Scoliosis is an abnormal curvature of the spine due to rotation of the vertebral bodies. It occurs most often in adolescents, affecting females 7 times more frequently than males.
SIGNS AND SYMPTOMS INCLUDE:
Most scoliosis cases are idiopathic which means that there is no identifiable cause for the condition. In some cases, scoliosis has been found to be caused by:
What if Scoliosis is left untreated
Scoliosis is normally a progressive condition and not something a child can outgrow. If left untreated, scoliosis can worsen and have serious long-term physical and emotional complications. Severe scoliosis, where the curvature exceeds 50 degrees, can cause the spinal rotation to reach a point where it impacts the patient’s chest structure, which can lead to decreased lung capacity and heart problems.
Individuals with untreated scoliosis may also develop a condition called spondylosis, which is an arthritic condition where the spinal cartilage becomes compressed and deteriorates causing joints to become inflamed with the possibility of the nerve compression and bone spurs.
The Adam’s forward bending test is a reliable, easy to do test that could indicate the possibility of a scoliotic curve. An X-ray will still need to be done to confirm the diagnosis and determine the severity of the curve but performing the forward bending test is a good place to start when diagnosing scoliosis.
METHOD:
High probability of scoliosis
When determining the risk of the curve getting worse(progressing) we take patient age and initial Cobb angle into consideration, the table below provides a guideline:
Cobb angle | Age 10-12 | Age 13-15 | Age 16+ |
<20⁰ | 25% | 10% | 0% |
20⁰ - 29⁰ | 60% | 40% | 10% |
30⁰ - 60⁰ | 90% | 70% | 30% |
>60⁰ | 100% | 90% | 70% |
Age plays a vital role in the treatment of scoliosis, while not everyone develops at the same pace, there is an anatomical marker that assists in determining how much time we have to possibly correct a scoliotic curve. We refer to it as the Risser sign which is determined by looking at the upper part of the pelvis (Iliac crest) on an X-ray. This marker in combination with the Cobb angle can assist us in estimating possible treatment outcomes.
Scoliosis treatment depends on the severity of the condition and the age of the patient. The curve is measured to determine the Cobb angle which will allow for certain treatment options using the following guidelines:
Bracing: Chêneau Type 3D design
The main principles of the Chêneau brace are related to a derotational mechanism created by forces and counterforces to bring the trunk into the best possible correction. This design aims to correct scoliosis by affecting the alignment and forces in all three anatomical planes.
When designing the brace, we aim to:
Understanding Scoliosis bracing
A scoliosis brace is a custom corrective orthotic device that makes use of the principles of the Chêneau Type 3D design to reduce the Cobb angle and rotation of the spine.
Depending on the severity of the curve and the age of the patient, it is generally recommended that the brace should be worn for 16-23 hours a day for optimal results.
The Chêneau type brace and the Schroth PSSE address the 3D biomechanics of scoliosis in the similar way. The increased expansions in the brace correspond to the Schroth PSSE de-rotational breathing mechanics, which aim to expand the collapsed areas of the trunk affected by scoliosis, attempting to correct the horizontal (axial) plane of the body.
Specific pressure areas in the brace and Schroth PSSE principles work hand in hand to correct the frontal and sagittal planes of the body. That is why the Chêneau type brace and Schroth PSSE are considered to be a 3D conservative treatment of scoliosis.
Thus it is important to understand the treatment process of scoliosis does not stop with the brace and this is why we recommend consulting with a Schroth trained therapist to assist our patients to in getting best available treatment and ensuring the best possible outcome.