Whether you’re taking your child to see a GP or an orthopaedic specialist, you’re going to have a lot of questions about scoliosis and the available treatment options. In this blog post, we’ll talk you through a range of scoliosis questions that you may wish to ask your doctor.

Speaking to a doctor

If you’ve just been diagnosed with scoliosis, there are a number of questions you can ask your doctor to help you gauge whether they’re offering you the right treatment plan. It’s important to ascertain their knowledge and experience with this condition before you go any further. Not every GP will have an extensive understanding of scoliosis, particularly if they’ve never dealt with a spinal curve like yours before. If that’s the case, the GP might not be able to offer you the responses to your questions that a scoliosis specialist could.  

Questions to Ask Your GP

Always be respectful towards your doctor, even if you decide not to pursue treatment with them. Try not to get upset or angry if you don’t agree with their assessment of your condition.
  • Have you ever come across a scoliosis case like mine before?
Every case of scoliosis is different, so it’s possible that your GP hasn’t treated a case of scoliosis like yours before. Doctors who’ve been working with scoliosis for many years may have patient testimonials and evidence to show that the treatment approach they’re suggesting works for cases like yours.
  • Will the treatment you’re suggesting help me achieve the results I want?
Each scoliosis patient has different expectations. Some people are most concerned with their appearance while others want to improve their mobility or flexibility. The treatment option that will help you achieve your desired results might not be the one that your doctor is prescribing. For example, a scoliosis brace can help to prevent your scoliosis curvature from getting worse, but if your main concern is your appearance, you might not want to wear a scoliosis brace all the time.
  • What can I do to improve my chances of success?
With more active approaches to treatment, you might be able to improve your results by following a particular regime or plan accurately, or by doing extra activities at home to improve the effectiveness of your treatment. That’s certainly the case with our exercise-based therapy programme, which should be continued at home once you’ve left the clinic.
  • What are my other options if I decide not to try the treatment you’re recommending?
If you’re nearing the end of your consultation and you’re not happy with how it’s going, it’s completely natural to wonder what your other options are. If your doctor has no other types of treatment for you to choose from, this could be a red flag. Even if the doctor genuinely doesn’t have any other treatment options lined up for you, they should be able to refer you to another doctor who can provide additional support and advice.  

Seeking Specialist Help

If you feel like you’ve exhausted your doctor’s knowledge and haven’t got the answer you wanted, it might be time to look elsewhere. Doctors are great, but when it comes to complex conditions like scoliosis, you could be better off speaking to a specialist. Here at the Scoliosis SOS Clinic, we’ll invite you to attend an hour-long initial scoliosis assessment with one of our specialist consultants. We can even conduct your initial consultation over the phone or via Skype if you have photos and/or X-rays of your back already. Before recommending a treatment path, we take 2 measurements of your back: one to assess the rotation or kyphosis/forward bend in your spine, and a second photographic scan of your spine that analyses your back shape and profile. Then we’ll summarise our diagnosis, explain our proposed treatment plan and give you an idea of therapy timescales, plus the type of results you can expect to achieve. Even if you attend one of our consultations, you’ll be under no obligation to pursue treatment with us. We want you to be empowered to make a choice about your spinal treatment and ultimately do what’s best for you.

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Spinal fusion hardware versus VBT

The USA’s Food and Drug Administration (FDA) recently announced that it had approved its very first spinal tethering device for correcting idiopathic scoliosis in children and adolescents. The Tether™ vertebral body tethering system is designed to help correct spinal curvatures in young patients whose bones have yet to fully mature. Made up of titanium anchors, bone screws and set screws, along with a flexible polymer cord, the device aims to prevent further curve progression, theoretically eliminating the need for spinal fusion surgery.  

What does this mean for young scoliosis patients in the USA?

