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Scoliosis

Adolescent Idiopathic Scoliosis Treated by Spinal Manipulation: A Case Study

By |June 22, 2013|Chiropractic Care, Scoliosis|

Adolescent Idiopathic Scoliosis Treated by Spinal Manipulation: A Case Study

The Chiro.Org Blog


SOURCE:   J Altern Complement Med. 2008 (Jul); 14 (6): 749–751


Kao-Chang Chen, Elley H.H. Chiu

Division of Acupuncture and Chinese Traumatology, Department of TCM, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.


OBJECTIVE:   This report of one case illustrates the potential effect of chiropractic manipulative therapy on back pain and curve progression in the at-risk, skeletally immature patient with adolescent idiopathic scoliosis.

CLINICAL FEATURES:   A 15-year-old girl experienced right thoracic scoliosis for 4 years. She received regular (medical) rehabilitation and brace treatment for 4 years, but the curvature of the thoracic spine still progressed. The Cobb angle was 46 degrees and surgical intervention was suggested to prevent significant deformity, which may be accompanied by cardiopulmonary compromise.

INTERVENTION AND OUTCOME:   This patient was treated with spinal manipulation two times per week for 6 weeks at the outset, which was gradually decreased in frequency. After 18 months of consecutive treatment, follow-up radiographs and examinations were conducted. The Cobb angle decreased by 16 degrees. Meanwhile, the patient’s lower backache eased and there was also an improvement in defecation frequency, which had been problematic.

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Clinical Biomechanics: Scoliosis

By |May 8, 2013|Chiropractic Care, Chiropractic Education, Rehabilitation, Scoliosis|

Clinical Biomechanics: Scoliosis

The Chiro.Org Blog


We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 13 from RC’s best-selling book:

“Clinical Biomechanics:
Musculoskeletal Actions and Reactions”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.


Chapter 13: Scoliosis

In traditional medicine, scoliosis is commonly ignored until gross cosmetic effects or signs of structural destruction are witnessed. In chiropractic, however, even minor degrees of distortion should be considered at the time of spinal analysis because of their subtle biomechanical and neurologic consequences, and to halt potential progression at an early stage. To give a better appreciation of these points, this chapter describes the general structural, examination, and biomechanical concerns that should be considered, along with the highlights of conservative therapy.


GENERAL CONSIDERATIONS


The Spinal Curves   [1-9]

A curved column has increased resistance to compression forces. This is just as true in the spine, as for a rib or long bone. Most authorities consider the spine to have four major curves: anteriorly convex curves at the cervical and lumbar areas and, anteriorly concave curves at the thoracic and sacral levels. Cailliet considers the coccyx a curve, but this curve is usually considered an extension of the sacral curve. A few authorities consider the atlanto-occipital junction as a separate anteriorly convex curve. Regardless, the spinal curves offer the vertebral column increased inflexibility and shock-absorbing capability while still maintaining an adequate degree of stiffness and stability between vertebral segments (Fig. 13.1).

Structural vs Functional Curves

The adult thoracic and sacral anteriorly concave curves are firm structural arcs as the result of their vertebral bodies being shorter anteriorly than posteriorly. The normal kyphosis of the adult thoracic and sacral curves is quite similar to that of the fetal spine. This is not true for the anteriorly convex cervical and lumbar regions where the curves are essentially the result of their soft tissue wedge-shaped IVDs. It is for this reason that the cervical and lumbar curves readily flatten in the supine position, while the thoracic kyphosis reduces only a slight amount.

There is a clinical correlation of disc wedging to disc disease. Most disc lesions are found in the cervical and lumbar regions where the greatest degree of physiologic wedging occurs. This appears to be true in both hyperlordosis and an exceptionally flat cervical or lumbar curve.

Effect of Bipedism

An adult discless spine would resemble that of the newborn. Since animals that walk on four legs and infants prior to assuming the erect position do not have the physiologic curves of the erect adult, it can be assumed that these curves are the result of bipedism. In the erect position, the lower lumbar area is especially subjected to considerable shearing stress. [10, 11]

Overall Balance

Although the spine is often considered as the central pillar of the body, this is only true when the spine is viewed from the anterior or posterior aspect. When viewed laterally, the spine lies distinctly posterior to the thoracic body mass essentially because of the space-occupying heart (Fig. 13.2), It lies much more centrally in the cervical and lumbar regions. An abundance of body mass also lies anterior to the midline in the head, which must be held by erector and check ligament strength if a thoracic “hump” or a flattened cervical curve are to be avoided.

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Outcomes For Adult Scoliosis Patients Receiving Chiropractic Rehabilitation: A 24-month Retrospective Analysis

By |September 5, 2011|Rehabilitation, Scoliosis, Spinal Manipulation|

Outcomes For Adult Scoliosis Patients Receiving Chiropractic Rehabilitation: A 24-month Retrospective Analysis

The Chiro.Org Blog


SOURCE:   J Chiropractic Medicine 2011 (Sep); 10 (3): 179–184


By Mark Morningstar DC, FACSP, FRCCM, FAAIM


Objectives:   The purpose of this study was to retrospectively report the results of patients who completed an exercise-based chiropractic program and its potential to alter the natural progression of adult scoliosis at 24 months after the clinic portion of treatment was concluded.

Methods:   A retrospective chart review was conducted at 2 spine clinics in Michigan, USA. Each clinic uses the same chiropractic rehabilitation program to treat patients with adult scoliosis. Multidimensional patient outcomes included radiographic, respiratory, disability, and pain parameters. Outcomes were measured at baseline, at end of active treatment, and at long-term follow-up.

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