Help!

[flerc]

4) Genetic cause could be seen as a current cause or only as an original or historically cause?
Many doctors when don’t know the reason of a problem says that is genetic and game over. Since genes could not be altered (could not?), nothing to do.
Some doctors are saying that about scoliosis and could it be right, but don’t explain what type of cause could it be, at least I could not understand it http://www.sciencedaily.com/releases...0226204549.htm
I don’t know nothing about genetic but I imagine it determine the way in which column would be formed until her completely development. But after, when growth is finished?
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I’m trying to understand the reasons for which many doctors say that is IMPOSSIBLE to reduce significant amount of degrees in a permanent way after growth is finished with conservative treatments. In fact it must to be defined what means permanent for each one.

If just when growth finished would exists a great vertebral wedge, it would seems an evident fact. A column could be seen as a stuck of vertebral bodies and if its has not the same height in both side, is difficult to imagine that stuck straight (unless strong muscles could do that anyway?)
So

5) Always then growth is finished with a severe scoliosis, it exists a great vertebral wedge?
Why it not exist during growing, or it exists? If exist (even a little less) during growth, how could it be than curve could be corrected in this time and not then?
How great it supposed to be finished growth, how could be determined in each case? What about metrics?
Is it like I imagine, only a (simple) matter of geometry to determine the limit of degree's reduction, knowing the height difference in both sides of each vertebra?

6) Why growth’s curve stopped just with column’s growth?
So related with last question, in fact it could be named as 5) a)

If vertebral wedge would be so terrible, it would be a logical reason, because if only the convex side of the vertebra growths, until it not finish, the curve obviously remains growing and then would stop.
But if it’s not so terrible, which could be the reason?
I think it is a gravitate matter. When a curve is done, gravitate force is decomposed in two forces: one vertical and the other horizontal.
During growth, vertebras must to displace inside the trunk (or with it), ever up in a normal column, but if for some unknown reason a curve exists, horizontal force pull its to side and then curve growth, because that force has not an opposite one, unless a brace, (that perform an external force) is used. When growth is finished, vertebras do not displaced any more and curve stops.
I’ think it seems reasonable since mammals has not scoliosis.. unless Sastre (Fed machine) take it’s for experiments.. It could be a different reason (but not opposite) of what he says about the growth’s cartilage in inter vertebral disk space.
I’m right?

[flerc]

4) Genetic cause could be seen as a current cause or only as an original or historically cause?

Saying it in other way: if we want to reverse scoliosis after growth, would be any genetic reason than obstruct that objective, as without any doubt, exists many reasons of other type?

During growth, vertebras must to displace inside the trunk (or with it), ever up in a normal column, but if for some unknown reason a curve exists, horizontal force pull its to side and then curve growth,...

In fact I belive is not only a matter of gravity lateral force, but a more complex physics problem which leads than if a curve line, find some kind of resistance in its extremities during its growth, then that line will growth in a more curve way.
But in any way, it could be seen as a lateral force that must to have an opposite one.

...because that force has not an opposite one, unless a brace, (that perform an external force) is used.

I know that braces not allways works. I have heard many times that sometimes trunk growth up, but curve growth too, so vertebras move inside the trunk in a lateral way.
In fact brace it is not the only way to apply external forces and internal forces could fight against the horizontal force too.
I think that in fact, brace apply an external force over trunk and no a direct one over column, as only surgery, gravity and inertial forces (Drop table technique) could do.

[flerc]

In some scoliosis, curve could continue growing after growth. Statistically it occurs in severes curves. Sometimes I have read about it as if it would be a mystery, surely attributed to be the same unknown original cause (that performs the first degrees, triggering all what comes then, as Sastre says?) that remains after growth, being then the current cause.

But again could be another physician reason involving gravity:
The resistance of any column decrease when curve increase because the lateral component of the gravity force increase. There is an increasing function between lateral component and Cobb angle. It’s not a lineal function and I have stopped this investigation that physics an engineers sure knows, but knowing that function could be determined an angle, that probably beyond it, lateral component’s growth, increase suddenly and dramatically, so column’s resistance would decrease in the same way, allowing curve to growth again.
That is what I mean with the critic angle, that some statisticals determine it as 40º, 45º, or 50º and surely is not the same definition for all surgeons who often recommend surgery according to that degrees (at least in my country). Surely other factors determine this critic angle as curve type, vertebras involved, plumbline test..
Of course as during growth, nothing is static but dynamic, so as much great the curve, much great biomechanical unbalance would exists (somebody said me that the critic angle for that unbalance is about 30º). And also in a static way, wright or bad posture would influence in that critic angle definition en each case, but
8) (for physicians) which is the function between gravity lateral component and Cobb angle?
9) (for doctors?) which is the function between that lateral force and column’s resistance?

