cover all the bases with my holistic approach, taking into consideration genes, hormones, diet, etc. I hope people who are going through those growth spurts, during those formative years, are supported with options and information.

But you do still prescribe bracing and surgery?


I still believe that there is a need for bracing, and a space for surgery.

By and large, this wait-and-see approach which is what a lot of people tend to adopt, is not a good solution. They can do something proactive about it.

And chiropractic treatment as well?

There's a very big misconception when it comes to scoliosis treatment that standard chiropractic adjustments can help... they don't help to improve scoliosis and even might make it worst due to joint instability. Scoliosis is such a complex condition to treat, that (chiropractic) manipulation wasn't getting the results I was expecting.

About 10% of the therapy I do for my scoliosis patients is chiropractic (related) the rest come from methods I studied from around the world which showed to positively impact scoliosis.

Tell us about how you got started on the books.


The initial purpose of my books was to teach and educate my own patients with scoliosis. There is a lot of information and misinformation on the Internet, but a lot of the times the information tends to be from many different sources and it's very hard to find reliable sources which people can trust. So the initial concept was to empower my scoliosis patients in understanding their own condition.

Oftentimes when people go to see a doctor, the doctors don't have enough time to explain what procedures and options there are available.

 

I wanted to give people both the information and tools so they can take care of themselves.

So it cuts both ways on the Internet...


There's definitely information overload on the Internet for most people. They get conflicted. They get confused. A lot of my patients before seeing me come very educated, but unfortunately most come with misinformation which come from secondary sources, from sites which aren't "research-based" or validated. While the Internet is fantastic and a great tool to have, it tends to confuse a lot of people these days.

Which of your books is the most popular so far?

My first book, Your Plan for Natural Scoliosis Prevention and Treatment was a bestseller in its category on Amazon even to this day. It targets an audience base that was looking for something to do apart from bracing, or surgery, or waiting-and-seeing. The readers and patients wanted to explore what they could do themselves about their condition and ultimately help them feel more empowered.

And you have addressed the changing consumption of information with your books, available in digital formats, as well as releasing apps? Tell us more about these digital tools.


With these apps, patients can monitor their own conditions in between their scheduled yearly doctor's visits. There's ScolioTrack which help a person track their curvature visually and measurement. While Scoliometer App helps to measure scoliosis using the Adams test.

Both are available on iPhone and Android devices. 

And you’re reaching even more people with your books, besides running a successful practice here in Singapore.


I do get a lot of emails from readers from around the world, who travel to Singapore for treatment with me personally. Others want me to fly over to see them because they can’t afford to come to Singapore which unfortunately I can't. Although I make sure I answer all emails and questions from my readers around the world. 

The most random place where you’ve received emails from?


A small city in South Africa which I didn't even know my book was available in.

And your books are published in different languages?


9 languages: English, French, Simplified Chinese, Italian, German, Spanish, Indonesian, Japanese and Korean.

What takes us most of your time on a daily professional basis, besides writing the books?

I'm taking care of my clients in Singapore for the majority of the time. I do get a lot of overseas clients coming in.

It's still early in the process but I've been working with an American educator/professor to formulate an accredited course so that I can teach others how to do the methods I'm doing.

At least with this, people around the world can go to someone they can trust locally and I can trust.

So were you always interested in cooking and hence the latest book?


I've always been fascinated about nutrition and how the body works. It’s about going back to basics, not just taking supplements to get healthy.

And I've always been passionate about food.

I took inspiration from chefs and nutritionists and customised the recipes based on Paleo Typing. I believe everyone has a particular genetic predisposition on what sorts of food they need to eat; some are more protein-based and high fat, whereas others are carbo-based and closer to vegetarians, and there are those in between.

It's understanding which foods help to switch the good genes “on” while turning the bad ones "off" which can predispose a person to conditions like scoliosis.

