Changes in scoliosis treatment due to Scoliscore

[Pooka1]

http://toyourhealth.com/mpacms/tyh/a...7&pagenumber=1

That's a chiro web site. The information might be correct but it needs to be checked. Chiro is not a science.

http://www.sciencebasedmedicine.org/...-chiropractic/

Is chiropractic a science? No.
Is chiropractic based on neurology, anatomy and physiology? No.
Are chiropractors doctors of the nervous system? No.
Does chiropractic improve health and quality of life? No.

[Pooka1]

And by the way, none of that applies to fusion for scoliosis as I hope is clear from the article. Scoliosis fusions are a tiny fraction of all fusions as I understand it. That point might be missed on a chiro site where they don't have the necessary training and where chiros have a different agenda than the patients.

Fusion is in fact the only scoliosis treatment with unassailable evidence of efficacy for certain patients. It's probably underused as opposed to over-used if I had to guess.

[flerc]

That's a chiro web site. The information might be correct but it needs to be checked.

I believe I saw a similar information in other sites.

Chiro is not a science.

http://www.sciencebasedmedicine.org/...-chiropractic/

Is chiropractic a science? No.
Is chiropractic based on neurology, anatomy and physiology? No.
Are chiropractors doctors of the nervous system? No.
Does chiropractic improve health and quality of life? No.

I may say I don’t know anything about chiropractic, except that I know about a millenary Tibetan chiropractic. But two members of my family refused surgery for spine problems and had an excellent and permanent outcome with chiropractors.

[flerc]

Scoliosis fusions are a tiny fraction of all fusions as I understand it.

Exactly, that is for me the biggest problem. A great business exists around fusion for different cases and even it’s not a good solution, probably it’s not so unacceptable because it’s applied mainly in one or two vertebras, so why to try with something different? Because scoliosis, without any doubt need something much better?.. well.. there are so few cases.. so the ‘solution’ for scoliosis would be to fuse no so many vertebras too and 'everybody happy'.

Fusion is in fact the only scoliosis treatment with unassailable evidence of efficacy for certain patients. It's probably underused as opposed to over-used if I had to guess.

May be true for some cases, but is not a good solution, so another solution must to be found for all cases. We have already discussed about that.

[flerc]

A great business exists around fusion for different cases and even it’s not a good solution, probably it’s not so unacceptable because it’s applied mainly in one or two vertebras, so why to try with something different? Because scoliosis, without any doubt need something much better?.. well.. there are so few cases.. so the ‘solution’ for scoliosis would be to fuse no so many vertebras too and 'everybody happy'.

If scolioscore will be used to that purpose, then we should not have any hope in medical community.

[marykay]

marykay, do you refer to this research work, recently published and which won the Best Award Paper at Eurospine 2010?

Eur Spine J. 2011 Jul;20(7):1069-78. Epub 2011 Apr 16.
Abnormal activation of the motor cortical network in idiopathic scoliosis demonstrated by functional MRI.
Domenech J, García-Martí G, Martí-Bonmatí L, Barrios C, Tormos JM, Pascual-Leone A.
SourceOrthopedic Surgery Department, Hospital Arnau de Vilanova, Valencia, Spain, Julio.domenech@ucv.es.

http://www.ncbi.nlm.nih.gov/pubmed/21499781

If that's not the research you know about, could you please give us some more info?

I honestly think this could be the beginning of a way out to this multifactorial










(apparently) pathology and, even though I've alrady gone through surgery, I'm deeply interested in the subjet. Thanks very much in advanced!

