Flexural-torsional buckling

[livingtwisted]

I'm not trying to solve anything, or stitch the research together in ways that the researchers aren't suggesting. It was a simple comment that got out of hand. My only point is just that just because different researchers are coming up with different "causes" doesn't mean that one is right and the others have to be wrong. It is a complex problem that could have more than one answer -- either for different types of scoliosis (possibly even classifications that don't exist yet), or that there are multiple factors that add up to the perfect storm of scoliosis, or that it is a chain reaction of events set off by one thing but that knowing any of the things along the way may help. Obviously the ideal is to understand everything we can that could help anyone with scoliosis whether they are not born yet or an adolescent just showing the first signs. Maybe even some day we will know enough that will lead to better solutions for untreated adults. But until then, I don't see any reason to argue over what is right and what is wrong. Everything is on the table.

[flerc]

I'm not trying to solve anything,

No, I never thought you was trying to solve so complex problem. When I said something as 'So all it depends on what problem do you want to solve', of course I was no referring to you

or stitch the research together in ways that the researchers aren't suggesting.

I’m not sure, but if you are referring to trying to alter the course of researches, I also don’t’ thought that , but it would not be ridiculous or regrettable. Is exactly what I think we should to do but is the issue of other thread and I respect if you disagree with this idea.

It was a simple comment that got out of hand. My only point is just that just because different researchers are coming up with different "causes" doesn't mean that one is right and the others have to be wrong. It is a complex problem that could have more than one answer -- either for different types of scoliosis (possibly even classifications that don't exist yet), or that there are multiple factors that add up to the perfect storm of scoliosis, or that it is a chain reaction of events set off by one thing but that knowing any of the things along the way may help. Obviously the ideal is to understand everything we can that could help anyone with scoliosis whether they are not born yet or an adolescent just showing the first signs. Maybe even some day we will know enough that will lead to better solutions for untreated adults. But until then, I don't see any reason to argue over what is right and what is wrong. Everything is on the table.

Sorry, I prefer to not reply until I’d be sure about what you means with 'Everything is on the table'.

[flerc]

I'm not trying to solve anything,

No, I never thought you was trying to solve so complex problem. When I said something as 'So all it depends on what problem do you want to solve', of course I was no referring to you

or stitch the research together in ways that the researchers aren't suggesting.

I’m not sure, but if you are referring to trying to alter de course of researches, I also don’t’ thought that , but it would not be ridiculous or regrettable. Is exactly what I think we should to do but is the issue of other thread and I respect if you disagree with this idea.

It was a simple comment that got out of hand. My only point is just that just because different researchers are coming up with different "causes" doesn't mean that one is right and the others have to be wrong. It is a complex problem that could have more than one answer -- either for different types of scoliosis (possibly even classifications that don't exist yet), or that there are multiple factors that add up to the perfect storm of scoliosis, or that it is a chain reaction of events set off by one thing but that knowing any of the things along the way may help. Obviously the ideal is to understand everything we can that could help anyone with scoliosis whether they are not born yet or an adolescent just showing the first signs. Maybe even some day we will know enough that will lead to better solutions for untreated adults. But until then, I don't see any reason to argue over what is right and what is wrong. Everything is on the table.

Sorry, I prefer to not reply until I’d be sure about what you means with 'Everything is on the table'.

[hdugger]

Sorry, I prefer to not reply until I’d be sure about what you means with 'Everything is on the table'.

I think she just means that nothing has been ruled out.

[flerc]

It was a simple comment that got out of hand. My only point is just that just because different researchers are coming up with different "causes" doesn't mean that one is right and the others have to be wrong. It is a complex problem that could have more than one answer -- either for different types of scoliosis (possibly even classifications that don't exist yet), or that there are multiple factors that add up to the perfect storm of scoliosis, or that it is a chain reaction of events set off by one thing but that knowing any of the things along the way may help.
Everything is on the table.

Mehera, I strongly agree with you! The more we know about the problem, the more the chance to solve it! All that researches may shown different causes. A problem may be multicausal as scoliosis is, and some causes may be the firsts, secondaries.. order n. And not only causes are useful or needed to be known.. but you showed to understand it very well!.