Manufactured by Zimmer Biomet, the spinal tether device has been presented as something of a breakthrough in paediatric scoliosis management. It is an innovative treatment option that aims to improve quality of life for young patients with idiopathic scoliosis. Dr Baron Lonner, Professor of Orthopaedic Surgery at New York City’s Mount Sinai Hospital, applauded the FDA’s decision, noting that vertebral body tethering (VBT) could become a “mainstream option for scoliosis treatment” in due course. The Tether™ VBT system is designed to help young scoliosis patients with a Cobb angle of 30-65 degrees.  

Idiopathic scoliosis in children

Idiopathic scoliosis is the most common form of scoliosis. The causes of idiopathic scoliosis are unknown (this is what the word ‘idiopathic’ means). It is typically diagnosed in children and adolescents between the ages of 10 and 18. The most commonly-prescribed medical treatment for idiopathic scoliosis is bracing. If the brace does not successfully halt the progression of the patient’s spinal curve, surgery may be recommended. Though often effective, the spinal fusion procedure can lead to problems of its own, with patients sometimes facing such issues as restricted motion and arthritis down the line. The FDA’s decision to approve this new tethering device could give young scoliosis sufferers a new hope in tackling their spinal issues.  

Is vertebral body tethering effective?

In June 2018, NHS England published a report titled Evidence Review: Vertebral Body Tethering for Treatment of Idiopathic Scoliosis. This review examined the effectiveness of VBT and the complication rates associated with this treatment method. Here are two key findings from NHS England’s report…
  • 5 out of 25 patients required repeat surgery: “At skeletal maturity, Ames, Samdami et al reported 5 patients from the cohort of 25 requiring repeat surgery to loosen the tether in order to treat or prevent overcorrection (Ames, Samdani, & Betz, 2016).”
  • In total, 44% of patients experienced some complications. In addition to the 5 patients who required repeat surgery (see above), another 5 experienced “transient thigh pain or numbness”, and there was 1 patient with “unresolved intercostal neuralgia“.
  • There’s not yet enough evidence of VBT’s effectiveness: “It is not possible at present, given the lack of experimental studies, to confirm that this treatment is relatively effective, safe and acceptable when compared to standard care.”
 

Scoliosis treatment at the Scoliosis SOS Clinic

While the FDA’s decision may be welcome news to young scoliosis sufferers in the USA, vertebral body tethering still has a long way to go as an alternative to spinal fusion surgery, and it remains to be seen just how effective the Tether™ will be in the long term. Note also that this treatment method still requires the patient to undergo an operation. If you’re seeking a less invasive option for yourself or a loved one with scoliosis, you may be interested in the treatment courses that we deliver here at the Scoliosis SOS Clinic in London, England. Our ScolioGold programme combines a variety of non-surgical methods to create a unique approach that is unlike anything offered elsewhere. Better still, the ScolioGold method is constantly evolving in line with advances in the field of non-surgical treatment, ensuring that our therapeutic programme continues to deliver the best possible results.

Contact Scoliosis SOS to book a ScolioGold consultation >>

FURTHER READING:
Surgery is often recommended once a scoliosis patient’s spinal curve has progressed beyond a certain point, and in the vast majority of cases, ‘surgery’ means spinal fusion surgery. This procedure involves joining two or more vertebrae together to prevent the patient’s curvature from growing; nowadays, this is usually achieved by fastening small metal screws called pedicle screws to the spine, then using a bone graft to ‘fuse’ the vertebrae together However, while this procedure is still the standard surgical scoliosis treatment method in most parts of the world, there are a number of risks associated with spinal fusion. Though rare, the potential complications include:
  • Screws placed in the wrong positions
  • Screws breaking or coming loose
  • Dural lesion
  • Infection
  • Various neurological, pulmonary, and vascular complications
In response to the risks sometimes associated with spinal fusion, a number of other surgical scoliosis treatments have been developed, and some of these new techniques seem to becoming increasingly popular. Today, we’d like to look at three relatively new surgical procedures and why they’re potentially preferable to spinal fusion surgery.

