Below is the overview from a case study of adolescent idiopathic scoliosis treated by spinal manipulation.

Here is a link to the full Adolescent Idiopathic Scoliosis Case Study – View PDF

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 rehabilitation and brace treatment for 4 years, but the curvature of the thoracic spine still progressed. The Cobb angle was 46° 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, followup radiographs and examinations were conducted. The Cobb angle decreased by 16°. Meanwhile, the patient’s lower backache eased and there was also an improvement in defecation frequency, which had been problematic.

Conclusions

Chiropractic treatment was associated with a reduction in the degree of curvature of adolescent idiopathic scoliosis in this case, after half a year of conventional medical treatment had failed to stop curve progression. This suggests that in at least some severe and progressive cases of scoliosis, chiropractic treatment including spinal manipulation may decrease the need for surgery.

Mark Morningstar, D.C.
Burl R. Pettibon, D.C.
Carol L. Remz, Ph.D.

The structure of the spine, and ultimately posture, are considered by some to be a
requisite to maintaining health and normal function.3 Abnormal posture can cause
alterations in some of our basic physiological processes, such as headaches, blood
pressure, emotions, lung capacity, and hormonal production.4 Yet maintaining an erect
sitting position is difficult because postural control is mainly reflexive and involuntary.
Therefore, although we can temporarily change our posture through voluntary muscular
action, inevitably our conscious control bows to our reflexive, neurological control of
posture. From this, we can logically presume that the best way to make a lasting change
to spinal structure, or posture, is to correct posture from a reflexive, involuntary
standpoint. This logic forms the foundation for a treatment protocol referred to as The
Pettibon System developed by Pettibon37,38 to correct the spine and posture through
gradual adaptation of the spinal and postural reflexes.

A fundamental difference in the overall medical education of a chiropractor is the
amount of importance placed upon restoring and maintaining the integrity of the nervous
system. Given that the nervous system controls and regulates all other body functions,12 it
is logical that it also controls spinal and postural position and movement. However,
chiropractic treatment has typically shown little success in making gross structural and
postural changes.16,29 The procedures used in The Pettibon System, in contrast to
conventional chiropractic treatment, heavily emphasize the importance of postural and
paravertebral soft tissues in making structural changes. Although most chiropractors also
incorporate physical exercises into their treatment regimens,22,23 these exercises usually
attempt to change postural through voluntary neuromotor pathways. They include mirrorimage
type exercises, where postural isotonic exercises are performed in mirror-image
fashion to the patient’s presenting posture. However, since we know that posture is under
reflexive control, it is much more difficult to change posture through voluntary means.
From a biomechanical perspective, chiropractors typically view the spine as a
series of 24 movable segments. As a result, chiropractic manipulation is typically
delivered on a segmental basis, using a variety of exams performed to locate a singular
misaligned vertebra. In contrast, The Pettibon System treats the skull as a vertebra.
Further, it is regarded as the single most important vertebra, given that most of the
reflexes that govern postural control are housed within the skull, such as the visual
system and vestibular apparatus. With these neurophysiologic capabilities, the skull is the
only vertebra that can orient itself to time and space. Many of our postural reflexes, such
as the vestibulocollic reflex,47 cervicocollic reflex,35 pelvo-ocular reflex,31 vestibuloocular
reflex,39 cervico-ocular reflex, and cervical somatosensory input,41,30,49 all serve to
maintain a level head position in relation to the visual field or to the neck and trunk.
Therefore, correcting the static structure of the cervical spine becomes a primary goal in
correcting overall spinal and postural position and movement, as the rest of the spine
orients itself in a top-down fashion.34 Once this is achieved, the rest of the spine is
corrected according to the normalized reference point.

Normal vs. Abnormal

Like any physiologic process, the spine and posture must also possess a normal
measurement. Just as blood pressure, serum cholesterol, body temperature, and blood pH
have normal values, so too must static spinal structure. The spine serves two distinct
functions: 1) provide protection for the spinal cord, and 2) provide structural support for
the bony frame. In providing this structural support, one common denominator exists for
all upright bipedal mammals: gravity. Given that gravity is a constant on Earth, a
corollary to the second spine function is that it also serves to adapt to gravity, while
allowing for a balance between support and flexibility. Various authors have attempted to
identify a normal spinal model.5,9,10,11 Most recently, Harrison et al.5,17,20,26 and
Troyanovich et al.44 outlined their definition of a normal sagittal spine by using elliptical
shell modeling. They conclude that the normal cervical curve should be a 42.5º arc of a
circle from C2-C7, the thoracic kyphosis should be a 44.2º ellipse when measured from
T1-T12, and the lumbar spine should be a 39.7º ellipse from L1-L5. According to
Kapandji27, each of these three areas should measure 45º arcs of a circle. The inherent
problem with an ellipse is the fact that an ellipse contains a stress point. The arc of a
circle, on the other hand, is radially loaded, meaning that an arc does not contain stress
points. When modeling the lumbar spine as an arc instead, as Kapandji27 does, each of the
lumbar segments bears the weight of the trunk uniformly. Therefore, it seems logical to
use the Kapandji spinal model as a clinical goal compared to sagittal ellipses. The spinal
model proposed by Pettibon,38 adapted from the parameters identified by Kapandji,27 is
pictured in Figure 1.

In discussing the concept of a normal spine, it is also important to address the idea
of clinical symptoms in spine correction. Although clinical trials have not been
conducted, theoretical models have attempted to demonstrate the inevitable result of
chronic abnormal spinal loading. For example, a forward head posture can reverse the
stresses placed upon the cervical spine. This causes degenerative changes at the anterior
portion of the mid and lower cervical spine due to increased compressive force at these
areas.19,21 It also creates traction stress along the posterior longitudinal ligament, thereby
promoting traction spur development. This concept is supported in a recent study by
Wiegand et al.,45 where abnormal changes in cervical spine configuration correctly
predicted cervical pathology 79% of the time. A significant relationship has also been
shown between cervical spine pathology and symptoms. Ironically, although cervical
pathology may be present with abnormal cervical spine structure, the relationship
between an altered cervical spinal structure and clinical symptoms is tenuous at best.36
However, it could be postulated, as in the case of scoliosis progression,48 that because the
cervical spine pathology may develop slowly over time, the body continuously adapts to
the abnormal position and advancing pathology. Therefore, symptoms do not develop
until a critical point has been reached, such as neuroforaminal stenosis or spinal canal
stenosis, eg. cauda equina syndrome.

The ultimate purpose of identifying a normal spine and posture is simply to
provide a reference point from which a clinical goal can be developed. Spinal correction
as a clinical goal and outcome is becoming more important and necessary in a society
where musculoskeletal complaints total nearly $50 billion in health care spending
annually.6 With the growing interest occurring in spinal correction, consensus on a
normal sagittal spine is desirable so that randomized trials and outcome assessments in
the clinical setting can be designed and tested.

