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Thread: PT as a treatment of scoliosis

  1. #31
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    Yes Flerc, I know about the bone remodeling which you posted. The problem is, you must have great amount of correction and that correction must be maintained for a very long time in adults in order to start bone remodeling.
    And why some curves progress and others don't? I think that 50 mark alone can't be taken into account because scoliosis is 3D deformity. No matter what the cause of scoliosis is, we know that biomechanics have a major role in curve progression. Vertebral body stapling works for children who are still growing, that is clear evidence it is mainly biomechanical disease, also that means that bracing MUST work in children if we achieve high correction(check out Rahmouni from Germany, I have seen some amazing results on his web page with his overcorrective braces.)
    You can't take into account just cobb angle, because vertebral rotation and spine's saggital profile also have influence on spine stability. Also, I think that vertebral bone density could influence progression. Maybe that is why females after menopause sometimes experience significant progression!?
    If only gravity leads to curve progression, than body weight is also important because additional weight surelly puts more stress on the spine.
    So, if adult scoliosis progression is influenced only by gravity and spine's ability to counter that force than we can say that all these components have influence: cobb angle, vertebral rotation, sagittal profile, body weight(BMI), bone density and also our posture. And yes, if ligaments hold vertebrae together, than loose ligaments and too much mobility is not good. This is so complex but it is all logical and makes sense. It just looks like medical comunity is not interested enough in this subject because they are now able to do these costly surgeries with acceptable outcome in most cases.
    Spring, where the appex of your curve was, which vertebras were included in your lumbar scoliosis?

  2. #32
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    Quote Originally Posted by boogaloo View Post
    Yes Flerc, I know about the bone remodeling which you posted. The problem is, you must have great amount of correction and that correction must be maintained for a very long time in adults in order to start bone remodeling.
    Hi Boogaloo, how many time is needed? Im not sure to understand well this issue but I suppose that remodeling may be good or bad. The bad remodeling leads to vertebral wedge which in turn would leads to progression.. a surgeon said me something as that bad remodeling leads to artrosis. It should be stopped!. Even if good remodeling cannot be achieved without surgery or braces, we need to break that vicious cycle. If good remodeling would need a long time having the vertebras without an important desviation or aligned, bad remodeling would not also need a long time the vertebras, all the time forming the curve? If during some hours during the day (or night) you have your vertebras aligned, that cycle would not be broken?

  3. #33
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    Quote Originally Posted by boogaloo View Post
    If only gravity leads to curve progression, than body weight is also important because additional weight surelly puts more stress on the spine.
    So, if adult scoliosis progression is influenced only by gravity and spine's ability to counter that force than we can say that all these components have influence: cobb angle, vertebral rotation, sagittal profile, body weight(BMI), bone density and also our posture. And yes, if ligaments hold vertebrae together, than loose ligaments and too much mobility is not good. This is so complex but it is all logical and makes sense.
    In kids, growth + gravity but in adults, what else? Probably muscular forces, but surely if we would live in the moon, that kind of internal forces would not be enough for progression.
    Not only vertebral shape, but also disc height seems to be important.. hydratation is needed, I heard that vertebra irrigation too.

    I think we need to improve the statical structure and I don't know what could be done with ligaments.. if muscles don't holds the spine, I don't know what could be done.. I thinks is mainly a static problem as I said to Kevin.. but what could I know..

    Quote Originally Posted by boogaloo View Post
    It just looks like medical comunity is not interested enough in this subject because they are now able to do these costly surgeries with acceptable outcome in most cases.
    Few days ago I heard a spinal surgeon saying he knows that within some years the surgeries he does will be seen as something brutish, but he is a human wanting to help and he cannot perform another kind of surgery. But for medical community, scoliosis seems to be a solved problem.

  4. #34
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    Quote Originally Posted by flerc View Post
    I think we need to improve the statical structure and I don't know what could be done with ligaments.. if muscles don't holds the spine, I don't know what could be done.. I thinks is mainly a static problem as I said to Kevin.. but what could I know..
    Probably something may be done to improve ligaments (Kevin said something), fascias and joints, but sureley muscular lenght and tone may be improved, but if they don't belongs to the static system.. wich could be the benefit?

  5. #35
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    I'm thinking that even if it would be true that the curve would remains with the same degrees if muscles would be cut (but not ligaments) anyway it would not imply that muscles don't belongs to the static system.. if some muscle lenght would be shorter, the curve should to change.

  6. #36
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    IF only ligaments holds the spine in a static way, as that proof in a cadaver seems to have shown, we may think that muscular improvement as Schroth, Seas and others proposed, would have not much sense. Which could be the benefit if the spine structure would remains the same? Just only to fight against the gravity force during exercise practice?
    But I suppose that that cadaver spine had not scoliosis. Probably in a normal spine, muscles has nothing to do with something different to movement.. it has really much sense. But with a lateral curve, I think it should to be different and probably some specific (which?) muscle may hold the spine in a better way if it is shorter or even with higher tone.
    We need to know anatomy, but probably this issue is a mystery not only for us.