Source: Senatus, 26th Dec 2014

Surgery to correct scoliosis a life-changer for Fall River woman

Besides healthy eating, Aguiar joined Planet Fitness where she said walking and weight lifting helped her to lose weight and gain strength.

 

 If Kayla Aguiar’s spirit had been broken, it would have been understandable.

Instead, the young woman overcame years of pain from scoliosis and being bullied at school for wearing a back brace and being overweight. Today, Aguiar is physically and mentally stronger than ever — and has lost some 85 pounds to boot.

“Proud” is how Aguiar, 23, describes her feelings.

“Every day, there’s progress,” Aguiar said. “What motivates me is helping other people.”

Aguiar was in the fifth grade when she was diagnosed with scoliosis, an abnormal curvature of the spine that occurs most often during the growth spurt before puberty, according to the Mayo Clinic web site.

By the time she was in seventh grade, Aguiar was wearing a back brace 24 hours a day and “starting to have a lot of pain.”

“I got made fun of my whole life,” Aguiar said.

Despite the physical pain from her severe curvature, Aguiar stopped wearing the brace.

“It was the emotional pain,” Aguiar said. “I just took it off. I couldn’t take it. I’d rather deal with the physical pain.”

No pain medication would alleviate her suffering, and it was too soon for any surgical options to be effective.

Aguiar said she turned to food. By the time she was 18 years old, she weighed 235 pounds.

“That was basically my outlet,” Aguiar said.

Her body was unable to handle the excess weight and caused gall bladder disease, needing surgery to remove the organ.

Aguiar said she tried to work as a teenager.

She got a part-time job making smoothies but would often “leave early because of the pain.”

Aguiar decided she would need to go ahead and have back surgery to correct the scoliosis. It was considered major surgery with a “huge risk” of paralyzation.

To decrease her risk, she started dieting to get herself as healthy as she could before the operation.

Aguiar underwent surgery on Nov. 30, 2011. An 18-inch titanium rod was fused into her spine. Then, it was three months of bed rest. At six months out, she started walking again.

Then, the real healing began.

“I started to pay attention to what I was eating,” Aguiar said.

Aguiar consumes a mostly vegetarian diet of “whole foods.”

“Most people think it’s hard to lose weight. It’s not if you just eat what the earth provides,” Aguiar said.


Source: Herald News, 1st Dec 2014

 

Severe kyphosis in Chinese Han patients linked to negative sacral slope, femoral shaft tilt

Negative sacral slope exists in Chinese Han patients with ankylosing spondylitis and thoracolumbar kyphosis, with severe kyphosis and a pronounced femoral shaft tilting as the most likely causes, according to study findings.

Researchers retrospectively reviewed data for 106 Chinese Han patients with ankylosing spondylitis with thoracolumbar kyphosis treated between October 2005 and October 2010. The researchers then analyzed 41 patients for whom lateral radiographs clearly showed the upper-third of the femur.

Patients were separated into groups by those who had a sacral slope of less than 0° (group A) and those who had a sacral slope of 0° or greater (group B). All patients had eight different sagittal parameters measured, and correlations between the sagittal parameters, femoral obliquity angle and sacral slopes were analyzed.

The researchers found patients in group A had significantly larger mean global kyphosis, lumbar lordosis, pelvic tilt, sagittal vertical axis and femoral obliquity angle compared with group B. However, group A also had significantly smaller pelvic incidence and sacral slope.

Although global kyphosis, lumbar lordosis, pelvic tilt and sagittal vertical axis were found to be significantly negatively associated with sacral slope, they were positively associated with femoral obliquity angle, according to the researchers. Pelvic incidence was found to be significantly positively associated with the sacral slope but negatively associated with the femoral obliquity angle.

The researchers found femoral obliquity angle and sacral slope had a significantly negative association.

http://jbjs.org/content/96/22/e188

Accelerated endochondral growth in adolescents with idiopathic scoliosis: a preliminary histomorphometric study

Abnormal longitudinal growth has been identified in the early pubertal stage of idiopathic scoliosis (IS) and is thought to contribute to the development of scoliosis. This phenotype may be caused by abnormal endochondral ossification, but histological evidence is lacking.


