Most people are relatively shocked to learn that the first scoliosis surgery was performed in 1865 (the year the civil war ended) and to no one’s surprise, it produced a rather poor outcome and soon after, resulted in one of the world’s first medical malpractice lawsuits.
Thankfully, scoliosis fusion surgery has come a long way since then, producing much higher levels of correction and a much lower risk of complications and infection at the time of the procedure. Unfortunately, much of the long-term published research on surgical correction for scoliosis reveals a rather poor and undesirably high rate of chronic pain.
Hardware failure complications in the 15-20 years following the spinal fusion procedure were high. Needless to say, these types of statistics have spurred a renewed search for “a better way” to treat scoliosis without surgical intervention.
The concept of using exercises to treat scoliosis is certainly not a new one and dates back to the time of the ancient Greek and Chinese civilizations, but they have produced very little in the way of consistent or measurable results. Most scoliosis exercise-based treatment programs, even today, consist of mostly stretching/traction, core strengthening, and some voluntary movement pattern based re-training, but again generally produce “hit and miss” type results for most scoliosis patients.
Recently, an effort to re-invent exercises for scoliosis has gained some real momentum. In large part, it’s due to a better understanding of scoliosis bio-mechanics, the neuro-hormonal origins of idiopathic scoliosis, and the multi-factorial nature of the condition itself.
The spinal bio-mechanics of scoliosis are unique to the condition itself, as well as each patient’s individual curve pattern. The most critical aspect of the scoliosis spine’s bio-mechanics lies in the un-coupled rotation pattern the seems to generate a “feed-forward” mechanism that causes the mid and lumbar spines to twist against themselves, much like a rubber band that has been twisted a few times too many. The results are a very complex bio-mechanically loaded curvature that becomes increasingly rigid as the rotation and size of the curvature increase.
One of the hallmarks of idiopathic scoliosis is the rapid progression seen in teenage females as they enter their first major adolescent growth spurt. A mild/minor scoliosis curvature can progress extremely rapidly in a matter of weeks to months without pain and often without anyone even noticing.
The extreme rapidness of the curve progression during a growth spurt highly suggests a neuro-hormonal trigger, which if discovered, may hold the key to preventing curve progression prior to the growth spurt. Currently, most efforts are focusing on melatonin signaling dysfunction, and a blood test may soon provide additional evidence.
As with most conditions, genetic predisposition is generally a pre-requisite to the development of any condition and idiopathic scoliosis appears to be no exception. The “Scoliscore” genetic test (now widely available), allows patients with mild scoliosis to test their genetic pre-disposition and determine their risk of developing a severe curvature of the spine.
Of course, the “multi” portion of any multi-factorial condition are the environmental factors that actually trigger the genetic predisposition to be expressed as the given condition (idiopathic scoliosis) in this case. Unfortunately, scoliosis research has barely scratched the surface in the investigation of the environmental factors, which most likely cause curve progression in adolescent females during periods of rapid growth.
There is a reason for cautious optimism in the hope that a scoliosis exercises based treatment methodology can one day alter the natural course of idiopathic scoliosis on a consistent basis one day in the near future.