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Thread: Another study finds assocation between HYPOkyphosis and Scoliosis

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    Another study finds assocation between HYPOkyphosis and Scoliosis

    ScoliosisJournal: Is decreased bone mineral density associated with development of scoliosis? A bipedal osteopenic rat model

    Our study did not show a statistically significant relationship between low mineral density and development of scoliosis in a bipedal rat model. Another interesting finding of this study was that in heparin treated animals, a relative thoracic hypokyphosis was present. Considering that idiopathic scoliosis is a three dimensional deformity presenting with hypokyphosis in the sagittal plane, we believe that the relative hypokyphosis in the heparin treated animals maybe of some value. With these findings it is not possible to prove or refute the long questioned relationship between osteoporosis and idiopathic scoliosis. Further studies are required to clarify the relationship between osteoporosis and development of spinal deformity in the growing spine.
    The scientists involved in this study didn't find the what they were looking for but once again they found that Scoliosis was associated with hypokyphosis (flat back). Just about everything I have read shows that Scoliosis is associated with hypokyphosis. My son doesn't have severe flat back but his spine has very little, natural kyphosis. It's fairly straight with very little hump.

    Paging Dr. McIntire!

    I can find pages of exercise links for HYPERkyphosis i.e. hunchback. A few studies (Spinal extension exercises prevent natural progression of kyphosis) found that exercise was an effective treatment for hunchback. But I can't find anything for flat-back.

    Are there exercises for Hypokyphosis? I've seen mention that tight chest muscles and weak back muscles contribute to hunchback. If tight chest muscles contribute to hunchback, could chest exercises treat flat-back by creating more kyphosis?

    Thanks in advance!
    Last edited by Dingo; 11-19-2011 at 01:00 AM.

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    Dingo, I'm just curious about your son. Has he had any x-rays taken lately to asses his progress? I know how you, or at least I, would want to keep the radiation exposure to a minimum at his young age, so I understand if he hasn't had any. The reason I ask, is that I always thought that the hypokyphosis was a result of the scoliosis. It would be interesting to know if the hypokyphosis came BEFORE the curvature took place. I've read that kids in the brace have induced hypokyphosis in order to reduce their curves, exchanging one deformity for another basically. My mother was very big on posture when I was growing up, yet I was the only one to develop scoliosis. But, on the other hand, I was the most obedient of my mothers children when it came to things like that. I'm not blaming mom for my disorder, but just curious if the order of operations is switched around as to what I thought it was. I thought the rotation either caused hypo or hyper kyphosis depending on the rotation, since both are quite common among scoli sufferers. I had never thought about chest strengthening exercises. It makes sense, though. When you tighten the chest, you automatically give the upper back a good stretch. I'm sure it couldn't hurt. Maybe doc McIntire will see this and chime in. Thanks for the info.

    Oh, and I found out last week, that I have basically no vitamin D in my system, so am taking megadoses to try and build it up. I wonder how long that has been going on? I'm going to ask my PCP if I shoud get a bone density test just to assess the condition of my bones since vit D is essential for proper calcium uptake in the bones.
    Last edited by rohrer01; 11-19-2011 at 09:14 AM. Reason: added thought

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    Quote Originally Posted by rohrer01 View Post
    Oh, and I found out last week, that I have basically no vitamin D in my system, so am taking megadoses to try and build it up. I wonder how long that has been going on? I'm going to ask my PCP if I should get a bone density test just to assess the condition of my bones since vit D is essential for proper calcium uptake in the bones.
    I think bone density and Vitamin D levels are separable within large ranges. As you know, I am on the same megadose regime as you for low Vitamin D but also just did a bone scan showing normal density.

    As far as I know, bone density is hereditary. There is not a single case to my knowledge of osteopenia or osteoporosis in either side of my family. I wanted to skip the bone scan because of that and because I naturally carry a lot of muscle which is known to be protective against low bone density. The nurse agreed that was generally protective but asked me to take the test as a baseline anyway. I relented and took the test and all values were well within normal range. In hindsight, I consider that a wasted medical test for me that unnecessarily drives up insurance rates. I will not be taking that test ever again.

    On the OP journal article, good for them and good for the journal for publishing the negative results. Some folks are reluctant to do so but I think they are important. A colleague of mine wanted to start a "Journal of Zero" where everyone could publish very high quality studies that would have showed something had it been there but it wasn't there.

