The ineffectiveness of Scoliosis Bracing

By Dr Kevin Lau

Scoliosis is known by the curvature of a person’s spine. The areas commonly afflicted are the middle or side bones of the spine. Scoliosis can be discovered at birth, while in the womb the bones of the spine fail to form properly or the ribs fuse together leading to congenital scoliosis. The condition poses minimal risk to infants and young children of both genders.

Neuromuscular scoliosis refers to muscle problems such as poor muscle control, muscle weaknesses and muscle paralysis caused by certain diseases (spina bifida, muscular dystrophy and polio). Idiopathic scoliosis has no cause and is frequently observed in adolescents, the majority being young girls. The spinal curves worsen as adolescents grow. The braces are less helpful to overweight patients afflicted with adolescent idiopathic scoliosis.

Treatment varies according to the cause of the scoliosis, the size and location on the spine and the growth rate of the patient. For curves between 24 to 40 degrees in adolescents, body braces are advised by doctors to stop the advancement of spine curving. Boston Brace, Milwaukee Brace, Wilmington Brace and Charleston Brace are the different types of braces. Each brace has an individual function and the patients’ health care provider has to choose the most suitable one for the patient.

Medical reports say the scoliosis brace does not reverse the curve; instead it applies pressure at certain points to straighten the spine. The importance of the brace is that it is adjustable as the patient matures.

The standard treatment prescribed is a scoliosis brace that corrects moderate curves of 24 to 40 degrees in adolescents. This treatment is recommended despite the lack of evidence to validate its prescription and the debate is still ongoing. Though hard and elastic braces have been shown to correct spinal curvature, the research does not provide definite answers. More investigation is needed to determine conclusively if body bracing is good for scoliosis patients. 

The preference for scoliosis bracing is in small part due to subpar research on the effects of scoliosis exercise in the 1960’s to1970’s.  It is important to consider the supervision of these research studies. The participants were instructed to engage in scoliosis exercises which were not directed towards relieving scoliosis curvature or pain. The orthopedic scoliosis specialist community took the research as the basis to advocate scoliosis bracing over exercise.

Recent long-term studies published in research journals cast doubt on the usefulness of the scoliosis brace treatment, especially on its supposed ability to halt the scoliosis spine progression, preventing the patient from needing scoliosis surgery or significantly altering the condition.

At the 2010 SOSORT meeting in Montreal, a speaker presented findings that demonstrated the possible negative impact scoliosis braces may have on an individual. When scoliosis braces were used on rat tails, which are structurally similar to the human spine, the rate of disc deformity increased. Moreover, the curvature of the scoliosis spine had an elevated chance of worsening.

Scoliosis & Epigenetics

Written by Dr. A. Joshua Woggon, Copyright 2012.

"Research is to see what everybody else has seen, and to think what no one else has thought."

-Albert Szent-Gyorgi, Nobel Prize Winner & Discoverer of Vitamin C


The role that genetics plays in the development of scoliosis remains controversial. While it cannot be disputed that scoliosis does have a familial component (people who have a family member with scoliosis are more likely to have it themselves), the fact that identical twins do not always share the disease of scoliosis emphasizes the role that other, non-genetic factors play in the development of scoliosis.

This topic was recently explored in detail by four of the most highly respected researchers in the field of scoliosis, including the foremost experts on the etiology (cause) of scoliosis, Burwell & Dangerfield, and the current editor-in-chief of the Scoliosis journal, Theodoros Grivas. The article, entitled Adolescent idiopathic scoliosis (AIS), environment, exposome, and epigenetics: a molecular perspective of postnatal normal spinal growth and the etiopathogenesis of AIS with consideration of a network approach and possible implications for medical therapy, was recently published in the journal Scoliosis, and is the first research endeavor to explore the role of epigenetics in scoliosis.

Epigenetics, while as complex as genetics if not moreso, can be summarized simply as the study of the environmental factors which regulate genetic expression. Through the process of methylation, genes can be "turned on" or "turned off" in response to these factors. Thus, an individual with a family history of cancer and who is at high risk for developing cancer themselves can modify their diet & lifestyle, which will actually re-write their genetic code to reduce their chances of developing cancer.

Due to the gaps in our understanding of what causes scoliosis, the traditional approaches of bracing & surgery can only aim at treating the effects of scoliosis; most notably, Cobb angle. Bracing & scoliosis surgery are mechanical in nature; they do not involve rehabilitation of the neurological systems of the body, and they do not claim to address what caused the scoliosis to develop in the first place. They merely respond to the presence of a lateral curvature of the spine by attempting to force it back into place.

The lack of research on the causes of scoliosis is, in part, driven by the sociopolitical forces which prevail and continue to promote bracing & surgery as the only solutions. In the last decade, epigenetics has revolutionized the way in which we understand many diseases. Unfortunately, this has not been the case for scoliosis, where "there are only sporadic reports suggesting that environmental factors are at work in etiology. [E]pigenetics does not figure in any causal analysis of postnatal normal spinal growth, or in the etiopathogenesis of AIS. This reflects current scientific opinion that genetic rather than environmental factors determine the etiology of AIS in accordance with the genetic variant hypothesis of disease."

In short, there is a very real possibility that environmental forces may play a larger role in the development and progression of scoliosis than genetic factors, but due to the current dogma, this possibility is simply not being explored in the United States.

