Scoliosis 101
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Scoliosis 101

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Scoliosis 101 describes the condition of scoliosis, how it is evaluated, traditional treatment recommendations,andt he most recent developments in non-invasive...

Scoliosis 101 describes the condition of scoliosis, how it is evaluated, traditional treatment recommendations,andt he most recent developments in non-invasive
rehabilitation based treatment. For more information visit http://www.treatingscoliosis.com or call

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    Scoliosis 101 Scoliosis 101 Presentation Transcript

    • Scoliosis 101 CLEAR Institute www.CLEAR-Institute.com Dr. Clayton J. Stitzel [email_address] Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Spinal Biomechanics
      • Ideal curves of the spine
        • Primary and secondary curves
        • Function of curves
          • Strength
          • Flexibility
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • What’s so Special About Scoliosis?
      • Said to effect 4.5% of population. It is probably closer to 10%
      • Mortality rate of 15%. (1)
      • Decreases life expectancy by 14 years. (1)
      • A study in 1988 revealed that 12% of college age women had Scoliosis. (2)
      1 Ahn et al, New Hampshire Spine Institute. The etiology of adolescent idiopathic scoliosis. Am J Orthop 2002 Jul;31 (7):387-95 2 “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)
    • What is Scoliosis?
      • Abnormal curvature of the spine greater than 10˚ in the sideways or coronal plane (Cobb angle)
      • Spine looks more like an “S” or “C” than a straight line
      • Many cases have rotational component
        • Shoulders and/or waist appear uneven (3)
      3 Fysh, Peter. “Scoliosis and the Child’s Spine.” Dynamic Chiropractic. 1994 Oct; 21 (12). Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Cobb Angle Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Types of Scoliosis
      • Infantile
        • before the age of 3
      • Juvenile
        • prepuberty:
          • 4 – 12 (girls)
          • 4– 14 (boys)
      • Adolescent
        • puberty to maturity
      • Adult
        • after maturity
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
      • True cause still unknown
        • Genetics (no isolated gene)
        • growth hormone secretion
        • connective tissue structure
        • vestibular dysfunction
        • melatonin secretion
        • platelet microstructure
        • 100% patients have proprioception mechanism defects (1)
      Etiology of Scoliosis 1 Ahn et al, New Hampshire Spine Institute. The etiology of adolescent idiopathic scoliosis. Am J Orthop 2002 Jul;31 (7):387-95 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Etiology of Scoliosis (Continued)
        • **27% of cases show brain stem asymmetries
        • **Changes in muscle appear to be secondary to the CNS disorder, NOT the CAUSE
        • Birth Trauma / Complications
          • Yes (71) 30%
          • No (165) 70%
            • Survey results from www.scoliosis-world.com
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Incidence of Scoliosis
      • Develops between ages 8 to 15
      • (growth spurt)
      • 7 times more prevalent in females
      • 80% of scoliosis origin unknown (1)
      1 Ahn et al, New Hampshire Spine Institute. The etiology of adolescent idiopathic scoliosis. Am J Orthop 2002 Jul;31 (7):387-95 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Physiological Effects of Scoliosis
      • Mid-back pain, lower back pain, neck pain, headaches, TMJ syndromes, premature disc and joint degeneration
      • Decreased pulmonary function
        • Breathing Exercise & FHP
      • Dramatic body image concerns
      • Coach Potato Syndrome
        • Decreased ability and willingness to participate in physical activities
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Your Child Has Scoliosis What Do You Do?
      • Options
        • Watch & Wait
        • Brace
        • Herrington Rod Surgery
        • Chiropractic Care & Neuromusculoskeletal Rehabilitation
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Bracing
      • 44% of bracing attempts are
      • considered failures
        • do not stop the progression
      • Less than 30 ° , there were no significant differences between braced and non-braced patients
        • Typically brace is prescribed when scoliosis is <20 °
      • 60% felt bracing handicapped their lives
      • 14% considered bracing left a psychological scar
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • SURGERY
