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 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 here 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.
Analysing what causes scoliosis

While scoliosis most commonly develops during adolescence, this debilitating condition can affect anyone at any time of life. Some people aren’t affected by scoliosis until they reach old age; others notice the symptoms far earlier. In some cases, the condition is actually present from birth (although this is quite rare).

The causes of scoliosis

In around 80% of cases, the exact cause of scoliosis is unclear. This is known as idiopathic scoliosis, which is by far the most common form of the condition. Idiopathic scoliosis is thought to occur due to genetic factors, but nobody knows for sure.

When scoliosis is not idiopathic, the cause may be one of the following:
  • Muscular dystrophy (also known as MD). This is a genetic condition that weakens the muscles over time. This gradual weakening can lead to – among other things – curvature of the spine. Learn more >

  • Cerebral palsy. This condition affects the patient’s movement and coordination, and can also cause irregular posture. Learn more >

  • Birth defects. As mentioned above, some people are born with scoliosis because their spines developed improperly in the womb. This is known as congenital scoliosis. Learn more >

  • Marfan syndrome. This is a hereditary disorder that affects the body’s connective tissues, which in turn can have an effect on the patient’s spine. Learn more >

  • Ageing. Getting older will naturally have an adverse effect on one’s body, and some previously healthy people are affected by scoliosis in their later years due to changes in the discs and joints that make up the spine. Learn more >
In the future, we may understand more about scoliosis (particularly idiopathic scoliosis), and this will hopefully help doctors to prevent some cases of scoliosis before they emerge. In the meantime, all we can do is treat the symptoms of scoliosis, such as postural deformities, decreased mobility, and chronic pain.

Surgical correction is the most common method for treating scoliosis, but many scoliotics find that they are able to overcome the symptoms of their condition through non-surgical, exercise-based physical therapy.

Click here to learn about non-invasive alternatives to scoliosis surgery; alternatively, please contact Scoliosis SOS if you wish to book an initial consultation with one of our scoliosis consultants.

Here at the Scoliosis SOS Clinic, we are committed to conducting research into our field on a constant basis. This research helps us to better understand scoliosis itself, and in turn, enables us to deliver the best level of treatment to those who suffer from it. To offer you some insight into the topics we have researched recently, here are a few short summaries outlining our aims and findings:

Back pain

Pain Research

The aim of this project was to determine whether or not an intensive 4-week scoliosis exercise programme could decrease patient pain in cases of idiopathic scoliosis, and to ascertain if it could then be maintained. Pain is one of the most common and most debilitating symptoms of the condition for both adults and adolescents, and we therefore wanted to examine whether or not a scoliosis-specific exercise programme would be able to significantly reduce pain.

35 patients took part in this study, and each one was asked to report their pain levels before the course, immediately after the course, and at a check-up session 6 months later. The results were very encouraging, as patients displayed significant reductions in reported pain, as well as displaying further improvements as they continued to use the home exercise programme thereafter.

Cobb angle research

Cobb Angle Research

This research was conducted to determine the impact of a 4-week scoliosis-specific exercise programme on the Cobb angle in subjects suffering from idiopathic scoliosis. The Cobb angle is the angle between the most tilted vertebral bodies above and below the apex of the spinal curve, and has been the standard by which to assess Scoliosis since 1948.

This study involved 11 patients, each of whom were given X-rays by an independent radiographer to compare the Cobb angle before and after treatment. This research displayed significant reductions in the Cobb angle for a range of patients with juvenile, adolescent and adult scoliosis, proving that scoliosis-specific physiotherapy is demonstrably capable of reducing the Cobb angle.

Body image

Body Image Research

For people suffering with scoliosis, body image is often a key motivation for seeking treatment. For this reason, we conducted a study into whether or not an intensive 4-week course of exercises would improve each patient’s body image; we also looked at whether improvements would be rated equally by therapists, a scoliotic rater, and the patients themselves.

82 patients with idiopathic scoliosis rated their own body image, and were also rated by two blinded physiotherapists and a scoliotic rater. Patients reported significant improvements in body image post-treatment, although there were variations between patients’ scores and those of the raters, demonstrating the importance of patient-rated body image in our treatment.

Click here for more detailed accounts of our scoliosis research, or contact us if you would like to find out more about the Scoliosis SOS Clinic and what we can do to help you.