Tata - did you get a chance to look at those websites I posted? I only saw this now. I haven't been on in quite some time. Those studies did show promise but they ended the research and the devices they used are no longer being made. Mary Kay

[marykay]

To those that were interested in the neurofeedback option I was exploring, unfortunately my daughters psychologist was not able to obtain a device as used in the research in Europe in the 1990's. He could not find anything similar in the States. It is too bad as the research did show promise. My daughter had the neuromuscular scoliosis; per her ortho at Mayo, he explained their research indicates this type of scoli starts with basically the nervous system not communicating normally to the musculature. Over time the muscles being in a continually abnormal position spasm and pull the spine out of place. Neurofeedback would have targeted trying to get the brain to pull the muscles back into a desired state. Based on the success of using the neurofeedback with my daughters other issues and my son's Tourettes, the methodology does make sense. If the dollars and research were there, I can see where this approach may hold some kind of promise. But it doesn't appear that will happen in the near future. For now we will have to move forward with the surgery next spring. Flerc, I am interested if you or a family member has had the surgery. Tata, has yours been a success? To anyone, why has that stapling not been tried in older kids or more severe curves?

[Resilience]

Actually, I sort of saw the infusion of corporate money as a bad fact. Corporate money goes in only with the idea of getting more money out. What gives the best return in medicine for a corporate interest? Consumables, like drugs and devices.

What *doesn't* provide a good return for corporate money? Non-consumables, like a physical therapists' time.

There is simply no reason for a corporation to ever invest in something that can't be consumed. There's no pay out for them. And that means that all of the corporate-driven research is going to be around drugs and devices, thus bolstering those kinds of solutions while starving funding for other kinds of solutions.

Sadly, I completely agree.

[Pooka1]

I don't think any lack of corporate money can possibly be blamed for the lack of an effective PT approach to date. PT approaches are low overhead. Someone just has to dream up certain movements and get some folks to try it. An exception is the work of PhD researchers like Dr. McIntire who work from first physiological principles.

The Schroth experience goes a certain distance towards suggesting that the lack of corporate money is not the problem. Also the SEAS approach doesn't seem to be suffering from lack of corporate funds. Rather the problem appears to be that no PT can be effective enough. The universe can be such that that is the case. Perpetual motion machines don't magically become possible just because we wish it.

[flerc]

To those that were interested in the neurofeedback option I was exploring, unfortunately my daughters psychologist was not able to obtain a device as used in the research in Europe in the 1990's. He could not find anything similar in the States. It is too bad as the research did show promise. My daughter had the neuromuscular scoliosis; per her ortho at Mayo, he explained their research indicates this type of scoli starts with basically the nervous system not communicating normally to the musculature. Over time the muscles being in a continually abnormal position spasm and pull the spine out of place. Neurofeedback would have targeted trying to get the brain to pull the muscles back into a desired state. Based on the success of using the neurofeedback with my daughters other issues and my son's Tourettes, the methodology does make sense. If the dollars and research were there, I can see where this approach may hold some kind of promise. But it doesn't appear that will happen in the near future. For now we will have to move forward with the surgery next spring.

It seems they are not interested in nothing else than fusion for ever. They should to combine this neurofeedback with other solutions. I know about significant reduction of big curves in 2 cases with Vojta, one of them in a neuromuscular case, but combined with craneosacral. In Cuba is not an unusual treatment. Sometimes may have good outcomes. Other methods take into account an abnormal behavior of muscles, something like a soft dystonia

Flerc, I am interested if you or a family member has had the surgery. Tata, has yours been a success?

No, my daughter has a big and large curve but we are trying with alternative methods because she feels really fine with one of them and medicine only knows about fusion, not a good solution and much worst when much vertebras are involved. In my family nobody had ever had scoliosis and as I know, only 3 members had back problems, but none of them had surgery. In the family of my wife maybe one uncle, I met her but I not remember anything about her back and she died some years ago so we are not sure and my wife never heard she suffered about complications as pain.

To anyone, why has that stapling not been tried in older kids or more severe curves?

Probably stapling is only useful in children with smaller curves as Hudgger said, but what may happen if a non invasive and cheaper surgery has good outcomes in adults? What would happen with centennial fusion business? It's reasonable to think this is the reason.

