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

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

Can hyperbaric oxygen be used to prevent deep infections in neuro-muscular scoliosis surgery?

The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery. Hyperbaric oxygen has been used as a supplement to treat postsurgical infections.


Our aim was to determine beneficiary effects of hyperbaric oxygen treatment in terms of prevention of postoperative deep infection in this specific group of patients in a retrospective study.


Methods: Forty two neuromuscular scoliosis cases, operated between 2006-2011 were retrospectively reviewed. Patients who had presence of scoliosis and/or kyphosis in addition to cerebral palsy or myelomeningocele, postoperative follow-up >1 year and posterior only surgery were the subjects of this study.


Eighteen patients formed the Hyperbaric oxygen prophylaxis (P-HBO) group and 24, the control group. The P-HBO group received 30 sessions of HBO and standard antibiotic prophylaxis postoperative, and the control group (received standard antibiotic prophylaxis).


Results: In the P-HBO group of 18 patients, the etiology was cerebral palsy in 13 and myelomeningocele in 5 cases with a mean age of 16.7 (11-27 yrs).


The average follow-up was 20.4 months (12-36mo). The etiology of patients in the control group was cerebral palsy in 17, and myelomeningocele in 7 cases.


The average age was 15.3 years (8-32 yrs). The average follow-up was 38.7 months (18-66mo).


The overall incidence of infection in the whole study group was 11.9% (5/42). The infection rate in the P-HBO and the control group were 5.5% (1/18), and 16.6% (4/24) respectively.


The use of HBO was found to significantly decrease the incidence of postoperative infections in neuromuscular scoliosis patients.


Conclusion: In this study we found that hyperbaric oxygen has a possibility to reduce the rate of post-surgical deep infections in complex spine deformity in high risk neuromuscular patients.
Author: Mustafa Erkan InanmazKamil Cagri KoseCengiz IsikHalil AtmacaHakan Basar

Source: BMC Surgery 2014, 14:85 Via 7th Space

Beyond braces for scoloisis patients

When Trevor Johnson was 11, his growing spine took a detour from the normal straight path. Instead of stacking neatly one atop the other, his vertebrae began to drift sideways into an S-shape and his rib cage started torquing to the left.



Trevor Johnson breathes into an inspirometer to improve lung function.



This spinal deformity, called idiopathic adolescent scoliosis, is common, affecting nearly 6 million Americans. In its early stages, the long-accepted approach is to wait and see whether the curve worsens.


Trevor's parents had been down this road before and were not alarmed. His older sister has scoliosis, too. By the time she finished her growth spurt, the slight swerve in her back was hardly noticeable and posed no health problems.

But Trevor would not be so lucky. Periodic X-rays showed his spine bending and twisting like a sapling surrendering to gale-force winds.


"First the curve was 11 degrees," said his mother, Amy. "It went to 19, then 25, then 34, then panic."


In February, the Johnsons were told Trevor needed surgery to straighten his spine so he could breathe properly and enjoy an active life. "Isn't there anything else we can do?" they asked.


There was.

Only a few months earlier, Lisa Angioli, a physical therapist in Exton, had been trained in the Schroth method, which uses posture correction, resistance training, and breathing exercises to stabilize the spine.


The method was developed in the 1920s and has been used in Europe for decades, but until three years ago, few places in the United States offered the treatment other than a small clinic in Wisconsin.


With pressure from an increasing number of parents like Trevor's who are loath to subject their children to major back surgery, more physical therapists are training in variations of the Schroth technique and more doctors are willing to consider its merits.


"Five or six years ago, I first started hearing parents ask me about it," said Suken Shah, the pediatric orthopedic surgeon who evaluated Trevor. As division chief of the Nemours Spine and Scoliosis Center in Wilmington, Shah said he had always encouraged patients to get exercise and stay active. Although many studies have been published in Europe about Schroth, no solid work has appeared in the top U.S. journals supporting claims that Schroth and similar therapies can help stop a scoliotic curve from progressing or actually reverse it, as many advocates claim.


That does not mean, however, the method is ineffective, Shah said.


"I'm open," he said. "We're interested in really good outcomes, whether that's operative or nonoperative. And nonoperative care is not optimal right now. We may not be acting early enough. And we may not be taking advantage of things available elsewhere."


John P. Dormans, chief of orthopedic surgery at Children's Hospital of Philadelphia and president of the Scoliosis Research Society, said the buzz about Schroth had been growing.


"There is still a lot of skepticism," he said. "But there is mounting evidence that specific exercises can be effective. As thoughtful surgeons, we support better, high-quality research to see if it really does work."


Nearly a century ago, Schroth, a German teacher who had worn a steel brace as a teenager to straighten her spine, developed exercises to treat scoliosis. She discovered that by assessing the back in three dimensions, practicing deep breathing, strengthening weak muscles, and training herself to reposition her shoulders, hips, and torso, she stood straighter and expanded her lung capacity.


She opened several clinics and began working with her daughter, Christa. After her mother's death in 1985, Christa treated patients in Germany, then went on to join forces with a doctor in Barcelona, fine-tuning the technique.


The treatment was brought to the U.S. in 2003 by Beth Janssen, a physical therapist from Wisconsin. Janssen's son had scoliosis and after two years in a rigid brace, still had problems with his posture and breathing. After hearing about the clinic in Barcelona, she took him there for treatment, then trained as a practitioner.


Janssen's clinic, Scoliosis Rehab, and one in Milwaukee, Spinal Dynamics of Wisconsin, were the two main sites offering treatment and training therapists in the method until 2012, when the Hunter College School of Physical Therapy launched a program.