    Also on the OP journal article, I continue to be amazed that bipedalizing mice is considered ethical.
    Sharon, mother of identical twin girls with scoliosis

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    Quote Originally Posted by Pooka1 View Post
    I think bone density and Vitamin D levels are separable within large ranges. As you know, I am on the same megadose regime as you for low Vitamin D but also just did a bone scan showing normal density.

    As far as I know, bone density is hereditary. There is not a single case to my knowledge of osteopenia or osteoporosis in either side of my family. I wanted to skip the bone scan because of that and because I naturally carry a lot of muscle which is known to be protective against low bone density. The nurse agreed that was generally protective but asked me to take the test as a baseline anyway. I relented and took the test and all values were well within normal range. In hindsight, I consider that a wasted medical test for me that unnecessarily drives up insurance rates. I will not be taking that test ever again.

    On the OP journal article, good for them and good for the journal for publishing the negative results. Some folks are reluctant to do so but I think they are important. A colleague of mine wanted to start a "Journal of Zero" where everyone could publish very high quality studies that would have showed something had it been there but it wasn't there.

    Also on the OP journal article, I continue to be amazed that bipedalizing mice is considered ethical.
    That makes me feel better. I don't know if anyone in my family had osteoporosis. I have very little muscle or fat, so it concerns me a little as I am also very small boned for my stature. I am not apt to break bones, though. As far as I know, I have only one documented fracture and that was when I slammed my finger in a metal door, ouch! One othe suspected fracture was when I was 11 years old and fell on my tailbone on a rock. I couldn't sit for over three months and it still aches now and then. So I'm hopeful that my bone density is good. Neither of my parents ever broke a bone, but my grandmother suffered a broken back just from stepping off the curb wrong, so I don't know.

    As far as bipedalizing mice, what do they do, cut their front limbs off? That's horrible! They use their little hands for so much, not just for walking. :-(

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    Quote Originally Posted by rohrer01 View Post
    That makes me feel better. I don't know if anyone in my family had osteoporosis. I have very little muscle or fat, so it concerns me a little as I am also very small boned for my stature. I am not apt to break bones, though. As far as I know, I have only one documented fracture and that was when I slammed my finger in a metal door, ouch! One othe suspected fracture was when I was 11 years old and fell on my tailbone on a rock. I couldn't sit for over three months and it still aches now and then. So I'm hopeful that my bone density is good. Neither of my parents ever broke a bone, but my grandmother suffered a broken back just from stepping off the curb wrong, so I don't know.
    That sounds like a good history consistent with not having low bone density in your family.

    As far as bipedalizing mice, what do they do, cut their front limbs off? That's horrible! They use their little hands for so much, not just for walking. :-(
    Yes they amputate the front legs as put them in tall cages where they have to reach up for food and water as far as I know.

    It seems like a HUGE OPEN question of whether bipedalizing quadrupeds is at all relevant to bipeds. What isn't open is that it is obviously cruel and probably shouldn't be done even if some relevance can be shown. I think PETA is around the bend on many matters but I agree with them taking a stand on recalcitrant cruelty issues in research labs because nobody else is brave enough to do so.
    Sharon, mother of identical twin girls with scoliosis

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    Quote Originally Posted by Pooka1 View Post
    It seems like a HUGE OPEN question of whether bipedalizing quadrupeds is at all relevant to bipeds.
    After thinking about this, it doesn't really make sense. To me it's like apples and oranges, both fruit, but very different. Just because we are both "mammals" doesn't mean that these types of studies would even make sense. I can see studying chemical pathways, genetic studies, medication studies (although they WAY overdo it there), and the such that eventually become relevant to humans. But studies on scoliosis by removing the forelimbs of an animal that normally walks on them would create such an enourmous unnatural stress on their bodies that it couldn't possibly be relevant to humans. Their skeletal structure is different. There musculature is different... apples and oranges.

    Now a study of scoliosis in non-bipedalized mice might be relevant as causes other than forcing them to walk on their hindlegs could be investigated. For example, I mentioned on the whale thread that when I raised mice, occasionally one would get sick. I always knew they were going to die when they developed hyperkyphosis. There was absolutely nothing I could do for them at that point. I observed the same thing in fish. Obviously curved spines in humans doesn't mean iminent death, but what caused this to occur in these sick animals might be something worth looking into.

