Type 1 Chiari Malformation

Despite the fact that there is no underlying cause for the development of scoliosis in 8 out of 10 cases, there are a number of medical conditions that can lead to a curvature of the spine.  We've discussed some of these conditions - including Marfan syndrome -  in the past, and today we'd like to talk about another: Chiari malformations.

What is a Chiari malformation?

A Chiari malfomation is a structural defect in the human brain that causes part of the cerebellum to sit below the foramen magnum. When the bony space at the lower rear of the skull is smaller than usual, the cerebellum and brain stem can be pushed downwards, affecting the function of this part of the brain. This can cause reduced muscle strength, balance problems, neck pain and dizziness, along with several other symptoms and medical issues.

How are Chiari malformations linked with scoliosis?

Spinal curvature is common among people with a type 1 Chiari malformation (CM), the most common form of the condition. In this form of CM, the lower part of the cerebellum extends into the foramen magnum without the brain stem, an opening that only the spinal cord passes through in normal circumstances. This form of CM is often left unnoticed until adolescence or adulthood, and is usually diagnosed during an examination for another condition. This means that you may already have identified your scoliosis without realising that CM is an underlying cause. 

Both a sideways (scoliosis) and forward (kyphosis) curvature of the spine can be caused by a type 1 Chiari malformation, and both of these conditions are often present in children due to the fact that their skeletons have not yet fully matured. As is the case with scoliosis itself, CMs are more commonly found in women than in men.

What treatment is available?

For sufferers of CM type 1, symptoms can usually be managed with medication. In more serious cases, skull and spinal surgery may be considered as an option to relieve pressure on the brain, or to correct a tethered spinal cord in children. To help relieve the pain and discomfort caused by spinal curvature, treatment options such as our ScoliGold method can provide lasting results without the need for surgical intervention. As with all of our patients, CM sufferers who attend a course at the Scoliosis SOS Clinic will receive a range of therapies tailored to their exact needs, relieving the symptoms of their spinal curvature while keeping their underlying medical issues in mind at all times.

For more information on how we can help to treat the symptoms of CM, please feel free to contact Scoliosis SOS today.
People who suffer from Marfan syndrome experience problems with the connective tissues within their bodies; this affects the structure of their form and the support of their internal organs. In most cases, the sufferer will have inherited the condition from their mother or father, as the gene responsible for Marfan syndrome has a very high chance of being passed from parent to child.

Diagnosing this condition can be particularly difficult for medical professionals, as the symptoms often vary from person to person. While in many cases the symptoms are visible in childhood, the condition often remains unidentified until the patient's teenage years, the process of diagnosis being made even more difficult by the rarity of the condition. 

Due to its effect on the body's tissues, Marfan syndrome can often cause problems with the body's growth and development. One common side-effect of Marfan syndrome is scoliosis, as it can cause the spine to curve to the sides abnormally. Statistics have shown that more than 6 out of 10 Marfan syndrome sufferers will develop scoliosis, causing them to experience back pain, and even leading to breathing problems in severe cases.

What can Scoliosis SOS do to help?

As there is currently no cure for Marfan syndrome, it is important that the syndrome's symptoms are managed in the best way possible in order to provide relief from pain and to reduce the risk of further complications. Although surgery is sometimes suggested as a solution for the symptoms of scoliosis, this is a fairly drastic form of treatment that comes with many risks to the patient. It also comes with a long healing time, which is an added inconvenience, particularly for younger patients.

At Scoliosis SOS, we take a different approach to treatment, using a variety of non-surgical therapies to deliver long-lasting results. Combining specially-devised exercises with osteopathic principals and other methods of treatment, the ScolioGold programmes delivered at our clinic are able to provide substantial reductions in spinal curvature. They also allow our patients to continue their progress at home, allowing them to see continued progress and experience ongoing relief from pain.

If you're a Marfan sufferer who has trouble dealing with the symptoms of scoliosis, please don't hesitate to get in touch! You can find more details of our treatment courses here.
There was potentially exciting news from Japan last month: researchers at Hiroshima University seem to have identified the gene that kick-starts the "genetic chain reaction" that eventually causes scoliosis.

As we've discussed previously on this blog, the causes of scoliosis are often unclear. However, according to a report from Asian Scientist, we are now one step closer to a solid answer: experiments on zebrafish have linked the development of scoliosis to an overactive gene called LBX1


It would seem that too much LBX1 activity can cause the spine to become misshapen as time progresses, resulting in scoliosis. This link is supported by the results of two different experiments:
  • #1 - Researchers injected a group of zebrafish embryos with extra LBX1 proteins. In these embryos, the cells that would eventually become the fish's backbone were notably wider than in embryos with normal LBX1 levels. The LBX1-boosted embryos that survived long enough to do so eventually developed misshapen bones in their backs, resulting in scoliosis.

