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17 May 2011

New spine therapy helps city teen keep dancing

Method doesn't require the rods and screws of traditional scoliosis treatment
Published 05/13/11
Natalie Schott is a dancer, so she worried that a surgery to correct scoliosis would ruin her future.The 14-year-old learned of her diagnosis last year, when others noticed the shifting of her spine.

When her doctor diagnosed her with the condition, she wanted to avoid surgery that would place a rod and screws in her back, fearing it would limit her flexibility.

So at the recommendation of a friend with scoliosis, Schott's parents sent her to a Pennsylvania clinic for a series of therapies that would help her brain determine proper posture. Her time there included working with instruments that relax the ligaments and soft tissues of the spine and those that are applied on the ball and socket joint to put the spine through a full range of motion.
"It sounds like torture," said Schott, an Annapolis resident who since has noticed the straightening of her spine. "I'm not sure how much longer (to do the exercises). It might be the rest of my life. If that means no surgery, I'm totally up for that."

Scoliosis - a sideways curvature of the spine - often occurs during the growth spurt before puberty, according to the Mayo Clinic. Occasionally, children with mild cases can be monitored closely and avoid additional treatment.

It can be treated with a brace for adolescents and children with a curvature of 25 to 40 degrees. For greater curvatures, doctors can perform a surgery that uses screws and a rod to align the spine.

The National Scoliosis Foundation estimates there are 6 million Americans with scoliosis and there is no cure. Currently, the Scoliosis Research Society still recommends three options after a diagnosis - observation, bracing or surgery.

A new way

Dr. Clayton Stitzel is one of about 50 doctors certified through the CLEAR Institute, a Minnesota-based nonprofit organization that offers doctors the Scoliosis Correction seminar series.
There, they learn about the "mix, fix and set" process that aims to create a stimulus in the brain to help it recognize abnormal spinal alignment. During the "mix" portion, the spine is put through a range of motion with various instruments, including a motorized table with belts that pull the curves out of the spine. Afterward, the "fix" phase calls for a mechanical adjustment of the instruments. "Set" is the rehabilitation stage that retrains patterns of moving and walking. The protocol is geared toward idiopathic scoliosis, which is the most common form that occurs in adolescents.

"The object here is how can we create a stimulus that causes the brain to recognize that the spine is in an abnormal position, and get it to self correct," said Stitzel, of the Lancaster Spinal Health Center, one of six of the certified doctors within 100 miles of Annapolis. "If we do that over a certain period of time, the brain will start to recognize the new normal posture."
Over the summer, Schott broke her foot. While she walked around with the boot, her mother noticed that her back was shifting and there was a slight curve leaning toward the side. She went to the Lancaster facility, where it cost about $5,000 for her regimented treatment. Insurance covers about 80 percent of the treatment, Stitzel said.

She will have to do exercises - about 30 to 45 minutes daily - until she's 16, which is when most girls reach skeletal maturity. Boys tend to reach it by 18, but girls tend to get scoliosis more often than boys. Incidents of scoliosis also are higher for gymnasts and dancers, Stitzel said.
"My dance teacher could tell (the difference) and said my back got straight, and my friends could tell, too," Schott said. "It can be tiring, but you've got to stick with it."

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