The History of Spinal Surgery
The first treatise on the treatment of spinal injuries dates back to around 1550 B.C., in the Egyptian writings known as the Edwin Smith papyrus. Hippocrates (460-370 BC), considered the Father of Medicine, is also considered to be the father of spinal surgery, having stated: "Look well to the spine for the cause of disease." His recommended method of treatment consisted primarily of traction and immobilization; similar treatments appear in ancient Arabic and Chinese literature as well. Early physicians avoided direct surgical intervention, which resulted in complications such as blood clotting, destruction of the muscle tissue, and paralysis. While medical knowledge continued to expand under physicians such as Galen of Pergamon (129-200 AD), who also coined the word, 'scoliosis,' Paulus of Aegineta (625-690 AD), Avicenna (980-1037 AD), Serefeddin Sabuncuoglu (15 c.), and Sir Percival Pott (17 c.), surgery on the spine did not become common practice until the early 1900's.
In 1953, Dr. Paul Harrington of Houston, Texas, began to develop what is now known as the Harrington instrumentation system. While initial results were promising, long-term follow up demonstrated poor results, and hardware failure was basically inevitable. The Harrington rods are essentially straight & rigid, which disrupts the normal curves in the spine. This led to dislodging of the hooks used to secure the rod.
A similar rod system was developed in 1976 by Dr. Eduardo Luque of Mexico City. These contoured rods attempted to avoid the high incidence of hardware failure through multiple points of fixation; however, this led to a higher rate of neurological complications. Dysesthesia - loss of the sense of touch - was seen in 1 out of every 10 patients.
Pedicle screw fixation, originally developed in 1949, has become a popular alternative to hooks and wires. Unfortunately, there is a very high risk of damage to the nerves and blood vessels, especially if the placement of the screws is inaccurate or unstable. Conventional placement of pedicle screws results in an accuracy rate of 45 to 85%.
New methods of surgical scoliosis correction are in high demand as research continues to document the poor long-term effects of rod instrumentation. Approaches such as spinal stapling, endoscopic instrumentation, and wedge osteotomies attempt to maintain spinal mobility while being as minimially-invasive as possible, but these procedures may not be ideal for every scoliosis patient.
No surgical procedure has ever demonstrated a 100% correction in every patient. Despite the best efforts of the medical community, surgery remains a last resort for people living with scoliosis. What is the reason for this? One might consider the lack of consideration for the position of the head & neck, both important functional components of the spine. Another reason could be the disregard for and damage done to the associated soft tissues - muscles, tendons, & ligaments - that are important in maintaining spinal integrity.
Although medicine continues to search for a "quick-fix" and an easy answer, the truth is scoliosis cannot be permanently corrected through external forces. Only through a thorough understanding of the biology & physics responsible for the deformation can the process be arrested and reversed. True scoliosis correction requires a comprehensive & holistic rehabilitation of the spine and all associated soft tissue components... and this requires a lot of hard work!
The Role of Neurohormones in Scoliosis
While we believe the primary causatory agent in scoliosis to be physical in nature (as the curves go out of the spine in one dimension, the body re-asserts them in antother), there is no denying that there are also biological components which may promote the development of scoliosis.
For example, in one study conducted at the Department of Orthopedic Surgery of the Nihon University School of Medicine in Tokyo, thirty chickens underwent removal of their pineal gland, which is responsible for modulating several important hormones, including growth hormones, through production of melatonin. All 30 chickens developed a scoliosis within 2 weeks, and showed gradual progression over the next 5 to 6 weeks. This study suggests that a disruption in melatonin levels in humans could serve as a contributing factor in the development and progression of scoliotic curves. But what could cause this disruption?
The pineal gland is innervated (supplied with nerves) from the Superior Cervical Ganglia, or SCG. The SCG is located in the vicinity of the second and third cervical vertebrae. As the curve in the neck is lost, the resulting impingement upon these spinal nerves may essentially disrupt the brain's control over the pineal gland, reducing or eliminating the supply of melatonin & its associated hormones.
An interesting parallel to this is the fact that 100% of people living with scoliosis have impairment of their respiratory function. While some of this is undoubtedly due to the compression of the lungs through the associated rib rotation, it is worth noting that the phrenic nerve, which innervates the diaphragm, also branches off in the location of the cervical vertebra. When this area of the neck is adjusted through specific chiropractic adjustments, an immediate and dramatic improvement in lung capacity is often noticed, sometimes within five minutes of the adjustment!
2007 Scoliosis Seminar Schedule Update
The dates of the Scoliosis Correction Seminar that will be held in Denver, Colorado, have been finalized! They are listed online under the "Seminars" link on www.clear-institute.com, and are also displayed below. Please tell your friends & colleagues about this opportunity to learn more about how chiropractic can help correct scoliosis in patients of all ages!
Scoliosis Correction Seminar
Denver, Colorado
Part I - March 10th & 11th - Sat: 9am - 6pm, Sun: 8am - noon
Part II - March 24th & 25th - Sat: 9am - 6pm, Sun: 8am - noon
Part III (workshop) - April 28th - Sat only: 8am - 6pm
To register, please go online to www.clear-institute.com, click on the "Seminar" link, and download the registration form. If you have any questions, or would like more information about the seminar, please contact us at care@clear-institute.com.
Scoliosis & Osteoporosis
The correlation between scoliosis & osteoporosis has always been evident, but a recent study done by the Department of Orthopedics & Traumatology at the University of Hong Long illustrates just how important it is to address this factor in scoliosis treatment. The bone density of 919 young women with moderate (Cobb angle of 10-39 degrees) to severe (40 or higher) scoliosis was compared with 300 girls without scoliosis; it was found that, "the proportion of osteopenic AIS [adolescent idiopathic scoliosis] girls in the severe group was significantly higher than that in the moderate group." The authors went on to conclude that, "prevention of osteopenia could be as important as controlling spinal progression in the management of AIS."
CLEAR Institute uses Whole-Body Vibration as part of its treatment protocols. In a scientific study conducted by Clinton Rubin at the New York University in Stonybrook, a frequency of exactly 30 Hertz (1800 rpm's) was shown to increase bone density in animals by an average of 33% in one year. The WBV platform recommended by CLEAR Institute is fixed at this frequency to ensure consistent, reliable results.
Thank you for reading! As always, please feel free to respond to care@clear-institute.com with your comments & questions. Until next month... be well, be happy, be healthy!
"It is always safe to assume, not that the old way is wrong, but that there may be a better way."
-Henry R. Harrower,
endocrinologist
