Scoliosis  101  CLEAR  Institute www.CLEAR-Institute.com Dr. Clayton J. Stitzel [email_address] Dr. Clayton Stitzel, 1-866...
Spinal Biomechanics <ul><li>Ideal curves of the spine </li></ul><ul><ul><li>Primary and secondary curves </li></ul></ul><u...
What’s so Special About Scoliosis? <ul><li>Said to effect 4.5% of population.  It is probably closer to 10% </li></ul><ul>...
What is Scoliosis? <ul><li>Abnormal curvature of the spine greater than 10˚ in the sideways or coronal plane (Cobb angle) ...
Cobb Angle Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
Types of Scoliosis <ul><li>Infantile  </li></ul><ul><ul><li>before the age of 3 </li></ul></ul><ul><li>Juvenile  </li></ul...
<ul><li>True cause still unknown </li></ul><ul><ul><li>Genetics (no isolated gene) </li></ul></ul><ul><ul><li>growth hormo...
Etiology of Scoliosis (Continued) <ul><ul><li>**27% of cases show brain stem asymmetries  </li></ul></ul><ul><ul><li>**Cha...
Incidence of Scoliosis <ul><li>Develops between ages 8 to 15  </li></ul><ul><li>(growth spurt) </li></ul><ul><li>7 times m...
Physiological Effects of Scoliosis <ul><li>Mid-back pain, lower back pain, neck pain, headaches, TMJ syndromes, premature ...
Your Child Has Scoliosis  What Do You Do?   <ul><li>Options </li></ul><ul><ul><li>Watch & Wait </li></ul></ul><ul><ul><li>...
Bracing <ul><li>44% of bracing attempts are  </li></ul><ul><li>considered failures  </li></ul><ul><ul><li>do not stop the ...
SURGERY  <ul><li>Herrington rod surgery </li></ul><ul><ul><li>Average pre operative  </li></ul></ul><ul><ul><li>curve = 72...
Posterior Spinal Fusion and Instrumentation Scoliosis surgery Harrington Rods Dr. Clayton Stitzel, 1-866-627-3009, drstitz...
Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
Are They Cured? <ul><li>Unfortunately, most patients return for 2 nd , 3 rd , and 4 th  surgeries </li></ul><ul><li>Rod ma...
How Do We Find Scoliosis? <ul><li>Orthopedic Screening Tests </li></ul><ul><li>Posture </li></ul><ul><li>Rib hump </li></u...
Preliminary Results of the Scoliosis Reduction and Rehabilitation Protocol: A Pilot Study   Mark W Morningstar, DC, Dennis...
Average Reduction:  28 to 11 degrees 8/19 No Scoliosis Average Reduction:  62% in 4-6 Weeks 8/19 No Scoliosis Dr. Clayton ...
Treatment (Mix, Fix, Set) <ul><li>Scoliosis Chiropractic Care </li></ul><ul><ul><li>Warm-up (Mix) </li></ul></ul><ul><ul><...
<ul><li>Wobble chair </li></ul><ul><li>Cervical Traction </li></ul><ul><li>Core Stimulation (ligaments) & Muscle Stimulati...
Eckard Table Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
Adjustments (FIX) <ul><li>#1 PRIORITY: Restore cervical lordosis </li></ul><ul><li>Adjust Anterior & Posterior Hip </li></...
Rehabilitation (SET)  <ul><li>Proprioceptive neuromuscular re-education  & rehabilitation </li></ul><ul><li>Head weights <...
Traction and derotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis....
The Crankshaft Phenomenon:  Is Cobb angle progression a good indicator in AIS?  Delorme, Labelle, Aubin  Research Center, ...
The Crankshaft Phenomenon   Compression and Rotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, ...
The Crankshaft Phenomenon can be “un-done” through traction and de-rotation. Dr. Clayton Stitzel, 1-866-627-3009, drstitze...
Jamie October 30-31,  December 27-29, 2006 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www....