Pettibon Manipulative Procedures

The Pettibon System uses a collection of manipulative techniques, performed both
by hand or adjustive mechanical instruments, and rehabilitative exercises not known to
the typical physiotherapeutic arsenal.39 The manipulative and rehabilitative procedures
are applied on an individual basis, so that every treatment plan can be designed according
to each patient’s needs. A brief look into the biomedical literature reveals that using a
combination of manipulation and rehabilitative exercises seems to outperform either
modality alone in achieving various clinical outcomes.2,13,24 Classically, the goal of
chiropractic manipulation is to correct misalignments within the spinal column. However,
the literature available to support this idea is limited at best. In The Pettibon System, by
contrast, spinal manipulation is performed in order to provide a temporary increase in
joint mobility so that the rehabilitative exercises can take advantage of this increased
range of motion. Central to this system is the idea that the manipulation is not the
corrective procedure; rather, the rehabilitative exercise becomes the corrective procedure.
The limited corrective ability of spinal manipulation stems from the neurophysiologic
adaptations to sudden applied mechanical forces. According to Guyton,14 when the spine
is subjected to sudden mechanical forces, the paravertebral soft tissue is stretched,
eliciting intrinsic dynamic and static stretch reflexes in the paraspinal muscles. These
reflexes cause a reflex contraction of the stretched muscle until the muscle has restored
its initial resting length. Therefore, spinal manipulation performed alone does not address
or counteract these reflex properties of the spine that are designed to protect it from
potentially injurious external mechanical forces.

Rather than addressing the spine as a series of individual segments, Pettibon37,38
addresses the spine according to the muscular attachments of the postural muscles.
Through this the spine is conceptualized as a functional entity made of six specific units,
divided by these muscular attachments. Although the individual vertebrae have
independent motion, they do not move independently within a functional confine.
Therefore, the specific goal of manipulative treatment in The Pettibon System is to
mobilize a region of vertebral segments described by its common muscle attachments.
How muscle attachments relate to Pettibon’s model of six functional units can be found
in Tables 1, 2 and 3.

The manipulations performed by hand also differ from conventional chiropractic
methods. Typically, compressive-type manipulative forces are administered in
conventional chiropractic. These forces are vectored perpendicular to the predominantly
vertical orientation of the paravertebral soft tissue, especially in the cervical spine.
Therefore, these soft tissues cannot adapt to this direction of force efficiently, and may
sustain injury from this type of manipulation. In contrast, The Pettibon System uses
distraction and accumulative type manipulative procedures. The forces applied in the
distraction procedures are vectored more cranially, thereby allowing the vertically
oriented soft tissue to better adapt to the forces with less chance of injury. The
accumulative force procedures represent the positional traction procedures.

Pettibon Rehabilitative Procedures

The heart and soul of Pettibon rehabilitative procedures is the patented (US Patent
#740087.403C1) Pettibon Weighting System™ (Fig.2). Its goal is to realign the centers of
mass of the head, trunk, and pelvis. It incorporates the use of head, shoulder, and hip
weights placed at specific areas with varying amounts of weight, depending upon the
patient’s needs. Since we know that the spine attempts to distribute body weight evenly
around the vertical axis of gravity, placing asymmetrical weights on the external body
surface causes the postural reflexes and spine to adapt to the change in weight
distribution, re-orienting this added weight around the vertical axis. In a study by
Saunders et al.,40 with 131 patients, initial neutral lateral cervical radiographs were
compared to lateral cervical radiographs with patients wearing 3 lb or 5 lb. frontal
headweights. On average, the cervical lordosis improved 34%, while the amount of
forward head posture was reduced by 14 mm in patients wearing 5 lbs. Those wearing 3
lbs. experienced a 31% improvement in cervical lordosis and 18mm reduction in forward
head posture. In a smaller study by Morningstar et al.,32 15 patients underwent a series of
three manipulative procedures, and were then fitted for a 4-lb frontal headweight.
Radiographic measures of cervical lordosis improved 9.9° and forward head posture
reduced 1.25 inches. While these studies have shown that external body weighting does
make spinal changes, their position is key to successful treatment.

Cailliet3 described adding weight to the top of the head to treat cervical
hyperlordosis. However, a previous study17 has shown that in a non-patient population,
the average cervical lordosis is 34º, less than the normal value of 42.5º identified by
Harrison et al.15 and 45º outlined by Kapandji27 and Pettibon38. Therefore, adding weight
to the top of the head to reduce cervical lordosis seems contraindicated for a majority of
the population. However, the Pettibon headweight is positioned on the patient’s forehead
just above the eyes, causing a posterior skull translation versus a superior translation. The
postural reflexes attempting to rebalance the skull’s new center of mass mediate this
posterior translation. This results in a reduction of the forward head posture and increase
in the cervical lordosis.

The Pettibon Weighting System is also considered a type of “isometric demand
exercise” where the weighting system retrains and strengthens weaknesses in the postural
muscles. Because patients vary in height, weight, shape, muscular strength, and medical
history, the practitioner cannot assume that the same abnormal posture in two different
patients will associate with the exact same muscle weaknesses. The Pettibon Weighting
System can only be accurately utilized in conjunction with radiographic measurements
because the reliability of visualizing cervical and lumbar sagittal alignment is extremely
low8. Therefore, all patients must undergo radiographic analysis while wearing the
weighting system designed specifically for them. While concerns tend to arise regarding
radiation exposure to the patient, the dosage used is always minimal. In fact, Toppenberg
et al.43 concluded that it would take 2500 cervical spine x-rays or 1250 lumbar spine xrays
to approach the radiation safety limit of 5 Rad for a fetus.

Another important aspect of the rehabilitative procedures used in The Pettibon
System is that they are intended to address the biomechanical properties of soft tissue.
Hysteresis, for example, is the stored energy in viscoelastic tissues, like muscles,
ligaments, and discs, that is decreased when these tissues are subjected to progressive
loading and unloading cycles over time.47 Since muscles, ligaments, and discs are the
structural “glue” of the spinal column, it is logical then to address these tissues when
attempting to make changes in the static structure of the spine. In The Pettibon System,
exercises are performed to decrease hysteresis in these tissues using the Wobble Chair™
(Fig.3) and the Pettibon Repetitive Cervical Traction™ (Fig.4). From a clinical
standpoint, the exercises are performed at the beginning of a patient visit prior to
manipulative intervention. This reduces the overall resistance of the soft tissues to the
manipulative force, thus allowing that force to assume a more corrective role. Once the
manipulative techniques are administered, the patient then wears the Pettibon Weighting
System while the soft tissue is less resistant. Therefore, in The Pettibon System, all of the
components of the spine are corrected and rehabilitated as a unit, using rehabilitative
procedures designed to target each type of tissue specifically.

Finally, another type of isometric exercise is used to rehabilitate normal spine
alignment. Kendall et al.28 demonstrated this exercise for the treatment of scoliosis, and
Pettibon has slightly modified the performance of these exercises by creating the Linked
Exercise Trainer™ (Fig.5) on which they are performed. The ways in which these
exercises are performed change the functional origin and insertion of the muscle. For
example, the action of a rhomboid muscle is to retract the scapula, when the spinous
processes of the mid thoracic vertebrae serve as the origin. However, when the scapula is
alternatively stabilized as the origin, the rhomboid now pulls on the thoracic spinous
processes, thus acting as a vertebral rotator muscle. Hence, this muscle can be used to
correct evidence of coronal curvatures in that region. Areas of muscle imbalance can
therefore be isolated and strengthened using the Linked Exercise Trainer, thus reinforcing
corrective spinal changes.

Pettibon Radiographic Analysis

For radiographic analysis to be reliable, the quantification of patient progress on
pre- and post-treatment x-rays must not be nullified by inconsistent patient placement.
Harrison et al.18 showed that small deviations in patient placement can alter the amount of
cervical lordosis by 6.9º. A pilot study by Stitzel et al.42 found that inconsistent bite line
positioning on lateral cervical radiographs can result in up to a 20% measurement error.
Therefore, The Pettibon System uses the bite line as a reference point for lateral cervical
radiographs.

