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Thread: Another study finds assocation between HYPOkyphosis and Scoliosis

  1. #16
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    Quote Originally Posted by Pooka1 View Post
    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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    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
    No, he had a posterior release and fusion.
    Son 14 y/o diagnosed January 20th. 2011 with 110* Curve
    Halo Traction & 1st. surgery on March 22nd. 2011
    Spinal Fusion on April 19th. 2011

    Dr. Krajbich @ Shriners Childrens Hospital, Portland Oregon



    http://tinyurl.com/Elias-Before
    http://tinyurl.com/Elias-After

  2. #17
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    Quote Originally Posted by Elisa View Post
    No, he had a posterior release and fusion.
    Ah okay. Do you know what is involved in that? Was it anything to do with ligaments?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

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    "We are all African."

  3. #18
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    Here's the deal as I understand it...

    In idiopathic scoliosis, the curvature and rotation are due to the anterior overgrowth of the spine. But anterior overgrowth of the spine can't possibly be primary cause because that does NOT explain the 7:1 ratio in girls to boys. So all the work on primary etiology remains.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  4. #19
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    I'd have to look it up again but I do believe the release had to do with snipping the ligaments to "loosen things up" as Dr. K said. After reading the other posts, I am thinking that loosening the ligaments help to rotate the spine back to more of a normal state and that the traction pulled out his lateral curve. After the release and traction, he went from 110* to 60* in 6 days! That's very impressive.
    Son 14 y/o diagnosed January 20th. 2011 with 110* Curve
    Halo Traction & 1st. surgery on March 22nd. 2011
    Spinal Fusion on April 19th. 2011

    Dr. Krajbich @ Shriners Childrens Hospital, Portland Oregon



    http://tinyurl.com/Elias-Before
    http://tinyurl.com/Elias-After

  5. #20
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    Quote Originally Posted by rohrer01 View Post
    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
    I am not aware that anyone has suggested or investigated that ligament tension is anything but secondary to the curvature. Do you know of anyone suggesting it is primary?

    Cutting ligaments, if that is even done, in treatment of large curves is not related to that being the cause of the curvature to my knowledge. As far as I can tell, the consensus is that the curvature is caused by the anterior overgrowth but who knows.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  6. #21
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    Quote Originally Posted by Pooka1 View Post
    but who knows.
    Not me! lol

  7. #22
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    Quote Originally Posted by Dingo View Post
    Rohrer01



    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.
    That's a horrible thought that these people had to die and THEN get their spines fixed with no benefit to themselves. I am deeply greatful to those who are generous enough to donate themselves to research so that others may benefit.

  8. #23
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    Pooka1

    I read through the links you posted and they were very interesting. One mentioned the deformed ligament hypothesis.

    The hypothesis that relative anterior overgrowth results in idiopathic scoliosis is not new. Roth9,10 explained the pathomechanism of idiopathic scoliosis with a spring-string model. According to this theory, the relatively shorter posterior column acts as a tether which hinders the lengthening of the anterior column during the period of rapid growth, forcing the spine to bend and rotate. Different tissues such as bone, spinal cord, ligaments, and muscles are included in the posterior column. The issue is which structure in the posterior column causes the tethering.1,2,9,10,13 The observation in the crankshaft phenomenon that continuous growth of the vertebral bodies results in the rotation of the fused segments of spine around the fixation rods suggested that the tethering force was located at the centre of rotation of the scoliotic spine.19 Tethering of the posterior soft tissues such as the posterior ligaments has been presumed to be the force acting on the spine to create the complicated deformity.2 Using a model in young rabbits, Somerville2 demonstrated that tethering the posterior elements could produce a scoliosis characterised by thoracic lordosis, rotation and lateral curvature of the spine. He postulated that the posterior ligaments failed to grow as fast as the bony elements and might act as a tether forcing the spine into lordosis. Flexion forced the apical vertebrae of this lordotic segment to deviate from the midline, resulting in scoliosis.
    Later studies suggested this might not be the case because the spine wasn't rotating around the predicted spot.

    But after reading all the links my general sense is that bone growth is a factor that scientists have good reason to be interested in but they can't definitively tell if it's primary.

    I'm not an expert on biomechanics but if bone growth is the problem I can't understand how Torso Rotation Strength Training could be effective. Unless maybe the amount of bone deformity is relatively small but somehow even a small amount can trigger a cascade of dysfunction in the muscles and ligaments that actually cause the Scoliosis.
    Last edited by Dingo; 11-19-2011 at 11:00 PM.