[Dingo]

Starting from the previous description of the spinal deformity in IS as 'buckling' of the spine a new hypothesis describing the initial spinal deformity in IS as flexural-torsional buckling, a three-dimensional type of failure of axially loaded columns, is proposed. According to the new hypothesis the initiating event (the earliest observable event) in IS is flexural-torsional buckling developing from the flexible parts (intervertebral discs and ligaments) of the affected spinal motion segments. Since flexural-torsional buckling occurs in columns with a cross-section of one axis of symmetry characterised by a much greater in-plane than out-of-plane bending stiffness the new hypothesis predicts that the initiating condition (the condition promoting the initiation) of IS is 'flexibility anisotropy' namely significantly higher bending stiffness in lateral bending than bending stiffness in flexion-extension of a part of the spine.

If I understand their hypothesis I believe that they are on the right track. When my son was born he was noticeably stiff in one direction which was odd for a baby. This must have lasted at least a year. When he grew old enough to run he didn't run like other children. He moved like a tank in a very stiff manner. This lasted until he was at least 5, maybe 6 years old. This strange movement didn't fit with the fact that he was a bright and otherwise athletic child.

I believe this hypothesis explains why torso rotation has been so effective for Scott's lateral curve. It didn't correct a muscle/strength imbalance. It stretched out the deformed ligaments around his spine. In just a few months he went from what I believe was around 15 degrees (I'll have to look) to something that looked completely straight with his shirt off.

He'll get his 8 year old x-ray in early October. I'll post it here if it shows the improvement that appears to have occurred in his lateral curve.

So far TRS has not had much effect on his rotation which was by far his largest problem.

Interestingly enough Dr. Douglas Kiester's research suggested tight ligaments around the spine. Traction had been tried for 100 years but didn't work. He had patients do stretching routines and it didn't work. Maybe the extra weight involved in TRS is what makes it effective... or maybe it's something scientists have yet to discover.

[Dingo]

Here is Scott probably not much older than a year. Unlike his dad he is a natural born athlete.

Movie: Scott hitting a baseball before he's old enough to talk

And yet at the same age he had trouble running and was very stiff. It was like his brain knew what to do but his body didn't.

His scoliosis probably started around age 3. His doctor noticed something was wrong at age 4 and he was diagnosed at age 5 with a curve of around 10 degrees and a bad rotation.

[hdugger]

I've probably mentioned this before, but he sure is adorable.

[Dingo]

Hi Hdugger, long time no chat! If Scott is cute it's all thanks to his mother. But believe me... there are many times he's not cute.

Case in point fighting with his brother in the minivan! 8-)

[Kevin_Mc]

Hi, I changed my username. So I'll no longer use the skevimc account. Most of the usual players seem to be on this thread so I figured this would be better than just starting a new thread to say my username has changed... Anyway...

Yes (or almost yes) if you only want to prevent scoliosis in future generations.
No (or not necessarily) if you really want to help in a significant way much people suffering it today.

I think part of the hope with etiology research is that, if you know what's causing it, a cure/treatment might be easily discovered. Although I agree with your general point that finding a cause perhaps has more implications for future patients.

Let me give you an example... the onset of puberty in under genetic control (sometimes as modified by environmental factors). It is not linked to the nervous system in any way to my knowledge. Disorders of the nervous system would not be expected to change the onset of puberty as far as I know. I picked this example because the onset of puberty in girls is scrutinized greatly with respect to AIS in girls. There are probably hundreds of other examples like that one.

Just as a minor point of interest, tumors in the brain associated with the endocrine system, e.g. hypothalamus or pituitary, can cause altered hormonal release which would affect puberty onset. Also, while everything requires a genetic component to be translated, a perfectly translated protein can still not function properly because of other, non-genetic influences.

[Pooka1]

Just as a minor point of interest, tumors in the brain associated with the endocrine system, e.g. hypothalamus or pituitary, can cause altered hormonal release which would affect puberty onset.

Yes and that would NOT involve the nervous system, yes? It involves function of a gland that changes its programmed secretions, no? So like perhaps environmental estrogen mimic molecules, that is another example of something that is NOT controlled by the nervous system in any way.