The aim of this study was to investigate whether there is abnormal endochondral ossification in IS patients at early stage of puberty by histomorphometric analysis of their iliac cartilage.


Methods: Fifty-two patients with IS and 19 controls were recruited and grouped according to their Risser grade (Group A: Risser grade 0 with Oxford stage 2-3; Group B: Risser grade 2). Group A consisted of 20 IS patients (mean age: 12.3 years) and 9 controls (mean age: 12.0 years), while Group B included 32 IS patients (mean age: 13.8 years) and 10 controls (mean age: 13.7 years).


Biopsies of the iliac cartilage were harvested intra-operatively and prepared using routine histological methods. Histomorphometric analysis was performed to quantify the thickness of the hypertrophic zone, the area and number of chondrocytes in the cell-nest, and the number of chondrocytes in the proliferative zone using Image-Pro Plus software.


Results: In Group A, a significantly thicker hypertrophic zone and larger cell-nest area and number of cells within the cell-nest, and in the proliferative zone, were found in iliac cartilages from IS patients compared with those of controls (all P <0.05).


In group B however, there were no significant differences in histomorphometric parameters between IS patients and the controls.


Conclusions: The differences in the histomorphometric results between IS patients and their controls for patients with Risser grade 0 and Oxford grades 2 &3, but not in those with Risser grade 2, indicated a pattern of accelerated endochondral growth in IS at the early stage of puberty, but not at the late stage.Trial registration: Current Controlled Trials: ChiCTR-CCC-13003988. Registered 17 December 2013.


Source: 7th Space, 13th Dec 2014

‘Sloppy’ doctor botched spine operation, disabling girl: suit

A renowned doctor who was once featured on the Discovery Channel botched a 13-year-old girl’s surgery so badly that she was left nearly blind and permanently disabled, a new Manhattan lawsuit charges.

Bethany Flanders went to Dr. Ohebena Boachi-Adjei at New York- Presbyterian Hospital in 2007 to correct her scoliosis but left permanently unable to walk and "almost totally blind."



Bethany Flanders, now 20, says she went to Dr. Oheneba Boachie-Adjei at the Hospital for Special Surgery in 2007, hoping he’d correct her scoliosis, a curvature of the spine that forced her into a wheelchair at times.

Instead, Boachie-Adjei performed a sloppy, rushed operation, leaving her “almost totally blind” and now permanently unable to walk, says her Manhattan Supreme Court suit.

“Bethany and her family put their absolute trust in the defendants here, and now a young woman has lost vision and is disabled forever,” their lawyer, Peter Johnson Jr., told The Post on Monday.

The doctor’s and hospital’s alleged mistakes included a failure to assure that Flanders was an appropriate candidate for the surgery, since she had nutritional and cardiac issues, Johnson said.

The lawyer said his client’s vital signs also weren’t properly monitored during the operation.

After Flanders developed scoliosis from a polio vaccine at age 1, her parents say they searched the country to find a surgeon who could straighten her spine as she got older.

They settled on Boachie-Adjei, who specializes in pediatric orthopedics.

The Columbia University-trained doctor was described as “arguably the world’s top surgeon of spinal deformities’’ in a plot summary of a 2006 episode featuring Boachie-Adjei on the Discovery Channel’s documentary series “Surgery Saved My Life.”

He closed his New York practice in June and returned to his native Ghana.

The Hospital for Special Surgery is a division of New York- Presbyterian Health Care System.

Boachie-Adjei did not return messages seeking comment. His former employer, New York-Presbyterian, also did not return messages.

Flanders, from the tiny town of Dallas in central Pennsylvania, is suing the hospital for unspecified damages.

Since the surgery, she suffers from blind spots and can’t see smaller objects such as her own foot, her lawyer said.

