Instrumentation Systems for Scoliosis Surgery

For the person anticipating scoliosis surgery, it is confusing and sometimes troubling to learn of the wide variety of instrumentation systems that are in use today. Why, the patient wonders, are there so many? How are they different? Which one is best? That last question is the easiest to answer. The fact is there is no one “best” instrumentation for every patient or for every physician. In planning the surgery, the physician takes a number of factors into account: the location and magnitude of the curve, the degree of rotation, the extent of deformity of the individual vertebrae, the rigidity or flexibility of the spine, the density of the bone, and the size of the patient. In addition, the physician may have a personal preference and skill for working with one instrumentation or another.

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Many adults with scoliosis, including those with prior corrective surgery, are curious about the risks and benefits of exercises and sports participation. In our experiences, most adults with scoliosis have never held discussions with medical professionals about these issues. Research based information about therapeutic or recreational exercise for adults with scoliosis is lacking. The advice expressed in this article will therefore reflect experiences described to us by our patients with scoliosis, and our recommendations to these patients.

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Exercise for Adolescents

Adolescents with scoliosis and their families have questions concerning exercise. These questions are usually about two general areas:

  1. Can exercise correct or stop the progression of the scoliosis curve?
  2. Are recreational exercise and sports participation advised?

In this article, we will present some of the advantages and limitations of exercise for adolescents with scoliosis. Adults with scoliosis, including those with corrective surgeries, often also seek advice about exercises, especially if they begin experiencing discomfort and stiffness in their backs. Therapeutic and recreational exercise for adults will be presented in a future article.

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Early Onset Scoliosis

From time to time, the National Scoliosis Foundation receives questions from parents about early onset or infantile scoliosis. To find out more about this spinal abnormality, we asked Nancy Schommer, author of Stopping Scoliosis, to interview Dr. Ronald Moskovich, who is Assistant Professor of Orthopedic Surgery at New York University as well as a practicing specialist in spinal disorders at the Hospital for Joint Diseases Orthopaedic Institute in New York City. What follows are excerpts from the interview.

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Chiropractic

The word “chiropractic” is a compilation of two Greek words which are interpreted to mean “efficient hands”. In 1898 David Daniel Palmer, the originator of chiropractic, set up the Palmer College of Chiropractic in Davenport, Iowa. Today, there are fifteen accredited institutions and programs in the US offering the Doctor of Chiropractic (DC) degree.
Following is an explanation of the nature, practice, and basic theories of chiropractic as defined by the Council of Chiropractic Education, and the Massachusetts Chiropractic Society.

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Throughout history man has tried to straighten out that which nature has bent, twisted, or curved. Hippocrates not only gave a name to scoliosis but he also tried to correct it. Over the centuries since then physicians have used a wide, and sometimes strange, variety of devices to straighten a crooked spine.
In today’s world when a growing adolescent is diagnosed with progressive idiopathic scoliosis and the curve is between 25 and 40 degrees, the physician will prescribe the wearing of a brace to keep the curve from worsening. Depending on the severity of the curve, the curve pattern, and the amount of growth remaining, the physician may not wait to document progression but will prescribe bracing on the initial visit.

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Answers to Questions About Mild Curves

Every year, the National Scoliosis Foundation receives letters and telephone calls from parents of young people who have been told they have a “mild” curvature of the spine. They are concerned and confused. They have been told that treatment is not presently necessary but may be in the future. Parents ask us, “are we to just stand by and watch our child become deformed?” To find out more about such curves, we interviewed Dr. William P. Bunnell, Chairman of the Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California.

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Adult Scoliosis

by Nancy Schommer, author of Stopping Scoliosis

Because so many adults have contacted the NSF, we asked Nancy Schommer, author of Stopping Scoliosis, to provide us with an update about adult scoliosis. In the course of her research, she interviewed Dr. David B. Levine, Clinical Professor of Orthopedic Surgery at Cornell University Medical College and Director of Orthopedic Surgery at the Hospital for Special Surgery in New York City. Following are excerpts from their conversation.

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June is Scoliosis Awareness Month!

Thank you to all the doctors, clinicians, nurses, healthcare/government officials and patients & family members who are working to spread the scoliosis awareness campaign throughout the U.S. and to many countries around the globe, from Canada, to the U.K. and as far reaching as Turkey.

We need a strong collective voice advocating for early detection and treatment to ensure that children and families receive the optimal care they deserve. A special thank you to our local policy makers, providers, and school nurses for their continual support for more than thirty years.

 

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