Scoliosis
Vertebral Canal Length Usually Shorter
in Scoliosis
Idiopathic scoliosis involves a rotation of vertebral bodies toward the convexity
of the curve. But how does this rotation affect the size and shape of the vertebral
canal? To answer this question, researchers in Scotland measured the axial
length of the vertebral canal and the anterior aspect of the vertebrae in 36
skeletons: 8 with normal spines, 13 with kyphosis, and 15 with probable idiopathic
scoliosis.
Compared with vertebral length, the vertebral canal of skeletons with scoliosis
was short. "The results are consistent with a conceivable hypothesis
that in some patients with idiopathic scoliosis, there may be impaired growth
in the length of the spinal cord, the posterior elements are tethered, and
as the vertebral bodies continue to grow, they become lordotic and then rotate," wrote
the study's authors.
Porter RW Idiopathic
scoliosis: the relation between the vertebral canal and the vertebral bodies Spine
2000 (Jun 1); 25 (11): 1360-1366
Popular Scoliosis Test Inadequate
The Adam's forward-bending test, a popular evaluation technique used for school
scoliosis screenings, "cannot be considered a safe diagnostic criterion for
the early detection of scoliosis," say researchers in the journal Spine. According
to the report, the forward-bending test fails to detect a significant number
of scoliosis cases, especially when it is used as the sole screening Investigators
collected data on 2,700 students who underwent scoliosis screening in 1987.
All subjects were aged 8 - 16 years at the time of the screenings, which included
the Adam's forward-bending test, Moire topography, scoliometer measures and
humpometer measures. At 10-year follow-up, the researchers determined that
the forward bending test produced five false negative results.
The article concluded that, "The wide-spread use of school scoliosis screening
with the use of the forward-bending test must be questioned." Instead, the
study's authors suggest that back-shape analysis methods be used to look for
scoliosis in school-aged youngsters.
Karachalios, T, Sofianos J, Roidis N, Sapkas G, Korres D, Nikolopoulos K Ten-year
follow-up evaluation of a school screening program for scoliosis. Is the forward-bending
test an accurate diagnostic criterion for the screening of scoliosis? Spine
1999 (Nov 15); 24 (22): 2318-2324
In-School Scoliosis Screening Not Effective
How effective are school-based screening programs for adolescent idiopathic
scoliosis? To answer this question, researchers sifted through data on 2,242
subjects who had attended kindergarten or first grade in Rochester, Minnesota
between 1979 and 1982. All subjects underwent annual scoliosis screenings in
grades 5 through 9.
A total of 92 children were referred for further evaluation, although only
74% of these students received a chiropractic or medical follow-up examination.
Altogether, 27 of the students referred for evaluation were diagnosed with
scoliosis by age 19. However, only five of these subjects were treated for
the disorder. The study's authors concluded that in-school scoliosis screening
is not effective. Instead, they stress that parents and health care practitioners
should monitor pediatric patients for signs of scoliosis. The report was published
in the Journal of the American Medical Association.
Yawn BP, Yawn RA, Hodge D, Kurland M, Shaughnessy WJ, Ilstrup D, Jacobsen SJ A
population-based study of school scoliosis screening JAMA
1999 (Oct 20); 282 (15): 1427-1432
Scoliosis
A paper in the European Spine Journal evaluated school children. During the
course of the five year study, scientists followed 839 children with idiopathic
scoliosis (measuring at least 10 degrees).
The researchers outlines several risk factors for curve progression. In general,
more pronounced curves had a greater tendency to advance than less seevere
curves. Girls were more likely than boys to experience curve progression, especially
prior to onset of menses. Curve pattern was a major predictor of advancement.
Girls with right thoracic and double curves were morem likely to develop increased
curvature. Among boys, right lumbar curves indicated a higher risk of progression.
Left thoracic curves in both sexes were less likely to advance.
Soucacos PN, Zacharis K, Gelalis J, Soultanis K, Kalos N, Beris A, Xenakis
T, Johnson EO Assessment
of curve progression in idiopathic scoliosis Eur Spine
J. 1998; 7 (4): 270-277
Chiropractic and Scoliosis
Children with mild scoliosis treated with chiropractic adjustments have shown
a reduction in their spinal curvature, according to the findings of a three-year,
$143,000 study funded by the Foundation for Chiropractic Education and Research.
This cohort study was conducted by Charles "Skip" Lantz, DC, PhD, director
of research of Life Chiropractic College West, and his associates. The researchers
were studying the effects of chiropractic full-spine adjustive procedures,
heel-lifts, and postural counseling on children 9-15 years old with mild idiopathic
scoliosis (less than 20 degrees of curvature, with no complicating conditions).
Study on
Chiropractic Care for Adolescent Scoliosis is Encouraging
Dynamic Chiropractic Archives ~ January 27, 1997
Children and Scoliosis
A recent study using sophisticated measuring devices and advanced computer
analysis found a significant difference in gait between normal subjects and
those with scoliosis.6 This was most noticeable in the medial-lateral component
of gait, indicating problems with pronation and supination control. They observed
that the "...differences between the scoliosis and the control group, together
with previously reported abnormalities of torsion in the tibia and femur and
the hypothesis of pelvic rotation, suggests these are primary mechanisms of
the cause of idiopathic scoliosis."
These researchers believe that gait asymmetry could very well be the underlying
cause of the balance and coordination problems that result in a curved spine.
They conclude: "Patients with scoliosis exhibit balance problems during the
stance phase of gait and have significant asymmetry in the frequency characteristics.
These findings could be a primary effect that contributes to the medial-lateral
deformity of the spine and its initiation and progression."
Muscular imbalances and recurrent subluxations may develop secondary to a child's
postural habits. Asymmetrical development of musculature used frequently in
a sport can also be the source of a nonstructural scoliosis. These curves are
usually mild, and will correct rapidly with education, corrective exercises
and chiropractic treatment.
Children
and Scoliosis
Dynamic Chiropractic Archives - February 12, 2001