Also, while everything requires a genetic component to be translated, a perfectly translated protein can still not function properly because of other, non-genetic influences.

Yes but my point was that the two etiologies being discussed in this thread are mutually exclusive. They can't both be right if they are both claimed to be primary.

Actually, I read the press release from Wise and she is quite measured about whether those two genes which map to the nervous system are primary. In fact she doesn't claim that as far as I know. There is nothing in her recent findings to indicate that perturbations to the nervous system are primary drivers of IS. So from that stand point, the disc (mis)shape and Wise's work are not really at odds (yet).

Anyone who wants to suggest the nervous system as the primary point of malfunction triggering IS has a lot of explaining (away) to do about the coincidence of curvature with puberty in girls. That puts it squarely with genes controlling hormone production (or cascading to something related). It may be one huge coincidence but that doesn't seem likely. But what do I know?

[Dingo]

Maybe it needs to be pointed out that understanding the etiology of any disease is extremely difficult. Most diseases are not well understood.

How the nervous system, genes, inflammation, deformed ligaments or a hundred other factors work together to create Scoliosis may not be known for decades.

Example:
Mounting evidence suggests that a simple stomach infection is the root cause of Rheumatoid Arthritis.
Sciencedaily: Gut-Residing Bacteria Trigger Arthritis in Genetically Susceptible Individuals

How could a stomach infection trigger joint damage? Come back in 20 or 30 years and maybe they'll know. The body does not necessarily work in an obvious or straightforward way.

[flerc]

Dingo, good for know again about you and your boy and congratulations for refused the recommended Watch and Wait. Of course all is uncertain but decisions should to be reasonable and is extremely difficult to think this about W&W.
I really hope good news.

Kevin_Mc (good username) it's ever a great pleasure for me to talk with you in any thread.. and sorry, as always is difficult for me to be brief when it happens.

Maybe it needs to be pointed out that understanding the etiology of any disease is extremely difficult. Most diseases are not well understood.

How the nervous system, genes, inflammation, deformed ligaments or a hundred other factors work together to create Scoliosis may not be known for decades.

Example:
Mounting evidence suggests that a simple stomach infection is the root cause of Rheumatoid Arthritis.
Sciencedaily: Gut-Residing Bacteria Trigger Arthritis in Genetically Susceptible Individuals

How could a stomach infection trigger joint damage? Come back in 20 or 30 years and maybe they'll know. The body does not necessarily work in an obvious or straightforward way.

Exactly!, even may be not actually a first cause but n different and independent 'first causes' and the order in which they are triggered may be absolutely irrelevant and different in different cases.. and not only the trigger order.. nobody may be sure that the first/s cause/s is/are the same in all IS. I think would not be an exaggeration to talk about centuries instead of years or decades.. it not seems to be enough knowledge to give any kind of estimations.

I think part of the hope with etiology research is that, if you know what's causing it, a cure/treatment might be easily discovered. Although I agree with your general point that finding a cause perhaps has more implications for future patients.

Certainly the causes of a problem should to be known to solve any problem., but of course to try to mitigate in a significative way the damage that a situation is provoking now to someone is different to avoid the posibility that the same situation may be lived in the future. The last is the kind of problem choosed by the medical community and of course nobody may say that was not a good decision leading to great achievements as the Poliomyelitis vaccine, even it was absolutely useless for people already having it and the same would be say about a discovery of a scoliosis vaccine.. something extraordinary without any doubt.

But it seems that a pathology as scoliosis has not much to do with a contagious disease as poliomyelitis, and not seems to be the best strategy in this case as so extremely difficult seems to be to understand the cause-effect chain and then the first/s cause/s. Even if someday may be discovered, nobody may be sure it would be simple to avoid it/s and more centuries may elapse without giving any kind of help to nobody. So another strategy not only trying to discover the first/s cause/s is needed, and not only because thinking in people having this problem today.