DeJeanne  March 24 – March 29, 2006   Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, www.treatingscol...
Sharon – 55 y/o female  1/19/05  2/28/05 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.tr...
Marvin – 82 Years Young   Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis...
<ul><li>Websites on scoliosis </li></ul><ul><ul><li>www.clear-institute.org /freeinfo </li></ul></ul><ul><ul><li>www.fixsc...
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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
rehabilitation based treatment. For more information visit http://www.treatingscoliosis.com or call

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Scoliosis 101

  1. 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. 2. Spinal Biomechanics <ul><li>Ideal curves of the spine </li></ul><ul><ul><li>Primary and secondary curves </li></ul></ul><ul><ul><li>Function of curves </li></ul></ul><ul><ul><ul><li>Strength </li></ul></ul></ul><ul><ul><ul><li>Flexibility </li></ul></ul></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  3. 3. What’s so Special About Scoliosis? <ul><li>Said to effect 4.5% of population. It is probably closer to 10% </li></ul><ul><li>Mortality rate of 15%. (1) </li></ul><ul><li>Decreases life expectancy by 14 years. (1) </li></ul><ul><li>A study in 1988 revealed that 12% of college age women had Scoliosis. (2) </li></ul>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. 4. What is Scoliosis? <ul><li>Abnormal curvature of the spine greater than 10˚ in the sideways or coronal plane (Cobb angle) </li></ul><ul><li>Spine looks more like an “S” or “C” than a straight line </li></ul><ul><li>Many cases have rotational component </li></ul><ul><ul><li>Shoulders and/or waist appear uneven (3) </li></ul></ul>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. 5. Cobb Angle Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  6. 6. Types of Scoliosis <ul><li>Infantile </li></ul><ul><ul><li>before the age of 3 </li></ul></ul><ul><li>Juvenile </li></ul><ul><ul><li>prepuberty: </li></ul></ul><ul><ul><ul><li>4 – 12 (girls) </li></ul></ul></ul><ul><ul><ul><li>4– 14 (boys) </li></ul></ul></ul><ul><li>Adolescent </li></ul><ul><ul><li>puberty to maturity </li></ul></ul><ul><li>Adult </li></ul><ul><ul><li>after maturity </li></ul></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  7. 7. <ul><li>True cause still unknown </li></ul><ul><ul><li>Genetics (no isolated gene) </li></ul></ul><ul><ul><li>growth hormone secretion </li></ul></ul><ul><ul><li>connective tissue structure </li></ul></ul><ul><ul><li>vestibular dysfunction </li></ul></ul><ul><ul><li>melatonin secretion </li></ul></ul><ul><ul><li>platelet microstructure </li></ul></ul><ul><ul><li>100% patients have proprioception mechanism defects (1) </li></ul></ul>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. 8. Etiology of Scoliosis (Continued) <ul><ul><li>**27% of cases show brain stem asymmetries </li></ul></ul><ul><ul><li>**Changes in muscle appear to be secondary to the CNS disorder, NOT the CAUSE </li></ul></ul><ul><ul><li>Birth Trauma / Complications </li></ul></ul><ul><ul><ul><li>Yes (71) 30% </li></ul></ul></ul><ul><ul><ul><li>No (165) 70% </li></ul></ul></ul><ul><ul><ul><ul><li>Survey results from www.scoliosis-world.com </li></ul></ul></ul></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  9. 9. Incidence of Scoliosis <ul><li>Develops between ages 8 to 15 </li></ul><ul><li>(growth spurt) </li></ul><ul><li>7 times more prevalent in females </li></ul><ul><li>80% of scoliosis origin unknown (1) </li></ul>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. 10. Physiological Effects of Scoliosis <ul><li>Mid-back pain, lower back pain, neck pain, headaches, TMJ syndromes, premature disc and joint degeneration </li></ul><ul><li>Decreased pulmonary function </li></ul><ul><ul><li>Breathing Exercise & FHP </li></ul></ul><ul><li>Dramatic body image concerns </li></ul><ul><li>Coach Potato Syndrome </li></ul><ul><ul><li>Decreased ability and willingness to participate in physical activities </li></ul></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  11. 