The Pettibon System also uses seated x-ray analysis rather than the standard
standing or recumbent positions. From a theoretical standpoint, seated x-rays may reduce
the amount of potential variability in patient positioning because the lower extremity
cannot effect the overall positioning. Furthermore, a seated position increases the stress
on the lumbar spine by 25%. Studies assessing the clinical validity for seated lumbar
films in detecting and grading spondylolistheses are currently being conducted. This
method of patient positioning produces a radiographic measurement error of only onehalf
to two-thirds of a degree in the cervical spine.25

Dynamic radiographic study is also performed in The Pettibon System. Cervical
and lumbar flexion and extension studies help the practitioner locate areas of spinal
instability due to ligamentous disruption. This analysis is performed according to the
American Medical Association’s Guide to the Evaluation of Permanent Impairment1
enabling the practitioner to document soft tissue injuries commonly overlooked in
recumbent and static x-rays.

Testing Prospective Patients for Treatment

Patients presenting to a conventional chiropractic facility will typically provide a
full case history, be subjected to some type of examination including palpatory,
neurological, and orthopedic testing, and undergo special studies such as plain film
radiography, magnetic resonance imaging (MRI), ultrasound, or computerized
tomography (CT). As long as there are no contraindications to manipulative treatment,
such as fracture, malignancy, marked instability, dislocation, or prior surgical
intervention, all patients are accepted for treatment, regardless of prognosis. The Pettibon
System, in contrast, allows for individualized patient testing to help determine, before
treatment begins, whether or not benefits are likely.

This patient testing is performed by weighting the patient’s head and shoulders
according to his/her preliminary x-ray findings. While wearing weights, the patient
performs a series of exercises on the Wobble Chair, followed by specific stretching
exercises. Afterwards, the initial x-rays are retaken, but this time while wearing the head
and shoulderweights. For example, if the patient’s cervical curve improves measurably,
and the forward head posture is reduced, then the patient can be expected to achieve a
significant outcome. However, if the cervical spine measurements worsen, then the
patient does not possess adequate muscle strength and/or endurance. At this time, if the
patient “fails” this test, he/she is not accepted as a candidate for treatment. However, the
patient may elect to participate in a strengthening program for a specified time period.
Once this program is completed, the patient is re-subjected to the testing protocol, and if
improvement is obtained, the patient is then accepted for treatment.

Phase of Care

The Pettibon System is divided up into three distinct phases: acute care,
rehabilitation and correction, and maintenance and supportive care. The goals of the acute
phase, which lasts from 14 to 21 days, include reducing or eliminating the patient’s
symptoms as quickly as possible, improving joint range of motion, and beginning the
restoration of normal sagittal spine alignment. Patients receive training on home care
equipment and procedures that they must do twice daily for strengthening postural
muscles and building endurance. At the end of acute care, patients are re-x-rayed to
assess their progress and qualification for rehabilitation and correction. This phase of care
requires three treatments per week, based upon the common knowledge that muscle
strength gains are achieved when a muscle is fully exercised three times per week.
Rehabilitation and correction continues until normal sagittal and coronal spine alignments
are achieved. This typically takes from 90 days to 24 months, depending upon the extent
of injuries, age of the patient, chronicity of the presenting complaint, and patient
compliance. Finally, maintenance and supportive care focuses upon making the structural
changes long lasting, through weekly workouts using the Linked Exercise Trainer and
training in lifestyle habits to support the patient’s health goals.
Preliminary Data

Although many of the individual parts of The Pettibon System have been peerreviewed,
any treatment method should also seek to provide outcome data on the overall
method to determine effectiveness, risks, side effects, and target populations. To date,
two studies outlining two specific subsets of patient populations have been conducted. In
a progressive study by West et al.46, 200 of a possible 1936 patients met the inclusion
criteria for this study. Of these, 177 participated in the trial intervention. Each patient was
evaluated using a visual analog scale (VAS), range of motion quantification, plain-film
radiography, and CT or MRI to rule out treatment contraindications. These patients were
treated by manipulation under anesthesia (MUA) using The Pettibon System
manipulative methods. Following the full MUA protocol, patients with cervical
complaints reported an average 62.2% improvement in VAS scores, while patients with
lumbar complaints reported a similar 60.1% improvement. A 68.6% decrease in patients
out of work and 64.1% return to unrestricted activity 6 months post-MUA was achieved.
Finally, there was a 58.4% reduction in prescription pain medication usage, and 24%
required no medication six months after the MUA.

A retrospective case series by Morningstar et al.33 followed the results of 22
idiopathic scoliosis patients selected consecutively at three different U.S. chiropractic
clinics. After a maximum of six weeks of treatment using The Pettibon System, an
average 17º reduction in Cobb angle measurements resulted. Although long-term follow
up was not recorded for this study, it does provide hope for an alternative to surgical
intervention.

Conclusion

The Pettibon System is a conservative treatment approach based upon basic
anatomical and physiological processes to correct the structure of the spine. There is little
doubt, according to the literature, that postural and spinal problems play a major role in
the United States, with a large portion of health care spending devoted to musculoskeletal
treatment annually.6 Therefore, it is appropriate to evaluate both the clinical effectiveness
and cost effectiveness of any treatment option. Future studies should also compare the
cost of treatment for The Pettibon System to other treatments using the same outcome
measures.

The advantages of The Pettibon System over other postural treatment methods
center on the utilization of neurophysiology to correct and maintain postural control.
Since posture is under a well-developed network of reflexes, any system recruiting these
postural reflexes to aid in spine and posture correction inevitably addresses more than
just the mechanical components. The effects of The Pettibon System on other
physiological systems are currently being explored. Randomized clinical outcome trials
are also being designed and conducted.