And while she studies biology at Misericordia University, her mother must still be her constant companion, driving her to class, taking notes during lectures and helping her perform basic functions throughout the day, Johnson said.


Source: New York Post, 1st Dec 2014

Rasterstereographic measurement of scoliotic deformity

Background

Back surface topography has gained acceptance in recent decades. At the same time, the motivation to use this technique has increased. From the view of the patient, the cosmetic aspect has played and still plays a major role as it provides a comprehensive documentation of cosmetic impairment. From the view of the medical practitioner, the aspect of reducing X-ray exposures in diagnosis and follow-up has been dominant and still prevails. Meanwhile, new aspects have emerged: due to the consequent three-dimensional view of the scoliotic condition, treatment success can be visualized convincingly. Clinical diagnosis is supported by information otherwise not supplied by X-rays, such as when functional examinations and diagnostic tests are recorded.

Track it from here:  

http://www.scoliosisjournal.com/content/9/1/22

Sloped Shoulders Related to Kyphosis, PE and a Fix

Sloped shoulders is very common among people with PE and is both a direct consequence of the kyphosis and the sunken sternum. The idea to help the upper back towards a correct position by using a clavicle support is well known today and I have even seen suggestions from doctors on the internet, that this can help mild cases of PE. But that is without the zero drop/barefoot shoes included! The effective combination; zero drop+clavicle support is a must to even be worth trying. So here I will give my hottest tip for a long time which I have tested myself for some time and it really has a good effect.

   1. Use zero drop shoes and no heavy clothes on the upper body.

   2. At the same time as point one; use a clavicle support to help correct the spine.

   3. Be physically active (stand up and walk) around two hours.

But as always: I don’t think that the more one uses it, the better it becomes. The body needs rest in between as with all form of physical training/stress. After all, you are going to physically correct your body quite dramatically so I use it just few hours a day (at least in the initial stage which I am into right now, zero drop I use constantly, the essential base of the whole thing).  

What does the clavicle support directly do?  

When the shoulders are held back in a natural position the muscles in the upper back will be activated so that they pushes the ribs in the direction of the sunken sternum, this will straighten the spine upwards and help further lift of the sternum.

I recommend to especially take a look on this post: “Nuss Procedure vs Do-it-Yourself-Procedure”. The clavicle support will help doing exactly what is described there.

(I will soon make a post about exercises on the gym which I have found beneficial for PE).



Source: Pectus excavatum revolution blog

Yoga pose for scoliosis patients

Scoliosis is defined as the lateral (sideways) curvature of the spine. It affects 5 to 7 million people in the United States. It can begin at any age, but it is most commonly found in adolescents.

In more than 80 percent of cases, the cause of scoliosis is unknown or idiopathic. Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed. Structural scoliosis does not reduce with postural maneuvers. Either type can be idiopathic or have an underlying cause such as trauma, neurological disease or tumors.

Patients with spinal curvatures often require an x-ray evaluation of the spine. The procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis.


Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have been advocated in the treatment of scoliosis. For patients with back pain along with the scoliosis, manipulation and exercise may be of help.


A recent research study in Global Advances in Health and Medicine, September 2014 has shown that performing a single yoga pose for 90 seconds three times a week may reduce spine curvature in patients with scoliosis in as little as three months. Scoliosis patients who did the side plank pose on the side their spine was curved toward experienced a significant improvement in their spinal curvature. Researchers found that spinal curvature improved by about 32 percent in all patients and it improved by 40.9 percent for the patients who performed the pose for at least three days a week. Among these patients, adolescents saw a 49.6 percent improvement in curvature, while adults saw a 38.4 percent improvement. The authors of the study conclude that asymmetrically strengthening the convex side of the primary scoliosis curvature with a side plank exercise performed daily appears to reduce curvature.


Most people with scoliosis lead normal, happy, and productive lives. Yoga (specifically the side plank) is generally well-tolerated and definitely worth adding as a daily exercise.



