:dropcap_open:W:dropcap_close:hat is the chiropractic profession’s position when it comes to treating scoliosis? What have our chiropractic universities taught us? Are we only treating subluxations and not the scoliosis? Are we adjusting for symptoms and not trying to correct the scoliosis? Why does the scoliosis patient live if there are extreme subluxations? Scoliosis is an abnormal curvature of the spine diagnosed as being more than a 10-degree Cobb angle. Horizontal vertebral body baselines are drawn on the superior and inferior aspects of the most tilted vertebra, and a perpendicular line is drawn to intersect. This angle is measured and that is the Cobb angle.
The standard medical treatment is to watch and wait from 10 to 25 degrees, brace it at 25 degrees, and perform surgery at 40 degrees.
Doctors of Chiropractic are frequently the first opportunity for patients to receive a scoliosis screening and it should be part of the chiropractic examination, especially with children from 10 to 15 years old.
The Scoliometer is an inexpensive tool to do this measurement and is more accurate than the Adams test.
:quoteleft_open:Some cases of scoliosis respond well to standard chiropractic treatment and some do not.:quoteleft_close:
It has been stated that scoliosis affects 4.5% of children1, 12% of female college students2, 25 – 30% of the general population3, and 68% of the population over sixty years old4.In 2000, an estimated 2.7 million patient visits were made to American chiropractors for scoliosis and scoliosis-related complaints5. Charles Lantz, DC states, “Full-spine chiropractic adjustments with heel lifts and lifestyle counseling are not effective in reducing the severity of scoliotic curves.” 6
Some cases of scoliosis respond well to standard chiropractic treatment and some do not. When they don’t respond, are we obligated to refer scoliosis patients to an orthopedic surgeon for bracing or surgery?
CLEAR Scoliosis Institute is the only organization in the chiropractic profession dedicated to finding an effective alternative to waiting, bracing, and surgery.
What are the options?
- Do a scoliosis screening on all your patients. Scoliosis accelerates at 11.7 years of age.7 The Adams test is ineffective8 because once the rib hump is present, the scoliosis is above 30 degrees. Use a Scoliometer and check posture, stance, and gait.
- If there is a scoliosis, do not adjust the “high side of the rainbow.” Do not perform posterior to anterior thoracic adjusting.9
- Monitor the scoliosis. Perform the Scoliometer test on every visit. Re-exams and x-rays should be done every three months.
- ScoliScore is a saliva based genetic marker test that will predict within a 99% certainty if an existing scoliosis will progress.10 It is applicable to a scoliosis from 10 to 25 degrees and for a child 9 to 13 years old.
- Communicate with the orthopedic physician about the case and your treatment plan and goals.
- Consider referring the patient to a CLEAR certified scoliosis doctor. This doctor will evaluate the patient and establish a treatment plan to reduce and stabilize the scoliosis. The CLEAR doctor will then work with the referring doctor to co-manage the patient.
Doctors of Chiropractic should be the spinal experts. Instead of referring the patient to an orthopedic doctor for bracing or surgery, consider an inter-professional referral to a CLEAR scoliosis doctor.
Chiropractic first, drugs second, surgery last!
References
- The etiology of Adolescent Idiopathic Scoliosis Am J Orthop 2002 Jul;31 (7) :387-95 Ahn et al, New Hampshire Spine Institute
- “Scoliosis screening of 3,000 college-aged women. The Utah Study – Phase 2”, Brigham Young University, Provo, UT, Francis RS. Phys Ther 1988 Oct;68(10):
- Chiropractic Technique: 1920, BJ Palmer
- Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Schwab F et al. Department of Orthopedic Surgery, Spine Service, Maimonides Medical Center, Brooklyn, NY, USA. fschwab@ worldnet.att.net Spine (Phila Pa 1976). 2005 May 1;30(9):1082-5
- Ref: Christensen MG, Kerkhoff D, Kollasch MW: Job analysis of chiropractic 2000. Greeley, Colorado: National Board of Chiropractic Examiners; 2000
- Effect of Chiropractic intervention on small scoliotic curves in younger subjects: A time-series cohort design. JMPT 2001 Jul-Aug;(6):385-93, Lantz CA, Chen J.
- Maturity Assessment & Curve Progression in Girls With IS J. Sanders et al, Journal of Bone & Joint Surgery, 2007
- J Pediatr Orthop. 1995 Jul-Aug;15(4):535-8.
- Posterior to Anterior Thoracic Spinal Adjusting in the Scoliosis Patient Is Contraindicated By Spinal Biomechanics Dr. Dennis Woggon, BSc, DC, CLEAR Institute, http://clear-institute.com/docs/PosteriorAnteriorThoracicAdjusting.pdf
- “Prediction of scoliotic cobb angle with the use of the Scoliometer” Spine, 1996 Jul 15;21(14):1661-6
- www.axialbiotech.com
Dr. Dennis Woggon is the Founder and Director of the CLEAR Scoliosis Institute. You can find additional information at www.CLEAR-Institute.org. Dr. Woggon can be contacted at [email protected].