As is logic to focusing in the first/s cause/s to prevent the scoliosis, we should to focus in the currents (mainly the lasts) to solve it in a satisfactory way. We may define a current cause in a short (and imperfect) way saying that is something provoking or allowing in an isolated way or combined with other causes the existence of the problem. So (continuing with imperfect definitions) if the effect of all this causes would be avoided, the problem would be solved.
Maybe that another cause-effect chain must to be undestand, because some causes (historical) may not exists any more after a time. Is better to see the connection between different current causes in an inverse order, so we may refer to the causes provoking or allowing the problem in a direct way as the primary causes, and the causes provoking or allowing its as the secondary causes and…. causes of order n.


I think those may be much of the primary and some of the secondary causes always presents. http://www.scoliosis.org/forum/showt...classification
For example, we may say that in every curve over x degrees, an abnormal muscular behavior/structure is a current cause and I know (although I had no time yet to read your thesis) you are doing a great work focusing in this cause, but what may happen if other researchers would do the same with other current causes, so much of them may be corrected to some extent?

And also may be not indispensable the knowledge about the first/s cause/s to prevent scoliosis.
Suppose that a cerebral disruption provoke a damage in internal organs, which in turn twist the spine. Maybe that some drug may avoid the damage provoked to the organs, so it would be the vaccine, because even the disruption would not be avoided (something probably impossible to achieve), the administration of the drug would avoid the organ's damage and then the scoliosis.

And even if the only one purpose is to help next generations.. would be so terrible that a curve appears if the application of a solution stop it or reverse it or avoid the complications that may implies?
Continuing with the example, may be that this drug may recompose the organs so this vaccine would be also useful to at least much people having scoliosis today.

So much investigation may be useful to both different purposes (prevent and solving). Even trying to correct some current cause may lead to their historical first cause and trying to discover a first cause, may lead to correct a current cause.
So both purposes may not be mutually exclusive and may have some milestones in common, but much Problem Solving concepts must to be taking into account as a feasibility and cost/profit study to select the best strategy. But of course it only may be perforned by a Project belonging to an important Organization

If knowing about first/s cause/s would demands so much time and other resources, the solution must to be intended now with the causes that are already known and get a feedback, incrementing in that way the knowledge about the problem.
That is achieved with incremental solutions, whose proved to be adecuated to uncertain problems, with dubious assumptions and the necessity to not delay so much at least some kind of help to people suffering the problem.. and in this way, the knowledge and the help given increase continuosly until a really satisfactory solution is reached.

[flerc]

Scott, I am reading one of your previous posts. Very interesting this site http://www.ndorms.ox.ac.uk/ooec.php I'm sure that a realy great knowledge about physical science is needed to understand the scoliosis system. As I know the current spine stability theory was developed by a physicist; surely is the only way to know about much fundamental facts as the resistance of the spine to oppose to the lateral component of gravity force. I think that force must to be known as a function depending on the inclination of each vertebrae and the weight supported by each of them, but I cannot found it and I'm not sure at all if I not made some mistake. I conclude is a sum of products of the weights and sin and cos of each inclination. Do you know exactly how is this function? Of course an aproximation must to be done about weights. And what part is resisting that force? It seems that not vertebras nor discs, I don't know how muxh ligaments, joints, muscles, organs or fascias.
Good your page, I was trying to find the M. Monroe book.

Thanks in advance

[Pooka1]

Now lets use our brains for just one damn second here.

I'm adding this to my sig file. Thanks.

If it is known that scoliosis has abnormal biomechanics, then doesn’t it stand to reason that just the plain pure existence of multiple curve patterns alone proves that there must be a biomechanical component to scoliosis??

There is biomechanics of a straight spine and biomechanics of a curved spine. The question on the table is what initiates going from straight to curved. That seems to require a trigger that changes the biomechanics. The biomechanics changes in response to the trigger. Researchers are looking at genetic triggers because, in the words of one prominent researcher, "Everything is genetic." Their field.

I’d have to say the current research focus is on genetics simply because genetics is something they can work on and hope to make advances on where biomechanics is really a bit of a dead end street.

I suggest that biomechanics is a way to study the downstream effects of the cause of scoliosis. I think they will figure out some better treatments before they find the trigger or, if found, are able to directly address it.

That’s all this article is, don’t buy into it.

Be careful about buying anything in the medical literature. Most of it is false.