Magnetically-controlled growing rods (MCGR)

Magnetically Controlled Growing Rods

Magnetically-controlled growing rods are already being used in more than 20 countries (including the UK and the USA) to treat scoliosis in children under the age of seven. During the MCGR procedure, the surgeon fastens titanium rods to the patient’s spine; these rods have a lengthening mechanism that can be operated magnetically, and after the operation itself, the patient attends a series of minimally-invasive ‘distraction’ procedures where a remote controller is used to lengthen the rods and correct the spinal curvature. This effectively puts the doctor in control of the child’s scoliosis until they have finished growing.

 

Stapling and tethering

Spinal Tethering Operation

Vertebral body stapling (VBS) and vertebral body tethering (VBT) are two minimally-invasive procedures that are usually performed on scoliosis patients who are still growing (e.g. teenagers and pre-teens). VBS uses malleable metal staples to join two or more vertebrae together, while VBT uses pedicle screws attached to a flexible cable at the site of the curvature. VBS is recommended for thoracic curves of 25-35 degrees and lumbar curves under 45 degrees; VBT can be used to treat thoracic curves between 35-70 degrees. Currently available only in the UK, the USA, India, Canada and New Zealand, the tethering and stapling procedures have no major reported complications and are generally less invasive than the more commonly-seen spinal fusion procedure.

Apifix

Apifix for Scoliosis

Apifix is a small implant that is attached to the spine using just two screws. No fusion is performed, and the procedure is not very invasive, leaving a far less visible scar than spinal fusion surgery.

Apifix Scar

This procedure is ideal for adolescents with idiopathic scoliosis, especially where the curve measures 40-60 degrees. Apifix is currently available in the USA, Israel, and across Europe. Any surgery carries risks and complications, depending on the procedure and patient presentation. If you are looking for a non-surgical alternative to spinal fusion, please contact the Scoliosis SOS Clinic today. We use an exercise-based regime called ScolioGold to correct scoliosis without any surgical intervention whatsoever. We can also assist with recovery after undergoing scoliosis surgery.
Chiropractic Treatment
If you’re somewhat familiar with chiropractic therapy, you might assume that it’s an ideal treatment for scoliosis (sideways curvature of the spine). Chiropractic focuses primarily on the spine, and if you’re a scoliosis sufferer, going to a chiropractor can seem like a far preferable alternative to wearing a brace or undergoing spinal fusion surgery.
But can chiropractic treatment really combat scoliosis effectively? That’s the question we’ll be attempting to answer today.

What is chiropractic?

Chiropractic is a form of medicine that is used to diagnose and treat musculoskeletal disorders, with practitioners using their hands (or a machine) to perform treatments on the bones, muscles and joints, which are commonly referred to as ‘manual therapies’. Chiropractic treatment usually involves a range of techniques, although this is often focused on the manipulation of the patient’s spine, in order to treat conditions which cause pain in the neck and lower back, including scoliosis.
While those who practice chiropractic are considered to be part of the healthcare profession, there have been many debates and controversies relating to its effectiveness over the years, particularly due to the fact that it does not refer to a single treatment. While there is evidence to support the fact that chiropractic medicine can improve and relieve persistent lower back pain, there is no strong evidence to suggest that it has the ability to treat other conditions.

Can chiropractors treat scoliosis?

As mentioned above, there is evidence to suggest that chiropractic has the ability to effectively treat lower back pain; however, this may not provide effective relief for the majority of scoliosis sufferers. Studies have shown that the practice is most effective in cases of acute, short-term pain, which means that it is unlikely to provide long-term results for patients with scoliosis, particularly for those with moderate to severe curves. In addition, there are some practitioners who treat scoliosis in the same manner as other spinal conditions, which is unsuitable for a condition which requires a unique approach, and can vary hugely from patient to patient.
Chiropractic treatment also does nothing to address the muscular imbalance that results from the development of a scoliotic curve, and it relies on the patient returning to see their chiropractor on a regular basis to maintain the desired level of pain relief.