References

1. American Medical Association: Guides to the Evaluation of Permanent
Impairment: 4th ed, Chicago, IL, 1995
2. Bronfort G, Evans R, Nelson B, Aker PD, Goldsmith CH, Vernon H: A
randomized clinical trial of exercise and spinal manipulation for patients with
chronic neck pain. Spine 26:798-799, 2001
3. Cailliet R, Gross L: The Rejuvenation Strategy. Doubleday & Company, Inc.,
Garden City, NY, 1987
4. Cailliet R: Neck and Arm Pain: 2nd ed, FA Davis Company, Philadelphia, PA,
1981
5. Castro WH, Sautmann A, Schilgen M, Sautmann M: Noninvasive threedimensional
analysis of cervical spine motion in normal subjects in relation to age
and sex: An experimental examination. Spine 25:443-449, 2000
6. Cox ME, Asselin S, Gracovetsky SA, Richards MP, Newman NM, Karakusevic
V, Zhong L, Fogel JN: Relationship between functional evaluation measures and
self-assessment in nonacute low back pain. Spine 25:1817-1826, 2000
7. Dulhunty J: A simplified conceptual model of the human cervical spine for
evaluating force transmission in upright static posture. J Manipulative Physiol
Ther 25:306-317, 2002
8. Fedorak C, Ashworth N, Marshall J, Paull H: Reliability of the visual assessment
of cervical and lumbar lordosis: how good are we? Spine 28:1857-1859, 2003
9. Frobin W, Leivseth G, Biggemann M, Brinckmann P: Vertebral height, disc
height, posteroanterior displacement and dens-atlas gap in the cervical spine:
precision measurement protocol and normal data. Clin Biomech 17:423-431,
2002
10. Gardocki RJ, Watkins RG, Williams LA: Measurements of lumbopelvic lordosis
using the pelvic radius technique as it correlates with sagittal spinal balance and
sacral translation. Spine 2:421-429, 2002
11. Gracovetsky S, Newman N, Pawlowsky M, Lanzo V, Davey B, Robinson L: A
database for estimating normal spinal motion derived from noninvasive
measurements. Spine 20:1036-1046, 1995
12. Gray H: Gray’s Anatomy: The Classic Collector’s Edition. Gramercy Books,
New York, NY, 1977
13. Gross AR, Hoving JL, Haines TA, Goldsmith CH, Kay T, Aker P, Bronfort G: A
Cochrane review of manipulation and mobilization for mechanical neck disorders.
Spine 29:1541-1548, 2004
14. Guyton AC, Hall JE: Textbook of Medical Physiology: 9th ed. WB Saunders
Company, Philadelphia, PA, 1996
15. Harrison DD, Harrison DE, Janik TJ, Cailliet R, Ferraentelli JR, Haas JW, et al:
Results of elliptical and circular modeling in 72 asymptomatic subjects, 52 acute
neck pain subjects, and 70 chronic neck pain subjects. Spine 29:2485-2492, 2004
16. Harrison DD, Jackson BL, Troyanovich SJ, Robertson G, DeGeorge D, Barker
WF: The efficacy of cervical extension-compression traction combined with
diversified manipulation and drop table adjustments in the rehabilitation of
cervical lordosis: a pilot study. J Manipulative Physiol Ther 17:454-464, 1994
17. Harrison DD, Janik TJ, Troyanovich SJ, Harrison DE, Colloca CJ: Evaluation of
the assumptions used to derive an ideal normal cervical spine model. J
Manipulative Physiol Ther 20:246-254, 1997
18. Harrison DE, Harrison DD, Janik TJ, Holland B, Siskin LA: Slight head
extension: does it change the sagittal cervical curve? Eur Spine J 10:149-153,
2001
19. Harrison DE, Harrison DD, Janik TJ, Jones EW, Cailliet R, Normand M.
Comparison of axial and flexural stresses in lordosis and three buckled
configurations of the cervical spine. Clin Biomech 16:276-284, 2001
20. Harrison DE, Janik TJ, Harrison DD, Cailliet R, Harmon SF: Can the thoracic
kyphosis be modeled with a simple geometric shape? The results of circular and
elliptical modeling in 80 asymptomatic patients. J Spinal Disord 15:213-220,
2002
21. Harrison DE, Jones EW, Janik TJ, Harrison DD. Evaluation of the axial and
flexural stresses in the vertebral body cortex and trabecular bone in lordosis and
two sagittal cervical translation configurations with an elliptical shell model. J
Manipulative Physiol Ther 25:391-401, 2002
22. Hawk C, Byrd L, Jansen RD, Long CR: Use of complementary healthcare
practices among chiropractors in the United States: a survey. Altern Ther Health
Med 5:56-62, 1999
23. Hawk C, Dusio ME: A survey of 492 US chiropractors on primary care and
prevention-related issues. J Manipulative Physiol Ther 18:57-64, 1995
24. Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG. Manipulation and
mobilization of the cervical spine: a systematic review of the literature. Spine
21:1746-1759, 1996
25. Jackson BL, Barker WF, Pettibon BR, Woggon D, Bentz J, Hamilton D, et al:
Reliability of the Pettibon patient positioning system for radiographic production.
J Vertebral Subluxation Res 4:1, 2000
26. Janik TJ, Harrison DD, Cailliet R, Troyanovich SJ, Harrison DE: Can the sagittal
lumbar curvature be closely approximated by an ellipse? J Orthop Res 16:766-
770, 1998
27. Kapandji IA. The Physiology of The Joints. Volume 3: The Trunk and
Vertebral Column: 5th ed. Churchill Livingstone, pp, 235-236, 1974
28. Kendall FP, McCreary EK, Provance PG: Muscles: Testing and Function: 4th
ed. Williams & Wilkins, Baltimore, MD, 1993
29. Lantz CA, Chen J: Effect of chiropractic intervention on small scoliotic curves in
younger subjects: a time-series cohort design. J Manipulative Physiol Ther
24:385-393, 2001
30. Ledin T, Hafstrom A, Fransson PA, Magnusson M: Influence of neck
proprioception on vibration-induced postural sway. Acta Otolaryngol 123:594-
599, 2003
31. Lewit K: Muscular and articular factors in movement restriction. Manual
Medicine 1:83-85, 1985
32. Morningstar MW, Strauchman MN, Weeks DA: Spinal manipulation and anterior
headweighting for the correction of forward head posture and cervical
hypolordosis: a pilot study. J Chiropr Med 2:51-54, 2003
33. Morningstar MW, Woggon D, Lawrence G: Scoliosis treatment using a
combination of manipulative and rehabilitative therapy: a retrospective case
series. BMC Musculoskelet Disord 5:32, 2004
34. Nicholas SC, Doxey-Gasway DD, Paloski WH: A link-segment model of upright
human posture for analysis of head-trunk coordination. J Vestib Res 8: 187-200,
1998
35. Peterson BW, Goldberg J, Bilotto G, Fuller JH: Cervicocollic reflex: its dynamic
properties and interaction with vestibular reflexes. J Neurophysiol 54:90-109,
1985
36. Peterson C, Bolton J, Wood AR, Humphreys BK: A cross-sectional study
correlating degeneration of the cervical spine with disability and pain in United
Kingdom patients. Spine 28:129-133, 2003
37. Pettibon BR: Chiropractic and Rehabilitation Procedures Re-invented To
Correct The Spine and Posture. The Pettibon Institute, Gig Harbor WA, 1994
38. Pettibon BR: Pettibon Spinal Biomechanics: Theory and Implications.
Pettibon Biomechanics Institute, Tacoma, WA, 1978
39. Pompeiano O, Allum JHJ: Vestibulospinal Control of Posture and
Locomotion: Progress in Brain Research: Volume 76. Elsevier Science
Publishers, 1988, pp 137-143
40. Saunders ES, Woggon D, Cohen C, Robinson DH: Improvement of cervical
lordosis and reduction of forward head posture with anterior headweighting and
proprioceptive balancing protocols. J Vertebral Subluxation Res 4:E1-5, 2003
41. Schieppati M, Nardone A, Schmid M: Neck muscle fatigue affects postural
control in man. Neuroscience 121:277-285, 2003
42. Stitzel CJ, Morningstar MW, Paone PR: The effects of bite line deviation on
lateral cervical radiographs when upper cervical joint dysfunction exists: a pilot
study. J Manipulative Physiol Ther 26:E1-7, 2003
43. Toppenberg KS, Hill DA, Miller DP: Safety of radiographic imaging during
pregnancy. Am Fam Phys 59:1813-1818, 1999
44. Troyanovich SJ, Cailliet R, Janik TJ, Harrison DD, Harrison DE: Radiographic
mensuration characteristics of the sagittal lumbar spine from a normal population
with a method to synthesize prior studies of lordosis. J Spinal Disord 10:380-
386, 1997
45. Weigand R, Kettner NW, Brahee D, Marquina N: Cervical spine geometry
correlated to cervical degenerative disease in a symptomatic group. J
Manipulative Physiol Ther 26:341-346, 2003
46. West DT, Mathews RS, Miller MR, Kent GM: Effective management of spinal
pain in one hundred seventy-seven patients evaluated for manipulation under
anesthesia. J Manipulative Physiol Ther 22:299-308, 1999
47. White AA, Panjabi MA: Clinical Biomechanics of The Spine: 2nd ed.
Lippincott, Williams & Wilkins, Philadelphia, PA, 1990
48. Wilson VJ, Boyle R, Fukushima K, Rose PK, Shinoda Y, Sugiuchi Y, Uchino Y:
The vestibulocollic reflex. J Vestib Res 5:147-170, 1995
49. Yoganandan N, Knowles SA, Maiman DJ, Pinter FA: Anatomic study of the
morphology of human cervical facet joint. Spine 28:2317-2323, 2003

Commonly, people living with scoliosis dread x-rays. After seeing their condition steadily deteriorate with x-ray each series, combined with the fear of too much radiation, some patients are reluctant to have more x-rays taken. But before you hesitate to undergo alternative scoliosis treatment for this reason, please consider the following facts about scoliosis x-rays.