    But back to the topic of exercise physiology, Dingo had a good question about whether or not certain exercises may help with hypokyphosis. That could defititely NOT be studied with any relevance in a bipedalization study.
    Last edited by rohrer01; 11-19-2011 at 02:43 PM. Reason: added thought

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    Quote Originally Posted by rohrer01 View Post
    After thinking about this, it doesn't really make sense. To me it's like apples and oranges, both fruit, but very different. Just because we are both "mammals" doesn't mean that these types of studies would even make sense. I can see studying chemical pathways, genetic studies, medication studies (although they WAY overdo it there), and the such that eventually become relevant to humans. But studies on scoliosis by removing the forelimbs of an animal that normally walks on them would create such an enourmous unnatural stress on their bodies that it couldn't possibly be relevant to humans. Their skeletal structure is different. There musculature is different... apples and oranges.
    Yes. These bipedalized rodents have iatrogenic/traumatic scoliosis whereas humans have genetic scoliosis. It could not be more apples and oranges. The only other animal besides humans known to have genetic scoliosis is a species (or two) of fish. All other cases in all other animals are not genetic.

    Now a study of scoliosis in non-bipedalized mice might be relevant as causes other than forcing them to walk on their hindlegs could be investigated. For example, I mentioned on the whale thread that when I raised mice, occasionally one would get sick. I always knew they were going to die when they developed hyperkyphosis. There was absolutely nothing I could do for them at that point. I observed the same thing in fish. Obviously curved spines in humans doesn't mean imminent death, but what caused this to occur in these sick animals might be something worth looking into.
    Good point.
    Last edited by Pooka1; 11-19-2011 at 04:06 PM.
    Sharon, mother of identical twin girls with scoliosis

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    Rohrer01

    I always thought that the hypokyphosis was a result of the scoliosis. It would be interesting to know if the hypokyphosis came BEFORE the curvature took place.
    No one has definitively proven the chain of events. However I've been told by a credible scientist that the order of events probably goes something like this.

    Step 1) Something breaks in the nervous system or some other system in the body (nobody has proven what this is)
    Step 2) Ligaments in the spine become deformed
    Step 3) As the spine grows the back flattens out because of the deformed "tight" ligaments
    Step 4) As pressure increases the spine begins to rotate
    Step 5) The lateral curve develops

    Because Scott's curve was +/- stable according to the computer that measured his X-ray he doesn't have to go back for a re-check until his 9th birthday in late September 2012.
    Last edited by Dingo; 11-19-2011 at 04:13 PM.

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    I thought there was wide agreement if not definition of IS as excessive growth of the anterior spine. The excess growth on the anterior portion forces would seem to force a simultaneous curvature and rotation to avoid a huge lordosis of the entire back where the curve is located. In fact there is lordosis present on the thorax for many/most(?) T curves which would be predicted and the entire process would be hypokyphosing it seems which again is what is observed in many cases. The back avoids a huge lordosis by curving and rotating as far as I can tell.

    That is a bone growth anomaly as I understand it. Now proving that as primary or secondary or tertiary or whatever would seem to be a bigger task.
    Sharon, mother of identical twin girls with scoliosis

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    Quote Originally Posted by Pooka1 View Post
    I thought there was wide agreement if not definition of IS as excessive growth of the anterior spine. The excess growth on the anterior portion forces would seem to force a simultaneous curvature and rotation to avoid a huge lordosis of the entire back where the curve is located. In fact there is lordosis present on the thorax for many/most(?) T curves which would be predicted and the entire process would be hypokyphosing it seems which again is what is observed in many cases. The back avoids a huge lordosis by curving and rotating as far as I can tell.

    That is a bone growth anomaly as I understand it. Now proving that as primary or secondary or tertiary or whatever would seem to be a bigger task.
    But this doesn't explain why some people have a lateral curve and hyperkyphosis. I know one person personally who has this pretty severely and seem to be getting worse the older he gets (he's older than me). I'm guessing it doesn't cause him much discomfort because he's never had it fixed. I don't "know" him well enough to bring up the subject as I am close friends with his sister and not him. I know that his parents only took him to chiros when he was growing up. But there are many others that have hyperkyphosis and lateral deformations. So I wonder what is going on there if, as you state, the concensus is overgrowth of the anterior spine? I believe hduggers son has hyperkyphosis and lateral scoliosis, but he also has some neurologic problems as well.