So far, only two physical therapists in this region are certified to practice the method: Johan van Schalkwyk in Cherry Hill and Lisa Angioli in Exton.


Like most physical therapists, Van Schalkwyk, 46, said that in his 16 years of practice, all his training, and continuing education, no one ever suggested patients with scoliosis needed specialized care.


A few years ago, when a patient asked him about Schroth, he looked into it and was struck by its logic. Last year, he took the course at Hunter, which has now certified more than 60 therapists, said Gary Krasilovsky, chair of the physical therapy department.


Scoliosis normally starts early in puberty and occurs equally in boys and girls, although girls are eight times more likely to have a curve progress to the point that they need a brace or surgery.


The catch-22 is that there is a higher probability of preventing a curve from getting worse when patients are braced early on, before they enter the peak of their growth spurt. But because it is impossible to predict whose curve will progress enough to require intervention, and it is impractical - and from a public-health perspective, too costly - to brace every child at the first sign of scoliosis, doctors do not recommend doing anything until the curve reaches 25 degrees.


"If you committed every kid with a 20-degree curve to a brace, you'd be overtreating," said Dormans. Studies have shown, he said, that people who enter adulthood with a curve of less than 40 degrees usually do not get any worse as they age.


For patients at risk of more serious curvature, reaching a consensus on the best treatment has been difficult for physicians.


In 2013, a large multicenter study was halted because researchers found bracing so effective in preventing curves from advancing that continuing with a control group would have been unethical.

"The benefit increased with longer hours of brace wear," the authors wrote in the New England Journal of Medicine.


Yet in the same issue, an editorial doubted the researchers' conclusions, saying the study wasn't big enough to evaluate a diverse group of patients.


It is no surprise, then, that an alternative therapy such as Schroth has been slow to gain acceptance among surgeons.


Advocates of Schroth and similar exercises say the central question is: Why not teach patients how to strengthen their backs, correct their posture, and breathe more effectively rather than passively waiting to see how far their curves progress?


"I believe in exercise as active observation," said Amy Sbihli, a Schroth-certified therapist in Burlington, Mass. She teaches the method at Hunter, which had a waiting list of 20 therapists for the course this fall.


"A lot of physical therapists who come to my courses tell me they're seeing so much scoliosis and don't know what to do with it," Sbihli said. "There's a world of unmet need."


Children's Hospital here is planning to offer Schroth therapy to patients in the spring, a spokesperson said.
At Nemours, Shah said, he is writing a business proposal to have two therapists trained in the method.
"It's hard to quantify the effect," he said, until larger, more rigorous studies are done. "But if we already assume it doesn't cause any harm and it might help, it's all good."


Exercise in general should be encouraged more, Shah said, noting that young ballet dancers with scoliosis benefit greatly from their keen awareness of posture, constant workouts, and stretching.


Among the most successful is Wendy Whelan, the exquisite dancer who retired Sunday after 30 years with the New York City Ballet. Diagnosed with severe scoliosis at 12, Whelan spent two years in a brace, but took ballet classes the entire time and continued, throughout her career, to practice breathing and stretching exercises to compensate for her asymmetrical back.


The advantage of Schroth over the standard physical therapy Shah said, is that it is customized to each patient's curve type and age. He cautions, however, against unrealistic expectations.


After traveling to Wisconsin and Barcelona for intensive and costly care, some of his patients with serious curves have returned to find they needed surgery anyway.


Schroth's expansion will be limited by insurance coverage and patients' self-discipline. Besides working with a therapist at least once a week for months, they must do exercises at home for 30 minutes five days a week or more.


Trevor Johnson believes the investment paid off.

Now 14, he has been working with Angioli once or twice a week since March and practicing at home nearly every day. During a recent session at Empower Physical Therapy, Angioli adjusted his posture and talked him through a series of subtle but challenging moves.


Angioli had been practicing for 25 years when a colleague told her about Schroth. The woman's sister was a ballet dancer who after being told she needed surgery for scoliosis opted for a brace and Schroth therapy. The results were dramatic.


Angioli received her Schroth certificate from Hunter on Oct. 8, 2013. "Are we totally against surgery?" she asked. "Absolutely not. In some cases, it's absolutely necessary." And for many patients, bracing is required.
"Check those ribs," she said as Trevor squared his shoulders. Gently tapping on his lower back, she coaxed, "Breathing here and here. Good!"


Later, Trevor hung by his arms from a special ladder, then, focusing on the weaker muscles in his shoulders and back, raised and lowered his body. In another exercise, he stretched sideways on the floor while Angioli slipped beanbags under his hip and neck, aligning his posture. He then lifted his top leg to strengthen targeted muscles, and, as before, drew breath into constricted spaces in his lungs.


"It was weird at first," Trevor said. "But then I got used to it."


At the time Shah recommended an operation, Trevor was in so much pain he could not sit through classes and his grades suffered.


"But I didn't want surgery. It would have taken me four months to recover and I would have needed more physical therapy after that. Plus, it was really expensive and they would have given me heavy drugs."
After he was put in a brace, he went for regular physical therapy, but "it made the pain worse."

Since he started with Angioli, he has doubled his lung capacity, is in much less pain, and can focus on his studies. When he was last X-rayed in August, his upper curve had fallen from 34 to 30 degrees and his lower curve from 35 to 27 degrees.


Trevor, who hopes to be an orthopedic surgeon one day, wonders why there is so much hesitation about Schroth. "It works," he said. "They ought to spread it further."

---

mdribben@phillynews.com
215-854-2590 @dribbenonphilly



Source  : Philly.com , 26th Oct 2014