I know that not only biomechanical unbalance and bad postures would increase that lateral force. In fact I think that in all scoliosis diagnosed as idiopathic, some causes as non idiopathic ones could be present, as neurological-muscle system disorders, vestibular system, structure problems as length difference in legs… genetic too, but depending on answer to question 4), genetics would not affect after growth, so all these factors contributes to increase lateral force but could not be considered a primitive cause, that is, if lateral gravity force could not affect column’s resistance (as it seems to happened after fusion), none of these factors would lead to increasing degrees over time.
Internally I’m sure that if my daughter could live all her life in the moon (regardless negative effects in muscles because almost gravity absence) her degrees would never increase.
Of course I could not expect some kind of possibilities, but is important to know if
10) Could it be that increasing degrees over time in sever scoliosis after growth would be only a matter of gravity force?.
Surely it’s a so difficult question to be answer in a categorist way, but could be that some research performed about column resistance and so on exists, over which could be concluding that, these kind of force could be sufficient to do that or not .

[flerc]

I have more questions to do, but I don’t know if I’m being sufficiently clear. I’m remembering again my English in those days and probably I’m writing something different of what I wanted to say.
I should to decide which of the hundreds of treatments I have seen would be the best for my daughter. Some of these are not available in Argentina.. it’s a so difficult decision and I feel I could not evaluate, if I’m not reasonable sure about the answers of that questions.

Would be great for me to receive some comments
Thanks in advance!

[Pooka1]

Fer,

I think I understand your questions.

I don't think anyone here has the training to answer them. I don't think orthopedic surgeons or medical researchers know the answers. There is much that we don't know.

The treatments we have today are not ideal. But they are all we have. We all want medical research to advance faster than it does.

Pero usted no puede conseguir sangre de una piedra. Lo siento.

sharon

[flerc]

Sharon, thanks for your comment. Sorely could be true what you are saying, but it would means that nobody in the world performes/ed a serious research about this pathology. What kind of research could be do without that elemental knowledge? It seems that the only objective is trying to discover the original cause!! It could be great for prevent it, but no one in the world care about current people with scoliosis?? I could not believe it.
I think that if great and experienced doctors don't know about that facts, somebody must to be performing a scientifically research, so if that basics facts are unknown, they are trying to discover it. They are surely working in your country. I think that could be possible for somebody in the Forum to contact them. Ojalá!

[Pooka1]

I think the medical researchers in ALL countries are working on the problem of the cause of idiopathic scoliosis. These people are geneticists, pathologists, molecular biologists, neurologists, endocrinologists, physiologists, etc. etc.

I think the orthopedic surgeons in ALL countries are working on conservative (bracing), non-fusion surgery (vertebral body stapling, vertebral tethering, etc.), and fusion techniques to make them better until we can prevent idiopathic scoliosis.

Everyone is working at what they are trained to do. But there is probably not much money for research. The surgeons are limited in their ability to do controlled research trials on new braces and surgical techniques. Pero esto es muy duro problema. Tenemos que esperar el conservador y técnicas quirúrgicas conseguir mejor. Es todo lo que podemos hacer.

(Estoy utilizando una máquina traductor... Espero que sea buena.)

Recuerdos

[cbeem]

Hola Flerc!

I have no advice for you, but your daughter is very lucky to have you as her father! Trust yourself. Ask questions. Information is power.

Buenas suerte!

Ciao!

[flerc]

Yes, surely it is true. More facts that should be seen as Fundamentals in conservative methods, could not be considered as that in surgery methods. But could it be say for all of these facts? They must to know much of that facts to be sure of that and that braces is the best conservative method, and that nothing must to be do before use it.
Any way until professional answers could be get, all of us could say which we think could be the more reasonable answer for each of that questions. Could be we make some advance together.. Mucho pedir?
Se entiende bastante bien ese traductor

Un saludo

[flerc]

Hola Flerc!