11. Your Child Has Scoliosis What Do You Do? <ul><li>Options </li></ul><ul><ul><li>Watch & Wait </li></ul></ul><ul><ul><li>Brace </li></ul></ul><ul><ul><li>Herrington Rod Surgery </li></ul></ul><ul><ul><li>Chiropractic Care & Neuromusculoskeletal Rehabilitation </li></ul></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  12. 12. Bracing <ul><li>44% of bracing attempts are </li></ul><ul><li>considered failures </li></ul><ul><ul><li>do not stop the progression </li></ul></ul><ul><li>Less than 30 ° , there were no significant differences between braced and non-braced patients </li></ul><ul><ul><li>Typically brace is prescribed when scoliosis is <20 ° </li></ul></ul><ul><li>60% felt bracing handicapped their lives </li></ul><ul><li>14% considered bracing left a psychological scar </li></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  13. 13. SURGERY <ul><li>Herrington rod surgery </li></ul><ul><ul><li>Average pre operative </li></ul></ul><ul><ul><li>curve = 72 ° </li></ul></ul><ul><ul><li>Average post operative </li></ul></ul><ul><ul><li>curve = 44 ° </li></ul></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  14. 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. 15. Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  16. 16. Are They Cured? <ul><li>Unfortunately, most patients return for 2 nd , 3 rd , and 4 th surgeries </li></ul><ul><li>Rod maintenance </li></ul><ul><li>Side effects </li></ul><ul><ul><li>Inflexibility </li></ul></ul><ul><ul><li>LBP </li></ul></ul><ul><ul><li>Headache </li></ul></ul><ul><li>“ 40% of operated treated patients with idiopathic scoliosis were legally defined as severely handicapped persons” (4) </li></ul>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. 17. How Do We Find Scoliosis? <ul><li>Orthopedic Screening Tests </li></ul><ul><li>Posture </li></ul><ul><li>Rib hump </li></ul><ul><li>X-ray confirmation </li></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  18. 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. 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. 20. Treatment (Mix, Fix, Set) <ul><li>Scoliosis Chiropractic Care </li></ul><ul><ul><li>Warm-up (Mix) </li></ul></ul><ul><ul><li>Adjustment (Fix) </li></ul></ul><ul><ul><li>Rehabilitation (Set) </li></ul></ul><ul><li>Maybe a little chocolate therapy </li></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  21. 21. <ul><li>Wobble chair </li></ul><ul><li>Cervical Traction </li></ul><ul><li>Core Stimulation (ligaments) & Muscle Stimulation </li></ul> Warm up (MIX) Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  22. 22. Eckard Table Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  23. 23. Adjustments (FIX) <ul><li>#1 PRIORITY: Restore cervical lordosis </li></ul><ul><li>Adjust Anterior & Posterior Hip </li></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  24. 24. Rehabilitation (SET) <ul><li>Proprioceptive neuromuscular re-education & rehabilitation </li></ul><ul><li>Head weights </li></ul><ul><li>Hip weights </li></ul><ul><li>Tight rope </li></ul><ul><li>exercise </li></ul>Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  25. 25. Traction and derotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  26. 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. 27. The Crankshaft Phenomenon Compression and Rotation! Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  28. 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. 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. 30. DeJeanne March 24 – March 29, 2006 Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, www.treatingscoliosis.com
  31. 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. 32. Marvin – 82 Years Young Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
  33. 33. <ul><li>Websites on scoliosis </li></ul><ul><ul><li>www.clear-institute.org /freeinfo </li></ul></ul><ul><ul><li>www.fixscoliosis.com </li></ul></ul><ul><ul><li>www.scoliosis-world.com </li></ul></ul>Resources for parents and kids Dr. Clayton Stitzel, 1-866-627-3009, drstitzel@clear-institute.org, http://www.treatingscoliosis.com/
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