  7. #37
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    Quote Originally Posted by flerc View Post
    sureley muscular lenght and tone may be improved, but if they don't belongs to the static system.. wich could be the benefit?
    psoas don't seems to have much to do with lordosis.
    http://www.ncbi.nlm.nih.gov/pubmed/7730392

    the same may be said about any other muscle and scoliosis?

  8. #38
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    Quote Originally Posted by boogaloo View Post
    Yes Flerc, I know about the bone remodeling which you posted. The problem is, you must have great amount of correction and that correction must be maintained for a very long time in adults in order to start bone remodeling.
    Boogaloo, as I know Spinecor for adults treatment lasts 18 months. Do you believe it would be enough?

  9. #39
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    Age 67
    62 degree right thoracic
    48 degree left lumbar
    3/4 " short left leg

    Have you had your leg lengths measured? In my opinion, I believe that my short left leg CAUSED my scoliosis. 6 weeks ago I had left hip replacement and the surgeon extended my left femur 1/2 ".
    I no longer where a lift.

    I have been doing exercises daily for 5 years after I "hit the wall" at the age of sixty.

    If you want to see what I do in the daily program, send an email request to rkochis65@gmail.com I will send a dropbox link. I use a combination of Egoscue and SLM Yoga
    Over the 5 years my curvatures have not changed (had them measured a year ago) but I can state without reservation that my posture has improved significantly.
    Randy

  10. #40
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    Great to read what you are saying RKochis, very much hopeful really. I’ll send you an email of course. I think is not true that is only a genetic matter the reason explaining why some people with a big curve are fine and others with a lesser curve are so bad. Non-surgical actions (not only treatments) has a lot to do for me. I’m not sure about muscles.. every day I think different. Today I remember what I thought about the atypical height difference in the morning.. also I heard that Rxs shows different degrees, so why could be it possible if muscles has nothing to do in order to hold the spine?Ligaments is again the reason? It’s clearly not only a discs matter.
    Really good to find someone as you here!!

  11. #41
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    That really interests me too. Why is curve magnitude bigger in the evening than in the morning, especially for those over 40? Maybe Linda could ask someone who is specialized in spine? That really happens because I feel that and I can see it, in the morning my torso looks taller and my back feels straighter. In the evening I feel like my ribs are closer to my pelvis and my torso looks shorter and I get that tired feeling in my back. If that curve worsening is because of ligaments I think that it would cause permanent worsening, and curve would not come back to its original shape after sleeping all night. I really think muscles are involved here because during the sleep they deeply relax and rest and in the morning they are capable of holding the spine straighter, how the day goes they get tired and can't hold the spine. But who knows, maybe my theory is completely wrong...

  12. #42
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    Curve magnitude may be slightly larger in the evening because the weight of the vertebrae increases loading over the day. We are also taller in the morning than the evening for the same reason . Susan
    Dxed 8/2011: Degenerative Adult-Onset Scoliosis age 65
    XRAY 1/2012: 25* T levoscoliosis/ 36* L dexroscoliosis w/ 4.1 cm coronal & 3.5 cm sagittal balance
    XRAY: 12/2012: Scoliosis curve same, Coronal Balance increased to 11.2 cm. T kyphosis 90 degrees
    Severe disc degeneration thoracic & lumbar, stenosis esp L4
    Surgery: T3 to S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries,
    19 & 22 March 2013, Dr. Serena Hu @ UCSF
    Postop incisional hernia @ ALIF incision, repaired 3/2014

  13. #43
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    I don't think the weight of the vertebrae changes (at least not in a single day). Curves increase during the day because the discs lose fluid. They regain that fluid at night.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  14. #44
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    Boogallo, probably nobody in the world is able to answer these kinds of questions. Probably if you ask this to 10 different specialized in spine professionals you’ll get 10 different answers. Maybe science cannot help us in this sense, probably not yet. We need to get the knowledge for ourselves. But it seems to be really very few people around the world interested in do this. What I saw today after some days that my daughter was in bed because sore throat cannot be explained in anyway because disc decompression, impossible really. Unfortunately I have not scoliosis, otherwise I could do some experiments with my body. .a lot of experiments really. Like this man I found some days ago. http://www2.pms-lj.si/bibliag/scoliosis.htm I bought some years ago exactly the same kind of corset for my daughter but she never used it.. I didn’t insisted very much, I’m not a health professional. This man says what I said in some threads about backpacks. If I would have scoliosis I would use it, I’d add more weight during the day. Some physiatrists talks about unconscious muscles. I’m not sure if it have sense but when I bend to the left I feel back muscles around right side activated and I’m not doing it in a conscious way. Some years ago I asked to my son to stand over my shoulders. I think it was unconscious and really fantastic the force of my muscles trying to make me taller. I think that during night those muscles ‘understand’ that is not any need to work, but in the morning, when we stand up, gravity force arises immediately so they try to make us taller. After some hours they begin to accept that manageable force and begin to stop to stretch us. But what if they see that gravity force is greater and greater during the day? I think they should to try to make us taller during all the day. Well.. surely your theory has much more sense..

  15. #45
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    If it would be true, it would be great!! A muscular brace! It would be really very simple to design a dispositive adding weight to the shoulders during the day.

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