Hot 'n' Healthy: Ripped at 68, weightlifter pushes all ages to hit the gym

By Chris Thompson 

Ripped at 68

At age 68, Tony O’Connor is as sharp mentally as he is physically. A retired engineer, he has been a competitive bodybuilder and personal trainer for 47 years. He is quick to tell you he is still learning and goes online every day to do research to better serve his clients.

His clients range in age from 10 to 85. O’Connor likes to say, “It is never too soon or never too late.”

With a diverse client base, O’Connor adheres to doctors’ instructions and adapts his training sessions to accommodate clients with shoulder or back injuries, scoliosis, diabetes, pregnancy, etc.

Cheri Acreed, 62, was diagnosed with polymyalgia rheumatica, which causes musculoskeletal pain. She has taken several serious falls and attributes no broken bones to the flexibility and lean muscle mass she has developed while training with O’Connor.

“Since being diagnosed two years ago, Tony is the best thing that has happened to me physically and mentally,” Acreed says.

Study: Anatomic Patterns Could Influence Appropriate Scoliosis Treatments

Written by  Kathleen Roney | February 06, 2012

According to a study published in Spine, different anatomic patterns of proximal thoracic curves could cause different altered positions of the esophagus relative to the spine and result in different potential risks of esophageal injuries during thoracic pedicle screw insertion.

Researchers took axial CT images from 20 patients with complete proximal thoracic curve, 22 patients with fractional proximal thoracic curve and 14 normal patients to evaluate the changed relative positions of esophagus in proximal thoracic curves of adolescent idiopathic scoliosis patients.

Key findings include:

•    Esophagus-vertebral angle was significantly smaller than that in the  normal group
•    EVA in the complete proximal thoracic group was significantly greater than in the normal group at each level.
•    The esophagus was at a high risk of injury with right anterior penetrated TPS in the CPT group.
•    Spine surgeons should choose appropriate pedicle screw length to avoid anterior cortical perforation in the PT region of AIS patients. 

Pain patients rebuild lives wrecked by addiction

They say they were overprescribed at Payette Clinic before drug agents raided it

Some of the faces and stories of the Payette Clinic are familiar.

There’s Harold Andres, the Vancouver Payette patient who robbed three pharmacies to get his oxycodone fix. His addiction landed him in prison for more than four years.

There’s Larae Corzine, who spent more than a year in prison for robbing pharmacies. The Vancouver woman became addicted to Oxycontin while a patient at the Payette Clinic.

And then there’s Rachel Daggett, the 18-year-old Oregon girl who died after smoking an oxycodone pill. The high school senior bought the pill from a Payette patient.

In March 2009, among allegations of overprescribing narcotic medications and prescription drug diversion, the federal Drug Enforcement Administration raided the Payette Clinic and, ultimately, ended its narcotic drug-prescribing operation.

The closure sent ripples through the community as hundreds of patients were left with nothing more than their addiction.

For every familiar story, hundreds of unknown stories exist.

Stories of the ashamed and embarrassed who will forever be labeled “addict” in the eyes of their family and friends.

Christina Scoliosis Treatment Insight

New Evidence of Synergy Between Vitamins A and D: Protection Against Autoimmune Diseases

Posted onJanuary 22, 2012by Chris Masterjohn

One of the perennial topics of this blog is the synergy between vitamins A and D.  A new Japanese study published last July in the journal Immunology Letters (1) provides further evidence of this synergy, this time suggesting the dynamic duo can courageously combat the most flagellant of our inner impulses, keeping our wayward neutrophils in check and barring them from wandering too far down the winding road that leads to autoimmunity.

These investigators faced a conundrum.  A number of studies suggest that the activated hormone form of vitamin D, calcitriol, has great promise for preventing and treating autoimmune diseases, but its usefulness in the clinical setting is currently limited because it promotes excessive accumulation of calcium in the blood and soft tissues.  One hardly wants to cure, say, psoriasis if it means having to pass kidney stones.

A Gut Check for Many Ailments

What you think is going on in your head may be caused in part by what's happening in your gut.

A growing body of research shows the gut affects bodily functions far beyond digestion. Studies have shown intriguing links from the gut's health to bone formation, learning and memory and even conditions including Parkinson's disease. Recent research found disruptions to the stomach or intestinal bacteria can prompt depression and anxiety—at least in lab rats.

Better understanding the communication between the gut and the brain could help reveal the causes of and treatments for a range of ailments, and provide diagnostic clues for doctors.

Exercise puts teens to a peaceful sleep

A new study has revealed that daily exercise improves a teenager's chances of a good night's sleep, while using the computer for more than two hours a day has the opposite effect.

The study of nearly 15,000 high school students found that those who spent at least an hour engaging in physical activity daily were significantly more likely to report "sufficient" sleep-eight hours or more per night-than students who were inactive.

Is this Better than Drugs for Neck Pain?

A new study funded by the National Institutes of Health found that when it comes to neck pain, the best medicine is no medicine.  The study tracked patients with recent-onset neck pain who were treated using either medication, exercise, or a chiropractor.  After 12 weeks, the patients who used a chiropractor or exercised were more than twice as likely to be pain free.

The patients treated by a chiropractor experienced a 32 percent success rate, while exercise resulted in a 30 percent success rate.  Patients treated with medication exhibited only a 13 percent success rate.

According to ABC News:

“The exercises prescribed to patients in the study were simple and designed to be performed at home with the help of instructional photos.”

Sources:

  ABC News January 4, 2012