    If, as Dingo states, there is a problem in the structure of the ligaments, then I could see that an uneven distribution of torque on the spine by these ligaments could cause it to go either way depending on which ligaments are deformed. Hmmmm

    Bone or ligaments, two different body systems (unless ligaments are now considered part of the skeletal system since they hold bone to bone - it's been awhile since I took A&P). Maybe there are both types. But thinking of Elisa's son, didn't they do a ligament release before putting him in traction so that his spine could straighten? It makes me wonder why they don't do everyone that way. I realize that his curve was HUGE, but I'd bet we would see a lot better corrections than we do if that was done (not necessarily the traction but the ligament release). I know in many adults anyway, they remove the disks to get flexibility, but why not do the release, too?

    On the other hand, if it were just ligamentous deformities, couldn't one develop a way to stretch the spine or would that be too dangerous? I know that they do some of that with infants and plaster casting but what about older kids? I see the problem there, too. If plaster casted for too long, then the muscles become weak. You'd think there would be some kind of PT that would put a stretch on the spine. They put me in traction for years and it did absolutely nothing, so draw you own conclusions I guess....

    I'm just rambling off thoughts as they come to my head, as I'm sure you can plainly see. ;-)

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    Pooka1

    That's not what I was told but it's possible.... (shrugs shoulders) nobody has proven the chain of events.

    If there is wide agreement on the etiology of Scoliosis I'd love to read about it.

    I think if Scoliosis was a bone growth problem it would have been proven decades ago.

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    Rohrer01

    But thinking of Elisa's son, didn't they do a ligament release before putting him in traction so that his spine could straighten?
    I remember reading a Scoliosis abstract that talked about scientists who tested a new spinal fusion technique on several cadavers. They cut a few ligaments and the spines rotated back into place. I can't remember how cutting ligaments affected the lateral curve or kyphosis.

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    Rohrer01

    On the other hand, if it were just ligamentous deformities, couldn't one develop a way to stretch the spine or would that be too dangerous?
    I've been told that's why Torso Rotation Strength Training is effective. Whether that's true I don't know. Nobody really knows why TRS works.

    If my memory serves me correct ligaments can be stretched in children. In adults if ligaments are stretched they become damaged and take a long time to heal.
    Last edited by Dingo; 11-19-2011 at 06:10 PM.

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    Knowing about anterior overgrowth doesn't really answer etiology

    There is a consensus that there is anterior overgrowth in IS. The vertebra have been measured. The question is whether it is primary.

    The overgrowth causes the curving and rotation and there apparently is no evidence that the rotation causes the curvature...

    http://books.google.com/books?id=3Zo...0spine&f=false

    This one also states that the opposite occurs in Sheuermann's kyphosis... there is a posterior overgrowth.

    So both IS and SK are associated with uneven vertebral bone growth but they don't know why that occurs of if it is primary as far as I can tell.

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    http://www.treatingscoliosis.com/adv...get-worse.html

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    The findings confirm previous anatomical studies and support the consensus view that in patients with thoracic AIS there is relatively faster growth of anterior and slower growth of posterior elements of thoracic vertebrae.
    http://books.google.com/books?id=3Zo...0spine&f=false

    http://www.ncbi.nlm.nih.gov/pubmed/16133084

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    http://web.jbjs.org.uk/cgi/reprint/85-B/7/1026.pdf

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    In re Elias, I think he had an anterior release, nothing to do with the ligaments as far as I know...

    http://www.mendeley.com/research/eff...hic-scoliosis/

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    http://books.google.com/books?id=htZ...0spine&f=false
    Sharon, mother of identical twin girls with scoliosis

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    Question: What do you call alternative medicine that works?
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    Quote Originally Posted by rohrer01 View Post
    But this doesn't explain why some people have a lateral curve and hyperkyphosis.
    That appears to be a combination of the bone growth issues of IS and kyphosis which are opposite... IS has relative anterior bone growth and kyphosis has relative posterior bone growth. I'm guessing that is rare compared to IS plus hypokyphosis on the one hand versus hyperkyphosis on the other. Or the posterior bone growth can cause curvature also but I don't think that is common based on the testimonials. Most kyphosis cases have pretty straight backs on A/P view for a reason. Don't really know though.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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