  9. #24
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    Quote Originally Posted by Pooka1 View Post
    Cutting ligaments, if that is even done, in treatment of large curves is not related to that being the cause of the curvature to my knowledge. As far as I can tell, the consensus is that the curvature is caused by the anterior overgrowth but who knows.
    It wouldn't really matter if the ligament deformity is the cause or not. If it helps to release the spinal deformity during surgery why aren't they doing more of it on smaller curves? You hear of so much rod breakage and bolts loosening. Wouldn't this help lessen the tension on the rods? I know a lot of breakage is due to pseudoarthrosis, but is all of it due to that? I would opt for a release if I could get a better correction.

    Actually, I would have opted for better exercises as a teen rather than the harmful ones that contributed to flattening my back out more. It may not have corrected the curve, but if I had had a good program when I was still flexible, maybe I wouldn't have the pain I have today....

  10. #25
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    Quote Originally Posted by Dingo View Post
    Pooka1

    I read through the links you posted and they were very interesting. One mentioned the deformed ligament hypothesis.



    Later studies suggested this might not be the case because the spine wasn't rotating around the predicted spot.

    But from reading all the links my general sense was that bone growth was something they are very interested in but they can't definitively tell if it's primary.

    I'm not an expert on biomechanics but if bone growth is the problem I can't understand how Torso Rotation Strength Training could be effective. Unless maybe the amount of bone deformity is relatively small but somehow even a small amount can trigger a cascade of dysfunction in the muscles and ligaments that actually cause the Scoliosis.
    Correct me if I'm wrong, but I do believe that muscle mass can influence the shape of bones. I have a friend that is over six and a half feet tall. When he went through his growth spurt, there was so much tension on his tibias that they actually bowed. I have also seen skeletons of people with large muscle mass vs. small muscle mass and you can see a difference in their bones. With that said I CAN see how TRS could work even if the bone growth were the primary cause, which of course no one knows for sure and absolute.

  11. #26
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    Anterior overgrowth can't possibly be primary unless and until they can explain why the 7:1 ratio of girls to boys fits within that being a primary etiology. I don't see it. The answer has to involve the different hormone regimes or something that is different between girls and boys. Because AIS is 7:1 and JIS is 1:1, that I think is the basis to suggest they are different conditions. And that's a pretty damn good basis for suggesting they are different in my opinion.

    That is a different question from the apparent consensus agreement that the curvature and rotation are in fact due the anterior overgrowth. If the front of the spine is growing faster and more than the back then something has to give. The result is curvature and rotation. I did not think this was still an open question.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  12. #27
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    Quote Originally Posted by rohrer01 View Post
    It wouldn't really matter if the ligament deformity is the cause or not. If it helps to release the spinal deformity during surgery why aren't they doing more of it on smaller curves? You hear of so much rod breakage and bolts loosening. Wouldn't this help lessen the tension on the rods? I know a lot of breakage is due to pseudoarthrosis, but is all of it due to that? I would opt for a release if I could get a better correction.

    Actually, I would have opted for better exercises as a teen rather than the harmful ones that contributed to flattening my back out more. It may not have corrected the curve, but if I had had a good program when I was still flexible, maybe I wouldn't have the pain I have today....
    Good points.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  13. #28
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    Rohrer01

    You could be right. It's certainly true that exercise and muscle mass impact the way bones grow. Athletes can deform their bones through exercise. I saw a study where they measured the bones in the feet of track stars and their left and right feet grew differently if they ran on an oval track.
    Last edited by Dingo; 11-19-2011 at 11:17 PM.

  14. #29
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    But kids who do various specific sports and kids who do no sports mostly still all have right thoracic curves. So the initial condition of using various muscles doesn't map to the curvature. It is not related.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  15. #30
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    Pooka1

    You're right. If the front of the spine grows faster than the back a curve would develop. But from those links I don't think they can prove why the bones are doing this. Maybe it's secondary to some other problem or just a small part of the overall problem.

    For instance (it's probably not this) but maybe the muscles are tight and they pinch the vertebrae and cause them to grow incorrectly. So actually the muscles are to blame. And even if you could fix the deformed vertebrae you'd still end up with Scoliosis because the muscles would keep pulling the spine out of place. Or who knows.

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