      • Herrington rod surgery
        • Average pre operative
        • curve = 72 °
        • Average post operative
        • curve = 44 °
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Posterior Spinal Fusion and Instrumentation Scoliosis surgery Harrington Rods Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Are They Cured?
      • Unfortunately, most patients return for 2 nd , 3 rd , and 4 th surgeries
      • Rod maintenance
      • Side effects
        • Inflexibility
        • LBP
        • Headache
      • “ 40% of operated treated patients with idiopathic scoliosis were legally defined as severely handicapped persons” (4)
      4 Gotze C, Slomka A, Gotze HG, Potzl W, Liljenqvist U, Steinbeck J. Long-term results of quality of life in patients with idiopathic scoliosis after Harrington instrmentation and their relevance for expert evidence. Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8
    • How Do We Find Scoliosis?
      • Orthopedic Screening Tests
      • Posture
      • Rib hump
      • X-ray confirmation
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Preliminary Results of the Scoliosis Reduction and Rehabilitation Protocol: A Pilot Study   Mark W Morningstar, DC, Dennis Woggon, DC, Gary Lawrence, DC, November 2004   Results: After 4-6 weeks of treatment, the entire sample size (22 ) averaged a 62% reduction in their Cobb angle measurements. Conclusion: The Scoliosis Reduction and Rehabilitation Protocol appeared to markedly reduce the severity of the Cobb angle in all 19 subjects. http://www.biomedcentral.com/1471-2474/5/32 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Average Reduction: 28 to 11 degrees 8/19 No Scoliosis Average Reduction: 62% in 4-6 Weeks 8/19 No Scoliosis Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/ Cobb Angle Measurements After 4-6 Weeks (Degrees)                       Subject #   Initial Post %   Subject #   Initial Post % 1   32 24 25   11   40 22 45 2   23 8 65   12   31 9 71 3   29 11 62   13   27 14 48 4   52 19 63   14   33 7 79 5   19 4 79   15   32 18 44 6   28 11 61   16   16 4 75 7   16 2 88   17   15 4 73 8   25 11 56   18   21 6 71 9   35 20 43   19   38 11 71 10   28 13 54                                  
    • Treatment (Mix, Fix, Set)
      • Scoliosis Chiropractic Care
        • Warm-up (Mix)
        • Adjustment (Fix)
        • Rehabilitation (Set)
      • Maybe a little chocolate therapy
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
      • Wobble chair
      • Cervical Traction
      • Core Stimulation (ligaments) & Muscle Stimulation
      Warm up (MIX) Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Eckard Table Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Adjustments (FIX)
      • #1 PRIORITY: Restore cervical lordosis
      • Adjust Anterior & Posterior Hip
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Rehabilitation (SET)
      • Proprioceptive neuromuscular re-education & rehabilitation
      • Head weights
      • Hip weights
      • Tight rope
      • exercise
      Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Traction and derotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • The Crankshaft Phenomenon: Is Cobb angle progression a good indicator in AIS? Delorme, Labelle, Aubin Research Center, Sainte-Justin Hospital Montreal Quebec, Canada No! The History channel had a program about ancient Egypt where they would take a 1/8&quot; strand of a gold strip and then twist it. The best necklaces were a perfect &quot;coiled&quot; position, but at a certain point, the necklaces would twist on themselves and deform and fold into themselves.  Once they hit that &quot;Euler Buckled&quot; position, the necklace was garbage. This is the &quot;Crankshaft Phenomenon.”
    • The Crankshaft Phenomenon Compression and Rotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • The Crankshaft Phenomenon can be “un-done” through traction and de-rotation. Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Jamie October 30-31, December 27-29, 2006 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • DeJeanne March 24 – March 29, 2006 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, www.treatingscoliosis.com
    • Sharon – 55 y/o female 1/19/05 2/28/05 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
    • Marvin – 82 Years Young Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
      • Websites on scoliosis
        • www.clear-institute.org /freeinfo
        • www.fixscoliosis.com
        • www.scoliosis-world.com
      Resources for parents and kids Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/