1. According to a study published in August of 2000 in the Journal of Radiology, “Patients undergoing scoliosis radiography receive doses that are low in comparison with other types of radiographic examination.” A similar study published that same month in Spine found that patients with scoliosis that received fifty or more x-rays from 1912-1965 had a risk of dying from breast cancer that was four times higher than non-x-rayed patients. At that time, there was a need for caution, since standard films were taken at 0.6 cGy (centigray). Today, films are shot with only 0.02 cGy – thirty times less than in the past. To achieve the same level of exposure, over 1500 x-rays would have to be taken on one patient. Pediatric x-rays are shot at an even lower level of magnitude.
2. When taking a precision x-ray – that is, one not to rule out fractures or abnormalities, but rather to measure the position of the spinal units – positioning matters more than one might think. Even a slight rotation off from center will skew the results and show an inaccurate image. For this reason, we must be very concerned about how the x-rays were taken. They must allow an objective outcome assessment. X-rays from other sources oftentimes can be unreliable if they are shot at different angles or focal distances, which prevent comparison between films. For this reason, a special device is used to assure accurate findings.
3. X-rays allow us to measure and quantify the results of treatment, and determine if alterations to existing treatment protocols are necessary. If you are seeking chiropractic care for your scoliosis, you should insist upon x-rays that are accurate and scientific; follow-up films should be taken every three months, and always in the exact same positioning. At the Scoliosis Rehabilitation Center, x-ray positioning is of paramount importance. Once proper films are taken, the correct treatment protocol can be instituted.

In achieving correction of the scoliotic spine, it is important to place emphasis on correcting the loss of cervical curve, also known as cervical kyphosis or hypolordosis. Loss of the curve in your neck will cause the spine below it to buckle. Traditional medical science views the spine as a bridge connecting the head to the pelvis. If a bridge begins to collapse, the correct approach is to try to hold it together by fusing its structure. Chiropractors, however, view the spine as an engine. If the engine in your car starts to run funny, and you fuse the cylinders together, this might not solve the problem. Motion is essential for proper functioning of the spine and the associated soft tissue components.

The reason your spine buckles as the curve in your neck disappears has to do with physics. When you carry your groceries in to your house from your car, you carry the bags close to your body. Increasing the distance between your body and the bags of groceries causes an increase in the apparent weight of your burden. In the same way, holding your head forward puts a greater stress upon your spine. In fact, for every inch the head moves forward from your center of gravity, the apparent weight of your head increases by 10 pounds!

One of the easiest ways for the body to adapt to this increased load is to add another curve into the spine. If you are holding a heavy weight in your hand and flex your wrist forward, your elbow will swing out to the side to make it easier for your muscles to support the weight. With our alternative scoliosis treatment, you can correct the scoliosis without bracing.

Why does the curve in your neck disappear?
There may be many different reasons. Sometimes it is a motor vehicle crash, or an incident of trauma. More often, however, it may develop slowly, over time, as we live day-to-day. Studying in school, working at a computer, or focusing on a project on our workbench often requires that we hold our head downwards and forwards for long periods of time. Eventually, this causes the spine to slip, bit by bit, until the muscles become tight and strong. The body then begins to use these stronger muscles more than the weaker ones, reinforcing the change in posture. With the loss of the curve in your neck, the nerves that travel from the brain to every single cell in our body begin to suffer. In a straight neck, with no curve at all, the spinal cord is stretched by 10%. If the neck buckles completely, this can increase to as high as 28%! If somebody pulled on your finger until it was 28% longer, you’d probably complain about it a little.

(Somewhere, something went terribly wrong…)

Why do the doctors at the Scoliosis Rehabilitation Center know that restoring the curve in your neck can help to correct a scoliosis?

Well, there is research that suggests scoliosis may correct spontaneously if the tension from the spinal cord is removed:

Can Hindbrain Decompression for Syringomyelia Lead to Regression of Scoliosis?

European Spine Journal, June 2000; 9(3):198-201
“[16] patients underwent a hindbrain decompression, and… the scoliosis was seen to improve or arrest its progression in 6.”

And other researchers have concluded that the spine adapts to a short, taut spinal cord by producing rotation in the spinal column, which will take pressure off of the nerves.

Can a Short Spinal Cord Produce Scoliosis?

European Spine Journal, February 2001; 10(1):2-9
“A short, unforgiving spinal cord could produce the abnormal rotatory anatomy observed at the apex of scoliosis…”

Of course, restoring the curve in the neck is only one aspect of our unique approach to scoliosis. Rehabilitating the muscles, tendons, & ligaments is also important, as is re-training the brain to use the postural muscles more evenly. For now, we hope you understand more about how what happens in the neck can affect the rest of the spine, and why it is important not to neglect the top of the spine in scoliosis correction!

CURVE PATTERNS IN IDIOPATHIC SCOLIOSIS

“The results of these studies are known as Euler’s laws and may be used to predict the behaviour of any column of known shape and proportions. The behaviour of curved columns differs from that of straight ones and may be summarized by saying that if force is applied to a rigid curved column so as to tend to increase that curve, then no lateral deviation or twisting of the column will occur even if the force is increased until brittle failure occurs. By contrast, if force is applied so that it tends to straighten the column, then twisting and lateral bending will occur during the phase of plastic deformation.

An example of this is the ease with which a metal rod may be bent to contour it to the spine in comparison with the difficulty of straightening it thereafter. The application of these laws to spinal mechanics is clear and has been stated before. However, if a fixed lordosis is subjected to forward bending it will behave like any other curved column when it is stressed to unbend it: it will twist and bend to the side. A scoliosis must result. If a further bending force is applied, for example by asking a patient with a lordoscoliosis to touch her toes, this rotation will increase; this is the mechanical basis of the clinical test of forward bending.

The practical importance of an understanding of the underlying sagittal profile of a scoliotic spine is in its application to the treatment of these deformities. If an abnormal sagittal profile is merely converted to a different abnormal profile, as with Harrington instrumentation, then further buckling and progression of the curve may be anticipated during growth.
Here is more factual information about Scoliosis with which to make informed decisions.

• “The mortality rate (with AIS)(Adolescent Idiopathic Scoliosis) is 15 %”.  “Individuals with Scoliosis life expectancy is decreased by 14 years”: idiopathic scoliosis:long term follow-up and prognosis in untreated patients. J.Bone Joint Surg Am 1981 Jun;63(5):702-12
• “The effects: Reduced life expectancy, it can stunt growth and decrease pulmonary function. It’s associated with headaches, shortness of breath, digestive problems, chronic hip, knee and leg pain”.  National Scoliosis Foundation.
• “The Scoliotic Group was characterized by a decrease in standing stability.  Center of Mass (COM) and Center of Pressure (COP) were significantly different between the scoliotic group and the norm.” Spine 27(17):1911-1917; 2002
• Scoliosis is not only a deformation of the spinal column, it is also a disease of the neuro-musculo-skeletal system.  Scoliosis is more than a  3-dimensional deformation of the spine.  It also involves postural disorganization, neuro musculo-skeletal dysfunction and unsynchronized growth patterns. IS (idiopathic scoliosis) could be reinforced by a disrupted integration of vestibular and visual signals at the cortical level”.  vestibular mechanisms involved in IS: Arch Ital Biol 2002 Jan; 140(1) 67-80

WHY OUR SCOLIOSIS TREATMENT IS DIFFERENT!