I have no advice for you, but your daughter is very lucky to have you as her father! Trust yourself. Ask questions. Information is power.

Buenas suerte!

Ciao!

Thanks cbeem!!! I wish to believe what you said about me. I'll continue doing questions, Information is power without any doubt.

Hasta pronto!

[dailystrength]

You are so lucky to have a doctor like that.

Pilates in my country seems to be so hard. I think that as Yoga must to be teaches from people with a great knowledge from scoliosis. The PT for strengthen your torax is from Pilates?

I have found a very excellent book which I want to recommend to everyone on the non-surgical forum. It is called Curves, Twists, and Bends by Annette Wellings. She lives with a pretty large curve successfully. She is a Pilates instructor who learned Pilates for her scoliosis. See: http://www.amazon.com/Curves-Twists-.../dp/1848190255. I am learning 1-2 exercises a day.

Did you passed from 20 to 49 in those years since 13 years old or since growth finished? It’s sound incredible they wanted to surgeon you with so few degrees!
What kind of exercise was you during the 70’ ?

Yes, I sure did. Well, ten years ago I was at 34 but they (a hospital in a different city) never measured it but just sent me home without an adequate report. When I went a year and a half ago to my current excellent Dr. for an x-ray, he measured this earlier x-ray which I had brought with me. I had progressed to 49 in those ten years, so 15 degrees in ten years. It was very upsetting becuase I could have been working on holding it steady with exercise all that time if the other hospital had measured it and talked to me about it. I looked into lawsuits but I cannot prove I was injured. But now there is no way to reverse the curve. I can only hope to hold it steady.

It has held steady in the last year with strengthening exercises. The Pilates I do is VERY modified as I had no muscle strength to begin with. I described them at another place on the forum; I will try to find that for you. ** Here it is: Post #17 on the Exercise thread.

thoracic pain has suddenly appears? What kind of dance? What do you mens with weights? I think combining different things would be the best. It’s a good signal you have improved in a short time.

I had the thoracic pain for the last 8 years however I am not sure it is related... it was in my neck and shoulder where the curve was- I had soft tissue manipulation from a PT and I stretch out my neck 2X/day and that has helped. I was lifting weights at the gym but I am not sure that is good to do. The dance classes were at the gym also-it is called "Nia"-- but I am not sure about that either. I do try to walk every day 30 min. and the stretches in the book I listed are excellent. I have read that Tai Chi is good too.

In fact that woman has over 60 years old and 80º.. less years but much more degrees!
It was so devastating for me to measure 56º a weeks before when in July was 47º and 57º 1 year before.. but you are right saying is not an emergency

I have read that measurements can vary greatly. I hope the next measurement is consistent or lower for you, though. As long as it is not rapidly progressing, my Dr. would say you are okay. Progressing one or two degrees a year is normal he said. Surgery will not necessarily take away pain, and also a lot of people with or without scoliosis live with some pain. He prescribed an NSAID which I took for a while but I no longer need it.

Thanks. I think it could be the only way for a good selection for the treatment of my daughter. I’m hopeful in this forum. I have only received the most absolutely indifference before.

Yes, it is hard to get answers when there are still so many questions. But I hope what my Dr. has told me encourages you, as well as this forum. Please ask if you have any more questions.

[flerc]

10) Could it be that increasing degrees over time in sever scoliosis after growth would be only a matter of gravity force?.
.

Regardless all causes that could increment gravity force, could be another primary force pulling down the back?
I believe that if Newton’s laws are true (in something we must trust and not only in God) only a force could increase degrees in a curve.

10 a) Could it be that muscles attach to gravity in its harmful work? That is, not only not to fight against it, but in some way pulling down or to side too?

I have heard about muscles more short or long than normal ones, but could it be that muscles in the convex side are making much more force than they should do?
It seems to be so credible, many therapies are focused in this cause as Mezieres’ s people, but there is any evidence of how great is that force in compare with lateral gravity force?

10 b) Coud it be that no only muscles could perform such kind of forces?

.

That is what I mean with the critic angle, that some statisticals determine it as 40º, 45º, or 50º ..
.

It’s wrong. That number reefers about the result against two forces: gravity (the only one depending on the answer to last question) and column resistance.
Any way, I think it’s very important to know it because could be determined in an objective way and says about the magnitude of one of the forces we should to fight against, although it could be increased or decreased by other factors.
In fact, more important that to know a number is to know the function relating lateral gravity force with the current curvature.