  • #2 - A second group of fish were genetically modified to promote extra LBX1 activity in some cells over the course of their lifetimes. Unlike the other group of embryos, some of these fish developed healthy backbones at first, but the spines still began to display a scoliotic curve as they grew older and entered adulthood.
The results of these experiments mirror the development of scoliosis in human beings; the first group of fish are analogous to people who are born with scoliosis, while experiment #2 offers a potential explanation for idiopathic scoliosis, which typically develops during adolescence.

(Even more intriguingly, the Hiroshima researchers noticed that their female test subjects were more likely to develop scoliosis than their male counterparts. Science has yet to provide a concrete explanation as to why scoliosis is more prevalent in women than in men, but it's certainly interesting to learn that this phenomenon applies to zebrafish as well as to human beings.)

Naturally, it will take a lot more research before these findings can be used to treat scoliosis, but it is very exciting to see these strides being made. In the meantime, if you'd like to find out more about how scoliosis can be treated without the need for surgery, please visit our ScolioGold Therapy page or contact us to arrange an initial consultation at the Scoliosis SOS Clinic.
Many discussions about scoliosis - and the treatment of scoliosis in particular - centre on something called the Cobb angle. The Cobb angle is among the most important indicators of scoliosis severity, and Cobb angle reduction is the primary goal of the non-surgical scoliosis treatment courses we deliver here at Scoliosis SOS.
 
Simply put, the Cobb angle is just a way of measuring the curve of a scoliosis sufferer's spine. It is named after John Robert Cobb, an orthopaedic surgeon from the USA; Cobb was born in 1903, and he conducted extensive research into scoliosis when relatively little was known about the condition. He identified that only 1 in 10 scoliosis sufferers actually requires surgical treatment, and so he devised the Cobb angle as a straightforward means of determining whether or not a patient's spinal curvature is severe enough to necessitate surgery.

Cobb angle examples

The X-rays below show Cobb angle measurements for five different scoliosis sufferers (all of whom were treated here at the Scoliosis SOS Clinic). The patients' ages range from 7 to 32 years old.
 
Cobb angle
 
More Cobb angle examples can be found here.

Using the Cobb angle to assess treatment needs

Scoliosis can only be diagnosed (and its severity assessed) by an experienced practitioner. However, here is a rough guide to what the Cobb angle means:
  • A Cobb angle of less than 10° is entirely normal - there is no such thing as a perfectly straight spine, and everyone will have some slight deviation in their spinal alignment.

  • 10° is generally accepted as the threshold for determining if somebody has scoliosis. Scoliosis will not be given as a diagnosis unless the patient's Cobb angle is 10° or more.

  • When the Cobb angle is between 20° and 40°, a back brace is usually recommended; back braces come in many different shapes and sizes, and some are worn only at night. However, some patients may be prescribed a brace at 15° or at 50° - it all depends on the hospital that's administering treatment.

  • How large does a patient's Cobb angle need to be before an orthopaedic surgeon will recommend surgery? The answer varies from country to country and is often influenced by whether the patient is already wearing a brace and/or undergoing scoliosis-specific physiotherapy. In the UK, the threshold is often 40°; in continental Europe, it's more frequently 50°.

  • 12° to 120°: This is the range of Cobb angles we treat using our ScolioGold therapy programme (although the majority of our patients exhibit curves of between 20° and 65°).
Click below to see how our treatment courses can help to reduce the Cobb angle or contact us now to book an initial consultation for yourself or a family member.
 
 
Scoliosis can be caused by a variety of different factors, but the condition's most common form is idiopathic scoliosis. Idiopathic scoliosis has no known cause, but it usually develops during adolescence and - interestingly - it is far more common in girls than in boys. Furthermore, there is some evidence to suggest that scoliosis tends to be more progressive in female patients than in their male counterparts.
 
So why should idiopathic scoliosis affect women more often (and more severely) than it affects men? As with the question of what causes scoliosis in the first place, science has yet to discover a solid answer to this mystery. However, we have seen a number of theories proposed - here's one of the more plausible suggestions:

It may be linked to patients' leptin levels

Leptin is a hormone that performs many different tasks in the human body. One of its best-known functions is appetite suppression; a hormone called ghrelin tells you when you need to eat, and leptin tells you when it's time to stop.
 
However, leptin seems to have many other effects beyond simply making you feel full. The hormone has been shown to affect bone growth in mice via the SNS (Sympathetic Nervous System), and it has been suggested that idiopathic scoliosis in females may occur as a result of "increased SNS activity" that also affects the patient's weight (girls with scoliosis tend to have a fairly low BMI).
 
However, it is important to note that this is merely a hypothesis; as stated above, there is no concrete, scientifically proven explanation for the high incidence of scoliosis in females compared to males. It's equally important to bear in mind that we treat a diverse cross-section of patients here at the Scoliosis SOS Clinic, and while the majority of our patients are female, we can help men to overcome the effects of scoliosis as well. Kurt, a 29-year-old man who travelled to our clinic from California last year, is a prime example:

 

 
Click here for more video testimonials from our previous patients, or contact us now if you'd like to arrange a consultation at the Scoliosis SOS Clinic.