The work we are doing is based on the fact that scoliosis is not just a spinal curvature, but involves abnormal spinal curves in the neck, as well as hip rotation. Active scoliosis patients always present to the office with forward head posture and a loss of the cervical lordosis (as seen on x-ray).  In addition, there is also abnormal biomechanical malpositions of the head and neck. Therefore, before the A-P dimension of scoliosis (the lateral curve you are concerned with) can be corrected, the cervical lordosis must be re-established first. Following this correction, the lateral curve (Cobb angle) is reduced to normal or as close to normal as possible.

Average change with the work we do is a 62 % reduction (permanent, if exercises are done) of the Cobb angle.

Please contact us for an in-depth consultation and examination to determine if our method of treating scoliosis non-surgically is right for you.

These results are achieved with a combination of specific spinal adjustments done with instruments, not by hand, specific rehabilitative procedures including proprioceptive neuromuscular re-education, muscle and ligament rehab and vibration therapy.The scoliotic spine compresses and rotates three dimensionally, therefore it must be de-rotated, and de-compressed in order to achieve correction. At the Scoliosis Rehabilitation Center, we use a vibration platform and vibration scoliosis traction chair as well as specific techniques to pull the Cobb angle back into proper alignment.

• “There were five times more back surface abonormalities in the blind population. These findings are compatible with a postural etiology of scoliosis in the visually impaired”. Conversely there is a decreased incidence of scoliosis in hearing impaired children”; visual deficiency and scoliosis; spine 2001, jan 1;26(1):48-52  what this means is that scoliosis is more than just a twist of the spine but something involving the vestibular system and those that are blind have a higher incidence of scoliosis because of the loss of balance etc with the loss of sight whereas those that can see but can’t hear show a decreased incidence since their balance and coordination is usually better than normal.

• “After brace treatment we found slight statistically significant increase in the mean lumbar curvature, but no significant change in the mean thoracic curve.” changes in curve pattern after brace ( Boston Brace) treatment for IS. Acta Orthop Scand 2002 jun 73(3): 277-81

• “Progression of 6 degrees occurred in 74% of boys and 46% reached surgical thresholds.  Bracing of male patients with idiopathic scoliosis is ineffective. Curves measuring >/=30 degrees were very likely to progress to surgery ; effectiveness of bracing male patients with idiopathic scoliosis. Spine Sep 15;26(18);2001-5

• “Since 1991, bracing has not been recommended for children with AIS at this center.  If bracing does not reduce the proportion of children with AIS who require surgery for cosmetic improvement of their deformity, it cannot be said to provide meaningful advantage to the patient of the community”; adolescent idiopathic scoliosis: the effect of brace treatment on the incidence of surgery. Spine 2001 Jan1;26(1)42-7 Children’s Research Center, Dublin, Ireland.

• “The deterioration of the curves was 3.5 degrees for all surgically treated curves and 7.9 degrees for all brace treated curves. Five brace treated patients had a curve increase of 20 degrees or more”. Radiologic findings and curve progression 22 years after treatment for AIS: comparison of brace and surgical treatment with matching control group of straight individuals. Spine 2001 Mar 1;26(5):516-25

Scientific studies have confirmed that there is a direct correlation between a patient’s perception of their health as measured by a health questionnaire, their mortality rate, and the severity of their scoliosis. In other words, the larger the degree of curvature, the more the scoliosis impacts your overall health and well-being, and reduces your lifespan.

Obviously, every degree of correction counts! But what is the real cost, per degree? Let’s take a moment to examine the value of various methods of scoliosis treatment as applied to a hypothetical patient with a 50 degree Cobb angle.

Harrington Rod Surgery:
At a cost of roughly $120,000, the surgeon performing the operation will aim to reduce the curvature by roughly 50%. So the cost involved would be $4,800 per degree of correction, and the correction achieved has been shown to be temporary. Curves will continue to worsen after surgery, by about one degree per year.

Typical Chiropractic Care for scoliosis:
In one study, participants averaged 1.4 degrees of correction after one year of “standard” chiropractic care. If one year of non-intensive chiropractic care is roughly $10,000, then this works out to about $10,000 per degree of correction… not to mention the time investment!

Scoliosis Bracing:
This is a trick question – bracing will never reduce the severity of scoliosis, and whether or not it even stops progression is heavily debated amongst orthopedic surgeons. But for our purposes, the value of bracing cannot be determined, because it is impossible to divide any cost by zero.

At the Scoliosis Rehabilitation Center, costs start at approximately $3,000 for one week of intensive care to $9,000 for two weeks of intensive care including a scoliosis traction chair for your home.  We also have longer comprehensive care plans for patients who live closer to Greenville.  Assuming the patient achieves results exactly equal to our average amount of correction, 62% of their scoliosis would be corrected after treatment (from 50 degrees down to 19). Value: $384 per degree of correction, 9.75% of the price per degree of correction when compared to surgery.

Bottom Line: Our method of scoliosis correction is both non-invasive and significantly less expensive than traditional treatments.

A Recent Email To Us:
Hi, I am doing a project on scoliosis for school, and not to long ago my cousin had surgery to correct her scoliosis and she became paralyzed from the waist down. And i was just wondering if you know of anything that can lessen the chance of becoming paralyzed during surgery? Thanks!
~Anonymous

The success of our scoliosis treatment, warrants a serious investigation prior to allowing any invasive procedure to be performed on yourself or a loved one.

After a few minutes spent reviewing internet sites devoted to scoliosis, you might end up feeling rather depressed and overwhelmed by the mass of contradictory and unscientific information to be found. It is no small wonder that so many scoliosis surgeries take place every year – from what you read on the internet (which is really the largest library in the world!), it seems to be the only option.

One study entitled, “Surfing for Scoliosis: the quality of information available on the internet,” the authors came to the conclusion that, “The information about scoliosis and scoliosis treatment on the Internet is of limited quality and poor informational value.”

The only website which earned their praise was the official Web site of the Scoliosis Research Society; this website is, of course, heavily biased towards traditional approaches such as bracing & surgery. It should not surprise us that this study was conducted by the Department of Orthopedic Surgery at Downstate Medical Center in Brooklyn, New York.

However, the true effectiveness of the Harrington Rod surgery does not live up to the claims. Curves progress even in surgically treated patients; “Initial average loss of spinal correction post-surgery is 3.2 degrees in the first year and 6.5 after two years, with continued loss of 1.0 degree per year throughout life.“

This is a mixed message, to say the least.

This is why the Scoliosis Rehabilitation Center is excited to promote the teachings and philosophy of the CLEAR Institute: there is a non-surgical treatment for scoliosis, with no psychological or physical scarring, that achieves lasting, positive results! This is the best alternative scoliosis treatment available. It is this message of hope that defines who we are, even more so than the results we achieve.

If you or someone you know is suffering from the all-too-real side effects of scoliosis, please take a moment to review the information about scoliosis on this site. We update our site with new information as often as possible. Call today to schedule an appointment, and keep an open mind to the alternative types of treatment that we may suggest. At the Scoliosis Rehabilitation Center, we understand that historical approaches to scoliosis have failed to achieve lasting results. You are probably frustrated about your past treatment options. Well, it is now time for action. Call (252-321-3579) or email for a consultation. One will be scheduled as soon as possible.