For more information, contact:

Dr. Wendy at haydenhealth@gmail.com. 


Source: CDA Press, 3rd Dec 2014

8 board members for the Scoliosis Research Society 2014-2015

The Scoliosis Research Society named the 2014 to 2015 board of director members, according to an AAOS Now report.

The new members are:

1. President — John P. Dormans, MD, former chief of division of orthopedics at The Childrens Hospital of Philadelphia

2. President-elect — David W. Polly Jr., MD, chief of spine surgery at the University of Minnesota

3. Vice president — Kenneth M.C. Cheung, MD, University of Hong Kong, Queen Mary Hospital

4. Treasurer — Paul D. Sponseller, MD, chief of the division of pediatric orthopedics at Johns Hopkins Children's Center

5. Secretary — Mark Weidenbaum, MD, Columbia Orthopaedics

6. Treasurer-elect — J. Abbott Byrd, MD, Atlantic Orthopaedic Specialists

7. Past president I — Steven D. Glassman, MD, Norton Spine Care

8. Past president II — Kamal N. Ibrahim, MD, Advocat Good Samaritan

The directors at large are:

• Ahmet Alanay, MD
• Laurel C. Blakemore, MD
• Manish C. Gupta, MD
• Baron S. Lonner, MD
• Praveen V. Mummaneni, MD
• Stefan Parent, MD, PhD

Additional leaders are:

1. Frank J. Schwab, MD — Research council chair
2. Daniel J. Sucato, MD — Education council chair
3. John R. Dimar II, MD — Education council chair-elect


Source: Beckers Spine , 17th Dec 2014

Does scoliosis surgery improve quality of life? 5 key notes

A study recently published in the Journal of Spinal Disorders & Techniques examined quality of life for adolescent idiopathic scoliosis patients before and after surgery.

The study authors examined 33 patients who underwent surgery for adolescent idiopathic scoliosis. The average age was 15.6 years old and average Cobb angle was 70.5 degrees. The patients were placed in two groups randomly, either receiving a hybrid procedure or pedicle screws alone.

The researchers found:

1. The results for SRS-30 and SF-36 significantly improved after surgery. The biggest changes were in the self-image and satisfaction with management domains of the SRS-30 survey.

2. The SRS-30 and SF-36 scores showed worsening pain and decreased function at three months after surgery. However, by 12 months after surgery the patients reported significant improvement from baseline.

3. The total SRS-30 scores were significantly improved at six months and 12 months after surgery.

4. Six and 12 months after surgery, sub-scores in these SF-36 areas were significantly improved:

• General health

• Vitality

• Social functioning domains

5. The curve magnitude, percent curve correction and instrumentation used did not have a significant influence over the SRS-30 or SF-36 scores.

"Surgical treatment of AIS improved patient quality of life, as shown by significant improvement on all SRS-30 and SF-36 domains," concluded the study authors.



Source : Beckers Spine Review , 21st Nov 2014

Woman forced to give up sport due to twisted spine braves jaguars, piranhas and poisonous snakes in 250-mile Jungle Run

• At age 14 Jennifer Adair was diagnosed with double scoliosis
  
• Her spine was curved into an S-shape, leaving her needing daily painkillers
  
• She wore a back brace, and was forced to give up sport altogether
  
• Last December she underwent surgery to correct the curve
  
• Six months later doctors gave her the all clear to run the Jungle Run
  
• The race saw her traverse South American mountains and the Amazon
  
• She came 38th out of 51 in the 250 mile race, braving all sorts of wildlife
   

As a teenager, Jennifer Adair swallowed a handful of painkillers every day to deal with crippling back pain.

Diagnosed with scoliosis at age 14, her curved spine put increased pressure on the heart and lungs and left her in agony.

She was told not to take part in sporting activities for fear of aggravating her back.

Now, thanks to surgery, the 34-year-old has been chased by jaguars and stung by wasps after completing a gruelling 250-mile Jungle Marathon.