[flerc]

I don't think any lack of corporate money can possibly be blamed for the lack of an effective PT approach to date. PT approaches are low overhead. Someone just has to dream up certain movements and get some folks to try it. An exception is the work of PhD researchers like Dr. McIntire who work from first physiological principles.

Non surgical solutions are more than Pt and as I said before Pt is a vast world and some methods are really based over scientifically outcomes. But we have discussed it before.

The Schroth experience goes a certain distance towards suggesting that the lack of corporate money is not the problem. Also the SEAS approach doesn't seem to be suffering from lack of corporate funds. Rather the problem appears to be that no PT can be effective enough. The universe can be such that that is the case.

I have heard about good outcomes with Schroth and Seas, (significant reductions of the curve), but anyway, if surgeons and PhD are the only ones in the world knowing about scoliosis, they should not be taken into account. Also we have discussed that points.

Perpetual motion machines don't magically become possible just because we wish it.

It’s not the case. There is a scientific demonstration about why this is impossible. Show me the demonstration about the same impossibility of non fusion and even non surgical solution. We only may demonstrate that medical community has not any interest in it.

[Pooka1]

If the medical commuity does not appear to be interested in a class of treatment modalities then my first assumption is tbat there is too little evidence to think it might work or too much counterevidence that it probably would not work or it is not based on scientific principles. PT to date falls into one or more of those categories. And people have been trying for a few thousand years.

[flerc]

If the medical commuity does not appear to be interested in a class of treatment modalities then my first assumption is tbat there is too little evidence to think it might work or too much counterevidence that it probably would not work or it is not based on scientific principles. PT to date falls into one or more of those categories. And people have been trying for a few thousand years.

It seems that evidence to think it might work for surgeons only would be possible if something works in all cases. That is not as science work, it has nothing to do with it. In what kind of world we would live if scientist, engineers, inventors.. thinks in that way.
Of course there is enough evidence to think it would be possible and logic theories and some (not enough yet) knowledge endorsing this idea.
PT as a formal discipline is relative new and is reasonable that in her first steps, the traditional PT seems to be not right oriented as I talked with Dr. McIntire. http://www.scoliosis.org/forum/showt...cular+question

But we have already discussed all this points before.

Originally Posted by Pooka1

Opposing the curve is the idea behind bracing. PT seems to be just less time spent opposing the curve. Or it is building up muscle to do what braces do. It seems like if hard braces fail then PT doesn't stand a chance. But I would welcome any dope-slapping from Dr. McIntire on this point as this is his field.

Rigid brace without stretching before the spine, imply an external force not very well used, and strengtheners muscles oriented techniques, as I talked in an extended post with Dr. McIntire, should to be used in an extremely right way and not all PT methods are oriented in this way, but anyway, what are medical community waiting to see, to became to do some attemting to get a best solution for scoliosis problem? That other people find the perfect solution for scoliosis?

Yes Sharon. I cannot believe that surgeons refers as non surgical methods only raindrop therapy, little hand-held massager or so on.
We may say that methods implement theories based over some principles. It's understandable that investigate a method not based over some principles that not seem to be so related with the scoliosis problem and there is not some evidence that work, may be considered a waste of time. Even also if that principles, despite would be so much related with the problem, the method or theory behind it, is out the scope of the western science as in some way could be say about Qui Gong.
Also if the principles are related with the problem to solve, but the theory not look very much convincing as seems to be with raindrop therapy (I suppose). It’s reasonable in all these cases that evidence should be required. But only in those cases.

So, if the scientific principle/s supporting a reasonable theory are related with the scoliosis problem, and the method seems to be a reasonable way to implement that theory, the method should to be considered.
That is what happens without any doubts with a method as Fed http://www.sastre-roca.com/metodofed.html It can not be considered as a PT method even is in fact a methodology that include PT and probably brace too. The research of the scoliosis vicious cycle, was previous to that invention and we can say that is what is attacked by this method. Sastre has made by her own (I think that not receiving one dollar from medical community) scientist research, also with animals, the theory behind this method is really consistent and extremely logic. The relevant assumptions (principles) were identified and conclusions (theory) were reached following right reasoning. And the method seems to be a right way to implement that theory. And it seems it works! http://www.sastre-roca.com/casospracticos.html But of course the last is not relevant to being considered a scientific method that should to be taken into account.

