Written and reviewed for scientific and factual accuracy by Dr. Austin Jelcick, PhD and Dr. Matthew Janzen, DC
How can I make my scoliosis curve reduction gained from treatment last?
A common concern of many parents who come to our clinic is “Will the changes last?”. Meaning, “If my child’s spine grows straighter, what will make it stay that way?” Maybe parents hear stories of a child going to a clinic to receive care where the spine improves, however, the improvement was only temporary with scoliosis returning in greater severity. Thus, being able to maintain the non-surgical scoliosis improvements gained through treatment is of paramount importance.
These stories are real, and we have heard them first hand from patients coming to us from other non-surgical clinics. With the looming threat of invasive surgery and horror stories of spines growing uncontrollably crooked, is there any way to be certain that one can win the fight against scoliosis and stay out of surgical range for good?
The good news is that there is a way to be certain of your successful outcome with non-surgical scoliosis treatment. Once you gain a straight spine, we know how to assure it stays that way. We have your problem solved. One by one we can eliminate the reasons for your child’s spine to have scoliosis. Here’s how non-surgical scoliosis improvements can be maintained:
Maintaining Scoliosis Curve Reductions #1:
Make the spine as straight as possible.
Research generally supports the observation that a smaller scoliosis tends to be more stable and less prone to relapse.1 So, finishing with as small a curve as possible must be one of our key goals. Thankfully we have tools that can help even large curves grow smaller.
For example, our Scoliosis Flexibility Trainer helps free up a stuck scoliotic spine to allow it to straighten out and untwist; thereby providing better scoliosis curve reductions. Our Silicon Valley BraceTM holds the progress made by the Scoliosis Flexibility Trainer. Here is an example of a large scoliosis being “untwisted” and straightened by such a treatment tool and then following the treatment by wearing the SV Brace. as part of the Silicon Valley Method.
Maintaining Your Reductions #2:
Hold the new ground you’ve gained for at least a year – and until fully grown (skeletal maturity).
The longer you hold the “new”, more straightened spine, the spine becomes more stable and “cemented” into this new position. This is much like orthodontic braces. Once the spine is moved into its new corrected alignment, it must be held there for a period of time to make this change a permanent one.
Here is a graph of a child’s spine growing straighter over time. It would be tempting to want to stop treatment at the red line mark. That is where the patient has experienced significant straightening of the spine. However, stopping treatment here would likely have allowed the curve to worsen again.
Notice the yellow arrow where we see a spike in the size of the patient’s curve. This is where the patient experienced their rapid adolescent growth spurt. To make the changes last, we need to continue the treatment all the way to the finish line, which usually is when the child is done growing (checkered flag).
Maintaining Your Scoliosis Curve Reductions #3:
Neutralize the root cause of your scoliosis to maximize your non-surgical scoliosis improvement. In other words, “Get rid of the driving force” that makes the spine want to coil down into a larger scoliosis.
That driving force, in most cases, can be identified and treated. Usually, this is due to a short or tight spinal cord.2–5 Special neuro-elongation methods can be used to lengthen the short spinal cord safely, thus freeing up the spine to extend back into a straighter alignment and allowing for a greater scoliosis curve reduction. When the driving force of the scoliosis is completely neutralized and the spine has been held straight for a solid period of time, a stable improvement can be attained.
Maintaining Your Reductions #4:
Correct the scoliosis while the spine is still growing.
Scoliosis gets worse the fastest when a child’s spine is at its highest rate of growth6, however, this is also true in reverse; when a child’s spine is held straight during growth some of our fastest curve reductions are seen. The bones can be more easily shaped and molded back into their desired (straight) shape. Once a growing spine is held straight, like a green twig, it will soon turn into a strong branch which resists future change.
Similarly, a curve made straight during growth leads to a strong, straight spine that will last. This graphic, used in Dr.Mehta’s study on “Growth As a Corrective Force”, illustrates this point beautifully by demonstrating how correcting the spine during growth leads to permanent correction as an adult. 7
Maintaining Your Reductions #5:
Center the spine over the pelvis.
When the upper body falls off to one side of the pelvis, this makes the spine unstable and allows the curve to worsen even in adulthood.8 By correcting the alignment of the posture and bringing the spine back to the center of the pelvis, stability is gained. To the right you can see what this looks like:
Maintaining Your Reductions #6:
Train the muscles and brain to hold your new alignment.
It is possible to utilize “weighted” exercise devices that will re-train the body and mind to automatically hold the newly aligned posture. Here is an example of a patient with a 60-degree curve training their spine straight in an exercise:
Maintaining Your Reductions #7:
Gradual weaning
Gradually wean from your corrective program and use maintenance exercises, if necessary, such as the ones listed in Step 6. Check the spine regularly using a standing MRI to assure progress is maintained. Similar to following orthodontic braces with a retainer, it is wise to wean oneself slowly from a scoliosis corrective program.
By using these seven principles, we have found that is possible to reduce the scoliosis curve and make lasting changes to one’s spine.
References
- Agabegi SS, Kazemi N, Sturm PF, Mehlman CT. Natural History of Adolescent Idiopathic Scoliosis in Skeletally Mature Patients: A Critical Review. J Am Acad Orthop Surg 2015;23:714–23.
- Roth M. Idiopathic scoliosis caused by a short spinal cord. Acta Radiol Diagn (Stockh) 1968;7:257–71.
- Roth M. Neurovertebral and Osteoneural Growth Relations, A concept of normal and pathological development of the skeleton. Univerzita J.E. Purkyne, Brno: Radiodiagnositic Clinic, Medical Faculty, 1985. 101 p.
- Porter RW. Can a short spinal cord produce scoliosis? Eur Spine J 2001;10:2–9.
- Burwell RG, Clark EM, Dangerfield PH, Moulton A. Adolescent idiopathic scoliosis (AIS): a multifactorial cascade concept for pathogenesis and embryonic origin. Scoliosis Spinal Disord 2016;11:8.
- Dimeglio A, Canavese F. Progression or not progression? How to deal with adolescent idiopathic scoliosis during puberty. J Child Orthop 2013;7:43–9.
- Mehta MH. Growth as a corrective force in the early treatment of progressive infantile scoliosis. J Bone Joint Surg Br 2005;87:1237–47.
- Negrini S, Aulisa AG, Aulisa L, et al. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 2012;7:3.