New Long-Term Studies on Scoliosis
From a scientific study entitled, "Nonoperative treatment for adolescent idiopathic scoliosis: a 10- to 60-year follow-up with special reference to health-related quality of life," published in SPINE, Feb 2006, we offer you a glimpse of "traditional" non-surgical methods of scoliosis correction, such as bracing, physical therapy, and electrical muscle stimulation. An average of 23 years after treatment with one or more of these modalities, follow-up with 81 patients led to the following conclusions:
"No significant differences in pain, disability, or HRQOL [health-related quality of life] were found between patients with and without brace treatment."
"...curve size was found to be a significant predictor for pain in a long-term follow-up. "
18 patients experienced substantial increases in their Cobb angle (11, an average of 19.0 degrees; 7 patients, an average of 16.3 degrees) while only 2 experienced reduction (-11.5 degrees on average).
Another interesting study, "Outcome at 10 years after treatment for adolescent idiopathic scoliosis," was published in the same volume of SPINE. The comments of its authors were significant:
"In adolescent idiopathic scoliosis (AIS), the options are BT [brace treatment] or ST [surgical treatment] and, together with the disease itself, they may both be physically and psychologically demanding."
"We... found no significant difference between BT and ST patients in the present study for any of the SF-36 variables. Compared with age-matched controls, the SF-36 scores were lower in the AIS patients. Brace related questions revealed a significant impact of the disease and the treatment on the patients' lives." [The SF-36 is a health survery designed to quantify the effect of the disease on a patient's quality of life.]
The above statement is basically concluding that scoliosis patients, whether treated with bracing or surgery, still experienced decreased quality of life. Combined with the statement from the earlier study ("...curve size was found to be a significant predictor for pain in a long-term follow-up"), this should indicate that bracing & surgery are largely ineffective at reducing curve size, and thus pain, in the long-term.
Another study looks at the long-term effects of reversal of the Harrington Rods implantation procedure; that is, what happens after the rods are removed:
"Spinal instrumentation is occasionally removed for various reasons, most commonly for postoperative pain or infection, in surgically corrected AIS. The fate of instrumentation removal in adults has been previously reported with documented loss of sagittal alignment. However, to our knowledge, the long-term follow-up after instrumentation removal in AIS has not been reported."
"There were 21 patients... at an average age of 14.8 years. Instrumentation removal occurred at an average of 2.4 years after surgery... with an average follow-up of 5.2 years. Fifteen patients underwent removal secondary to pain (2 of these with undetected infection) and 6 for known infection."
"There was an immediate loss of approximately 4 degrees in the main thoracic curve and 6 degrees in the [lumbar] curve after removal, with continued settling of an additional 6 degrees in the main thoracic curve, and 3 degrees in the [lumbar] curve."
"Instrumentation removal in AIS is not always a benign process because the long-term follow-up of this cohort of patients shows a "settling" effect in the coronal plane of the main thoracic and [lumbar] curves after instrumentation removal."
The conclusions of the above study should be pertinent and frightening to those considering surgical treatment for their scoliosis. Infection, hardware failure, & corrosion occur in the majority of patients with Harrington rods; average loss of correction is 1.0 degree each year. New recommendations are being made that the rods should be removed 4 years after implantation to prevent cases of chronic infection, corrosion, or hardware failure, requiring a surgical procedure twice as long as the initial implantation procedure.
Informational brochures are available for free from CLEAR Institute to help people living with scoliosis understand their options in treatment, and expose them to the research on bracing & surgery which may paint a different picture than what they might have been led to believe. For a free copy, please e-mail care@clear-institute.com, and include "Scoliosis Brochure" in the subject heading!
Welcome, New Doctors!
The Scoliosis Correction Seminar in Denver, Colorado, was completed last weekend, and introduced over 20 new doctors to the life-changing mission of chiropractic scoliosis correction. Their full contact information & business address can be found on www.clear-institute.com.
Dr. Michael Cadwallader - Highlands Ranch, Colorado
Dr. Lynn Bunin - Boulder, Colorado
Dr. Lewis Holm - Littleton, Colorado
Dr. Kurt Perkins - Colorado Springs, Colorado
Dr. Ronald G. Salvaggione - Colorado Springs, Colorado
Dr. Jeffrey Henry - Colorado Springs, Colorado
Dr. Chung Joon Seo - Aurora, Colorado
Dr. Tim Cummins - Aurora, Colorado
Dr. Joseph Singh - Aurora, Colorado
Dr. Jeffrey Shaw - Granby, Colorado
Dr. Joseph Arvay - Northglenn, Colorado
Dr. Paul Price - Littleton, Colorado
Dr. Michael Farrell - Ft. Collins, Colorado
Dr. Aaron Miller - Parker, Colorado
Dr. Brian Webb - Parker, Colorado
Dr. Wendy Mehaffey - Lakewood, Colorado
Dr. Paul Austin - Louisville, Colorado
Dr. Kelvie Culpepper - Poplarville, Mississippi
Dr. Catherine K. Carson - Fairfax, Virginia
Dr. Robert Luckey - Victor, New York
Dr. Bill Ferris - Victor, New York