For more evidence that bracing is ineffective, let’s look to a study published on March 15, 1997, from the Ste. Justine Hospital in Quebec:

“Boston brace treatment produces complex trunk motions that tend to shift the spine and rib cage anteriorly [forward], with little derotation and lateral displacement to the left, whereas ideal correction would be the opposite [emphasis added].”

“A more optimal way to achieve trunk corrections could be made by applying loads laterally on the convex side and on the anterior thoracic [front of the chest] opposite the rib hump, with a system that constrains mechanically the posterior rib hump from moving backwards.”

This study, and others like it, led to the development of the Scoliosis Traction Chair that we use at the Scoliosis Rehabilitation Center and that the CLEAR Institute designed and patented in 2004. Why did it take seven years for someone to act on the idea that scoliosis could be corrected biomechanically? Maybe it’s because when all you have is a hammer (or scalpel), every problem looks like a nail (or patient in need of surgery!).

Comment from one of our lovely patients:

I found out from my family physician that I had scoliosis.  I did some research online and found out that my choices were bracing or surgery.  I’m pretty young and wasn’t ready to have major spinal surgery.  I found the CLEAR-Institute website.  I called and got information from them.  They recommended Dr. Kean.  After 3 months of scoliosis treatment therapies I have had a 17 % reduction in my scoliosis curve.  I am currently treating there and look forward to seeing my improvement at my next re-exam.  ~ Amy R.

I have scoliosis.  I had previously seen a few other chiropractors.  I found Dr. Kean on the internet.  He helped my condition.  It has improved through treatment so well that I am back to my usual activities (swimming, school, and work).  I have no more pain when carrying out everyday activities.  My words of encouragement are:  Chiropractic Works! ~ Lindsey A.

It’s time to take a new look, from a fresh perspective. The training we have received at the CLEAR Institute has given us a unique understanding of the mechanics and physics involved in the spine that many other healthcare practitioners, and unfortunately even many other chiropractors do not.

Please do not make the mistake of assuming that, simply because your family doctor is unaware of alternatives, they do not exist, or they are unscientific. You might be surprised by how much science is involved in chiropractic.

By the way, the above study was compiled and performed by the Department of Mechanical Engineering. When it comes to scoliosis, physicists are closer to hitting the mark than the physicians designing these braces!

After being diagnosed with scoliosis, bracing is often the next traditional treatment method recommended. Here’s a typical story that we often hear – being told by a scoliosis patient.

This is my scoliosis story………….

This was my third time to the orthopedic doctor’s office.

We had just been waiting and watching my curve get worse. I was hoping that he would finally do something! It was that doctor who told me I needed a back brace. After a few tears streaked down my face he handed me a box of tissues and said, “You’re being very brave, you won’t regret your decision. This is typical protocol. Just make sure you wear it as recommended”.

So I went to another specialist who measured me and fitted me into the torture device that they like to refer to as a back brace. I had to “break myself into it” by wearing it for one hour the first night, then for an extra hour the next, a few more the day after that, until I was used to wearing the brace for twenty-three hours a day. In that one hour of freedom, I was supposed to work out and shower.

I looked ridiculous in my back brace. It stuck out from my shoulders, and pushed the top half of my butt down. I couldn’t breath, could hardly walk, and had a hard time sitting down. Every time I sat down in my desk for class, I had to shimmy myself up out of it so I didn’t pinch my chest. I was incredibly self-conscience. I wore loose clothes and big sweaters with hoods to hide my hunch-looking back. This happened in high school, and it was terrible. I felt like I was walking like a robot. I was constantly out of breath and unable to catch my breath because there was no room for my ribcage to expand and make room for my lungs. People would knock on the front of it and call me plastic-abs. I pretended not to mind, but the constant comments penetrated deep. I couldn’t sleep. I would toss and turn to no avail trying to find comfort. When it got warmer, I still wore huge sweaters to attempt to hide my back brace and would overheat. It pinched my left sciatic nerve and I was constantly in pain. I had to quit orchestra because I couldn’t play the violin and breathe at the same time. During gym, I had to struggle to strap myself back into the back brace without the help of a parent and answer awkward questions about what on earth I was wearing. During this time of my life, I was constantly looking up different surgical procedures online to try and find an alternative solution so I wouldn’t have to wear this brace anymore.

The summer in between high school and college, my back started bothering me. I felt awkward and uncomfortable in my own body – whether attempting to do sports, sitting down, standing at work, or just plain lying down to sleep. I had a bad feeling that things were worsening, so I went back to the doctor. I heard him and some nurses whispering in the hall about my condition, as if I were some kind of odd creature, poor and condemned to a horrible fate. I cried and felt betrayed by him, and also by my own body. My scoliosis had progressed, but he assured me that there was nothing I could do, and that the progression was slight. I started doing some additional research and found out that many times back braces end up making things worse – causing muscle atrophy and essentially ruining any kind of support I may have had on my own before the ‘treatment’.

After a year and a half of wearing the brace, the post films showed that my curvature had progressed past 40 degrees and the surgeon really started to push my mom and dad to have the surgery as soon as possible. I thought the surgery was inevitable. On that day, I discovered CLEAR Institute’s alternative treatment for scoliosis.

View the entire Possibilities for the Reduction and Correction of Scoliosis Brochure – View PDF

Introduction

Scoliosis is estimated to affect 4.5% of the general population. In a nation of approximately 273 million people, this means that over 12 million cases of scoliosis exist, and almost 500 more are diagnosed each day – about 173,000 every year. According to some studies, the average scoliosis patient will suffer a 14-year reduction in their average life expectancy1. This means that if by some miracle we could eliminate scoliosis completely, this would add 168 million years of health and productivity to our society.

Clearly this is not a minor issue, but an epidemic, and one that should be taken very seriously. Finding a proven and cost-effective method of treating scoliosis should be the chiropractic profession’s top priority. Until we have done so, I do not believe that any chiropractor in the world has the right to describe themselves as “spinal experts.” There are no scoliosis experts. If there were, there would be no scoliosis patients.

The information provided here is intended to be the first step in a long journey towards coordinating the care and correction of scoliosis patients throughout the world. Please consider it carefully, evaluate the alternatives, and then make a conscious and deliberate decision on its validity. For too long, professional jealousy and the status quo have dominated all facets of the health care profession. It is time to refocus on the real reason this profession exists – to serve our patients. Let us place the health and well being of those who have been entrusted to our care before any personal considerations, and work together to find the most effective cure for every condition.

Scoliosis Surgery: the Untold Truth

Every year in the United States, roughly 20,000 Harrington rod implantation surgeries are performed on patients with scoliosis, at an average cost of $120,000 per operation. One-third of all spinal surgeries are performed on scoliosis patients.
Every year, about 8,000 people who underwent this surgery in their youth for the
correction of their scoliosis are legally defined as permanently disabled for the rest of
their lives8. Even worse, follow-up x-rays performed upon these individuals reveal that,
an average of 22 years after the surgery was performed, their scoliosis has returned to
pre-operative levels. The Harrington rods inserted into their spines will either bend,
break loose from the wires, or worse, break completely in two, necessitating further
surgical intervention and removal of the rod. Once the rod is removed, corrosion (rust) is
found on two out of every three.

After the operation is performed, the average patient suffers a 25% reduction in their spinal ranges of motion. Non-fused adult scoliosis patients do not have this same impairment. This flatly contradicts the claim that having a steel rod fused to your spine will not affect your mobility, physical activities, or quality of life. These facts are never shared with the patient prior to the surgery. Parents do not choose the Harrington rod implantation procedure because it is the best choice for their son or daughter, but rather because they are misled into believing that it is the only choice. However, many studies suggest that the side effects of the surgery are worse than the side effects of the scoliosis itself.