Vojta, ABR and also Rpg and others Meizierist’s therapies http://es.wikipedia.org/wiki/M%C3%A9...%A9zi%C3%A8res (sorry is in Spanish but I sure you like to read the Observation prínceps) based over scientist principles too, probably could be considered as belonging to PT, but the theory is really different. Meizierist’s therapies theory could be seen as opposite in at least some points to traditional PT. Abr http://blyum.typepad.com/on_abr_and_...lustrated.html is the invention of a mathematician with a thesis in Biomechanical, and the theory takes into account the concept of tensegrity, that is used by ostheopats (but probably discovered in biology by a surgeon). In fact Rpg and others more are also taking into account something like tensegrity (when focus is over fascias) and biomechanical, but ABR is the only one method or discipline in the western world focusing in smooth muscles. I not agree that should to be considered a non scientific methods because is taking into account concepts never investigated by the medical community.

it probably would not work or it is not based on scientific principles. PT to date falls into one or more of those categories. And people have been trying for a few thousand years.

One point I'd like to comment on is the idea that alternative treatments have had hundreds and hundreds of years to cure scoliosis, and if they haven't done it in that time, they never will.

One of the obvious fallacies of this statement is the idea that knowledge and investigative techniques in alternative treatment areas has been "advanced" for hundreds of years. If we're not discounting surgery because they didn't have anything effective even by 1920, then there's no reason to discount alternative treatments because the ancient greeks weren't effectively straightening spines.

The second obvious fallacy is the idea that, even in modern times, alternative treatments have had equivalent access to research money and patients and so should be advancing at the same rate as surgical treatment. With the exception of the Schroth people (who I think really have to produce a research paper or back off their claims) no other treatment modality has anywhere near the resources required to publish a decent paper. Anyone other than the Schroth people who wants to really test out a theory is required to work with surgeons in order to access a good pool of patients, and come up with at least $100,000. So, unless the surgeons are interested and the research money is there, there's just no solid path to investigating any of these ideas.

That in no way proves that these alternative methods are effective, but the counter-argument that the lack of researched results proves that they're *ineffective* is obviously false. One might just as well say that any other field of medicine that hadn't currently offered a cure - genetics, drugs, etc - had proven by it's lack of current treatment that it would never offer an effective treatment if it hadn't already.

[Resilience]

I don't think any lack of corporate money can possibly be blamed for the lack of an effective PT approach to date. PT approaches are low overhead. Someone just has to dream up certain movements and get some folks to try it. An exception is the work of PhD researchers like Dr. McIntire who work from first physiological principles.

The Schroth experience goes a certain distance towards suggesting that the lack of corporate money is not the problem. Also the SEAS approach doesn't seem to be suffering from lack of corporate funds. Rather the problem appears to be that no PT can be effective enough. The universe can be such that that is the case. Perpetual motion machines don't magically become possible just because we wish it.

I am not familiar with SEAS but will look into it now. thanks!

[flerc]

Any idea?

Originally Posted by hdugger

Actually, I sort of saw the infusion of corporate money as a bad fact. Corporate money goes in only with the idea of getting more money out. What gives the best return in medicine for a corporate interest? Consumables, like drugs and devices.

What *doesn't* provide a good return for corporate money? Non-consumables, like a physical therapists' time.

There is simply no reason for a corporation to ever invest in something that can't be consumed. There's no pay out for them. And that means that all of the corporate-driven research is going to be around drugs and devices, thus bolstering those kinds of solutions while starving funding for other kinds of solutions.

Sadly, I completely agree.

It seems to be by far the main cause of the problem. What we may do?