Ms Adair, from Manchester, traversed across South American mountains and the Amazon rainforest as part of the week-long endurance race.

As a teenager Jennifer Adair took a daily dose of painkillers due to painful spine condition scoliosis. She had to give up sport. But at age 34, she braved jaguars, snakes and wasps to finish a the 250-mile Jungle Run

 Ms Adair spent a week traversing the South American mountains and the Amazon to come 38th out of 51 runners (pictured left and right during the race)

Six months after her surgery, Ms Adair was given the all clear to take on the challenge. As part of the race she was stung by 15 wasps, causing her face to swell. She is pictured here in the jungle

She finished an impressive 38th out of 51 runners - despite her condition, which often leaves her in great pain.

Diagnosed with double scoliosis, meaning her spine is curved into an S-shape, as a teenager she was given a back brace to deal with the pain.

She was forced to give up sport in case it aggravated her back, and only reintroduced gentle exercise in her late 20's.

In December last year she decided to have surgery to correct the curve.

Although she had been active as a teen as participated in races as an adult, she didn't know if the pain of a tough marathon would be too much.

But just six months after her surgery, she was given the all clear to take on the challenge.

Working as a brand manager for Tommy Hilfiger, she swapped her mirror and make-up for a backpack, braving piranhas, poisonous snakes and jaguars.

Ms Adair said: 'It was hell. It was amazing and really hard at the same time.

At age 14, Ms Adair was diagnosed with scoliosis (left) - meaning her spine was S-shaped. She wore a back brace and was told to give up sport. But last December she had an operation to correct the curvature (right)

The race was a week-long and Ms Adair is now working on a documentary called 'Breathe' about her exploits, which she hopes will raise awareness to her condition

At one point Ms Adair caught a mystery illness which left her unable to eat. She is pictured here in the jungle during her challenge

*******************************************************
WHAT IS SCOLIOSIS AND WHAT ARE THE SIGNS OF THE CONDITION? 

Scoliosis is the abnormal curvature of the spine in an S-shape.

Signs include a visible curve in the spine, one shoulder or hip being more prominent than the other, clothes not handing properly and back pain.

Pain usually only affects adults with the condition.

In most cases, the cause of the scoliosis is not known but it can be caused by cerebral palsy and muscular dystrophy.

In the UK, scoliosis affects three to four children could of every 1,000.

It is also thought that as many as 70 per cent of over 65s have some degree of scoliosis.

It is more common in women than in men.

Most children with the condition do not require treatment as it is mild and corrects itself as the child grows.

However, in severe cases the child may need to wear a back brace until they stop growing.

Occasionally, a child needs surgery to straighten their spine.

In adults, it is usually too late to treat the condition with a back brace or surgery so treatment revolves around reducing pain.

*******************************************************

'I wanted a challenge but the challenge I got wasn't the one I was expecting.'

She stormed through stage one, an area dubbed 'jaguar alley', in eighth-place overall.

But while the big cats made her swallow her heart in fear, it was an attack by wasps that stung the most.

She was hit by the insects 15 times, causing her face to swell

One runner almost died from an allergic reaction, but miraculously still managed to complete the race.

Ms Adair said: 'You could hear the jaguars in the trees and you could smell them.

'One got very close to me and the first time I heard one growl I nearly swallowed my heart.

'But the wasps attacked just half an hour into the race and my cheek swelled up so much that I could see it.'

She was also struck down by a mystery illness that left her delirious and forced her to go two days without food, a particularly dangerous situation when braving super-humid conditions.

'My back was really sore on the second day and my condition means puts pressure on my lungs so I couldn't breathe,' she said.

'But by the next day I had too many other problems to feel it.'

Ms Adair is now working on a documentary called 'Breathe' about her exploits, which is set to be released for free in the next six months in a bid to raise awareness of the condition.



Source : Daily Mail - UK , 20th Nov 2014