Consider the titles & conclusions of the following studies:

Treating Scoliosis in Young Unneeded
Journal of the American Medical Association (JAMA), Stuart Weinstein, MD, University
of Iowa, 2003.
“Many with curvature of spine go on to lead normal lives. Many adolescents
diagnosed with spine curvatures can skip braces, surgery or other treatment without
developing debilitating physical impairments, a 50 year study suggests.”

Long-term results of quality of life in patients with idiopathic scoliosis after
Harrington instrumentation and their relevance for expert evidence.
Gotze C, Slomka A, Gotze HG, Potzl W, Liljenqvist U, Steinbeck J.
Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8
“CONCLUSION: Forty percent of operated treated patients with idiopathic
scoliosis were legally defined as severely handicapped persons 16.7 years after the
surgery.”

Medical Complications in scoliosis surgery
Curr Opin Pediatr 2001 Feb;13(1):36-41

“[Complications] include the syndrome of inappropriate antidiuretic hormone, pancreatitis, superior mesentaric artery syndrome, ileus, pnemothorax, hemothorax, chylothorax and fat embolism. Urinary tract infections, wound infection and hardwarefailure are not addressed.” [They were not addressed because happened so often!]

Results of Surgical Treatment of Adults with Idiopathic Scoliosis
J Bone Joint Surg AM 1987 Jun;69(5) :667-75 Sponseller, Nachemson et al,
“Frequency of pain was not reduced… pulmonary function did not change… 40%
had minor complications, 20% had major complications, and… there was 1 death [out of
45 patients]. In view of the high rate of complications, the limited gains to be derived
from spinal fusion should be assessed and clearly explained to the patient.”

Corrosion of spinal implants retrieved from patients with scoliosis
Akazawa T, Minami S, Takahashi K, Kotani T, Hanawa T, Moriya H.
Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-
1 Inohana, Chiba, 260-8670, Japan. J Orthop Sci. 2005;10(2):200-5.
“Corrosion was seen on many of the rod junctions (66.2%) after long-term
implantation.”

Scoliosis curve correction, thoracic volume changes, and thoracic diameters in
scoliotic patients after anterior and posterior instrumentation
Int Orthop 2001;25(2):66-0
“The correlation between the change in Cobb angle and the thoracic volume
change was poor for both groups.” [e.g., whether fused in the front or back of the spine,
surgery will not improve cardiopulmonary function.]

Radiologic findings and curve progression 22 years after treatment for AIS
Spine 2001 Mar 1;26(5):516-25
“Initial average loss of spinal correction post-surgery is 3.2 degrees in the first year and 6.5 after two years with continued loss of 1.0 degrees per year throughout life.” [So, if a 50 degree Cobb angle is corrected by surgery to 25 degrees, it will return to its pre-operative condition of 50 degrees after roughly twenty years.]

Prospective Evaluation of Trunk Range of Motion in AIS Undergoing Spinal Fusion
Spine 2002 Jun 15;27 (12) :1346-54 Engsberg et al, Wash U, St. Louis, MO
“Whereas range of motion was reduced in the fused regions of the spine, it was
also reduced in un-fused regions [emphasis added]. The lack of compensatory increase
at un-fused regions contradicts current theory.”

Health-related quality of life in patients with AIS; a matched follow-up at least 20
years after treatment with brace (BT) or surgery (ST)
European Spine Journal 2001; Aug; 10(4): 278-88
“49% of surgically-treated patients admitted limitation of social activities due to
their back.”

Paul Harrington, known for inventing the surgery that implants metal rods in
scoliotic spines, stated in 1963 that, “metal does not cure the disease of scoliosis, which
is a condition involving much more than the spinal column.”

Below is the overview from a case study of scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series.

Here is a link to the full Scoliosis Case Study – View PDF

Abstract Background

The combination of spinal manipulation and various physiotherapeutic procedures used to correct the curvatures associated with scoliosis have been largely unsuccessful. Typically, the goals of these procedures are often to relax, strengthen, or stretch musculotendinous and/or ligamentous structures. In this study, we investigate the possible benefits of combining spinal manipulation, positional traction, and neuromuscular reeducation in the treatment of idiopathic scoliosis.

Methods

A total of 22 patient files were selected to participate in the protocol. Of these, 19 met the study criterion required for analysis of treatment benefits. Anteroposterior radiographs were taken of each subject prior to treatment intervention and 4-6 weeks following the intervention. A Cobb angle was drawn and analyzed on each radiograph, so pre and post comparisons could be made.

Results

After 4-6 weeks of treatment, the treatment group averaged a 17° reduction in their Cobb angle measurements. None of the patients’ Cobb angles increased. A total of 3 subjects were dismissed from the study for noncompliance relating to home care instructions, leaving 19 subjects to be evaluated post-intervention.

Conclusions

The combined use of spinal manipulation and postural therapy appeared to significantly reduce the severity of the Cobb angle in all 19 subjects. These results warrant further testing of this protocol.

J Bone Miner Res.  2004; 19(3):352-9 (ISSN: 0884-0431)

Verschueren SM; Roelants M; Delecluse C; Swinnen S; Vanderschueren D; Boonen S
Laboratory of Motor Control, Department of Kinesiology, Faculteit Lichamelijke Opvoeding en Kinesitherapie, Katholieke Universiteit, Leuven, Belgium.

High-frequency mechanical strain seems to stimulate bone strength in animals. In this randomized controlled trial, hip BMD was measured in postmenopausal women after a 24-week whole body vibration (WBV) training program. Vibration training significantly increased BMD of the hip. These findings suggest that WBV training might be useful in the prevention of osteoporosis.

INTRODUCTION: High-frequency mechanical strain has been shown to stimulate bone strength in different animal models. However, the effects of vibration exercise on the human skeleton have rarely been studied. Particularly in postmenopausal women-who are most at risk of developing osteoporosis-randomized controlled data on the safety and efficacy of vibration loading are lacking. The aim of this randomized controlled trial was to assess the musculoskeletal effects of high-frequency loading by means of whole body vibration (WBV) in postmenopausal women.

MATERIALS AND METHODS: Seventy volunteers (age, 58-74 years) were randomly assigned to a whole body vibration training group (WBV, n = 25), a resistance training group (RES, n = 22), or a control group (CON, n = 23). The WBV group and the RES group trained three times weekly for 24 weeks. The WBV group performed static and dynamic knee-extensor exercises on a vibration platform (35-40 Hz, 2.28-5.09g), which mechanically loaded the bone and evoked reflexive muscle contractions. The RES group trained knee extensors by dynamic leg press and leg extension exercises, increasing from low (20 RM) to high (8 RM) resistance. The CON group did not participate in any training. Hip bone density was measured using DXA at baseline and after the 6-month intervention. Isometric and dynamic strength were measured by means of a motor-driven dynamometer. Data were analyzed by means of repeated measures

ANOVA. RESULTS: No vibration-related side effects were observed. Vibration training improved isometric and dynamic muscle strength (+15% and + 16%, respectively; p < 0.01) and also significantly increased BMD of the hip (+0.93%, p < 0.05). No changes in hip BMD were observed in women participating in resistance training or age-matched controls (-0.60% and -0.62%, respectively; not significant). Serum markers of bone turnover did not change in any of the groups.

CONCLUSION: These findings suggest that WBV training may be a feasible and effective way to modify well-recognized risk factors for falls and fractures in older women and support the need for further human studies.