Of course not only lateral gravity force, that could be terrible beyond some critic angle is the matter. Vertical force could probably be worst because could increase vertebral wedge, performing more pressure on the concave side. Another function could be determined to measure gravity force, vertical in these case and must to be easier to do because involve mainly trigonometry’s knowledge.

[flerc]

I have found a very excellent book which I want to recommend to everyone on the non-surgical forum. It is called Curves, Twists, and Bends by Annette Wellings. She lives with a pretty large curve successfully. She is a Pilates instructor who learned Pilates for her scoliosis. See: http://www.amazon.com/Curves-Twists-.../dp/1848190255. I am learning 1-2 exercises a day.

Good discovered! Did she says how many degrees have her curve?

Yes, I sure did. Well, ten years ago I was at 34 but they (a hospital in a different city) never measured it but just sent me home without an adequate report. When I went a year and a half ago to my current excellent Dr. for an x-ray, he measured this earlier x-ray which I had brought with me. I had progressed to 49 in those ten years, so 15 degrees in ten years. It was very upsetting becuase I could have been working on holding it steady with exercise all that time if the other hospital had measured it and talked to me about it. I looked into lawsuits but I cannot prove I was injured. But now there is no way to reverse the curve. I can only hope to hold it steady.

When my daughter was 14 years old a surgeon measured only 43° when in fact it was 54°. Sure we would have performed a very much effective plan if that angle had been measured in the right way. I had must to learn how to measure Cob angles. Now the current physiotherapist is telling me that last x-ray is under 50°, but now I’m absolutely sure about what I’m measuring. I have read that Cobb angle is measured over the two more inclined vertebras of the curve toward the concave side, so it is so easy to obtain it. The only doubt I could have, is about it is in fact a universal criteria all over the world, as I think it should to be.

It has held steady in the last year with strengthening exercises. The Pilates I do is VERY modified as I had no muscle strength to begin with. I described them at another place on the forum; I will try to find that for you. ** Here it is: Post #17 on the Exercise thread.

Sorry, I could not find it. Could you paste a link?

I had the thoracic pain for the last 8 years however I am not sure it is related... it was in my neck and shoulder where the curve was- I had soft tissue manipulation from a PT and I stretch out my neck 2X/day and that has helped. I was lifting weights at the gym but I am not sure that is good to do. The dance classes were at the gym also-it is called "Nia"-- but I am not sure about that either. I do try to walk every day 30 min. and the stretches in the book I listed are excellent. I have read that Tai Chi is good too.

Could you paste a link to Nia?
Have you read about lifting weights as good for scoliosis?? I have read as one of the worst than could be do, but.. my wife told me months ago that my daughter seems so straight carrying on her school bag over her shoulders, so I thought that is natural that the body make some kind of unconscious resistance, leading the back to be more straight.. I’m thinking now that back stretching exercises should be doing with a weight over the shoulders. As osteopaths say ‘the structure follow the function’ (or something like that), so the body should be adapted by itself to be more efficient for function requirements. I wish to have scoliosis so I could prove some kind of ideas with myself..
I have heard the some about Tai chi, but I think Qi Gong is best for column.. who knows?

I have read that measurements can vary greatly. I hope the next measurement is consistent or lower for you, though. As long as it is not rapidly progressing, my Dr. would say you are okay. Progressing one or two degrees a year is normal he said. Surgery will not necessarily take away pain, and also a lot of people with or without scoliosis live with some pain. He prescribed an NSAID which I took for a while but I no longer need it.

Thanks, I hope that too. In fact I’m absolutely sure about the correctness of the measure of the 3 last x-rays. I think that was not taken under same conditions, because she could straight so much her column, surely reducing degrees and one side of her pelvis seems to be much greater than the other in the July x-ray, as it was taken with some inclination. so I think she did not stand up in front the x-rays. But doctors don't help with any idea, so I must to analyse all by myself.

Yes, it is hard to get answers when there are still so many questions. But I hope what my Dr. has told me encourages you, as well as this forum. Please ask if you have any more questions.

[/QUOTE]
Thanks! I'm remains sure that knowledge must to be acquired before thinking in the best choice and just only to could speak with people with a different vision as most people in that part of the world is great for me.