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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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  • 1. 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/
  • 2. 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/
  • 3. 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)
  • 4. 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/
  • 5. Cobb Angle Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 6. 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/
  • 7.
    • 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/
  • 8. 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/
  • 9. 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/
  • 10. 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/
  • 11. 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/
  • 12. 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/
  • 13. 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/
  • 14. Posterior Spinal Fusion and Instrumentation Scoliosis surgery Harrington Rods Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 15. Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 16. 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
  • 17. 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/
  • 18. 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/
  • 19. 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                                  
  • 20. 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/
  • 21.
    • 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/
  • 22. Eckard Table Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 23. 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/
  • 24. 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/
  • 25. Traction and derotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 26. 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.”
  • 27. The Crankshaft Phenomenon Compression and Rotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 28. 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/
  • 29. Jamie October 30-31, December 27-29, 2006 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 30. DeJeanne March 24 – March 29, 2006 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, www.treatingscoliosis.com
  • 31. 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/
  • 32. Marvin – 82 Years Young Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  • 33.
    • 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/