Are there any alternatives to chiropractic treatment?

While the repositioning of joints can contribute towards successful treatment, this should be complimented with other treatment methods in order to achieve long-term success. Here at Scoliosis SOS, our ScolioGold treatment method uses manual and physical interventions to treat scoliosis sufferers; however, this does not make up the entirety of our treatment approach. Instead, we combine this therapy with stretches and exercises to form a more holistic treatment plan, which addresses multiple aspects of the sufferer’s condition, as opposed to focusing on a single element of the condition. ScolioGold is a long-term system of care that is designed to help scoliosis patients self-manage their condition rather than forcing them to rely on repeated visits to a practitioner.
To find out more about our ScolioGold programme, visit our Video Experiences and Testimonials page to see how we have helped previous patients to correct and improve their scoliosis symptoms. You can also get in touch to enquire about our courses, by filling in our quick enquiry form here.
scoliois physical therapy
 
No two cases of scoliosis are exactly alike – symptoms and their severity vary hugely from patient to patient and depend on a number of contributing factors. Due to several possibilities in how scoliosis can occur and progress, no one treatment is universally effective; certain treatment routes may be effective for some patients but fail to provide the desired results for others.
 
Another issue that often arises when it comes to treating scoliosis concerns the patient’s personal circumstances and physical abilities. The typically-recommended treatment for progressive curves in young people is a back brace, which is fitted to the patient’s exact measurements and worn for extended periods of time in an effort to limit curve progression. For patients whose curves are progressing at a particularly rapid rate (to a degree that has the potential to limit their mobility, breathing capacity and overall health), spinal fusion surgery is often recommended in order to permanently halt the curvature’s progression. While these options may provide encouraging results for some, others may find them ineffective or limiting, and this prompts many scoliosis sufferers to seek out alternative treatments.
 
One approach that is often discussed as an alternative to surgery and bracing for treating scoliosis is physical therapy – that is, the non-invasive treatment of spinal curvature via a series of exercises and manipulations. While this type of therapy can be an effective form of treatment for scoliosis when performed correctly, the term ‘physical therapy’ is very broad, and individuals are often left confused as to what this treatment actually involves.
 
Below is an explanation of how and why physical therapy is used to treat scoliosis, along with a closer look at the forms of physical therapy that we use here at our clinic:

Why is Physical Therapy Used to Treat Scoliosis?

Scoliosis patients may seek treatment via physical therapy for a number of reasons, including:
  • Avoiding the complications and physical limitations associated with surgery.
  • Improving body image by reducing the visibility of the curve and avoiding surgery scars.
  • Improving flexibility and mobility by strengthening the muscles surrounding the spine.
  • Relieving the pain caused by scoliosis (often experienced by scoliosis suffers who have undergone surgery).
  • Preventing curve progression using corrective techniques in a way that allows continued maintenance and improvement.

How Does Physical Therapy Work?

Physical therapy for scoliosis works by repeating a series of corrective movements and techniques, which are intended to limit restrictions, improve posture, strengthen the back muscles, and increase the patient’s range of motion. All of this contributes to reducing the level of pain experienced by the patient, along with improving their physical ability and correcting the visual symptoms of the condition.
 
Here at Scoliosis SOS, we achieve optimal results for each patient by assessing and treating their condition on an individual basis and by providing a range of targeted physical therapies that treat the various aspects of their scoliosis condition. While the Schroth method forms the foundations of our treatment approach, this is complemented and supported by a range of other proven techniques, which work in unison to form our ScolioGold treatment programme.
 
To find out more about how physical therapy can be used to treat scoliosis, or to discuss the unique requirements of your condition, simply get in touch with the Scoliosis SOS team today.
 
Further Reading: Meet Our Physiotherapists