Possible causes in my case

[Craig831]

Hello to all. I'm 42 yr old male who was diagnosed with severe Kyphoscoliosis somewhere in the 74 to 87 degree curviture back in July of 1981. I have thought about the possible causes to any spinal curviture and mine. I thought hard over the years. One idea dawned on me back in the mid 90's. I vividly remember a position I slept in from ages 11 to 18. In bed face down with my right arm folded under my right side of my chest, possibly pushing the rib cage and spine into a Kyphoscoliosis curviture over the years when your growing. Parents need to monitor there children's sleeping positions. Another cause maybe double jointedness. I was very double jointed as a kid and teens. Children are very limber. They may be playing in ways that may contribute to a spinal curviture over the years when they are growing up. So the important thing is to monitor children's backs as they are growing up. Especially from ages 10 to 18 yrs old. Watch out for the poor postures and when watching TV,Video games and working on PC's. My grandmother back in 1975 said something about my back and no listened. By 1977,my sisters boyfriend at the time said something about my back and then everyone listened. I'm afraid that poor sleep position may contribute to spinal curvitures over time.

[Mary Lou]

Hi Craig,

I'm not so sure I agree with your sleeping theory, but I do agree with you that bad posture is a good sign to watch out for. My 13 y.o. daughter had surgery two and a half months ago to correct her Kyphoscoliosis. Her shoulders looked "rounded" and my husband was constantly telling her to put her shoulders back. Not knowing any better we thought it was bad posture. The bad thing is, no one ever tells you what Scoliosis looks like, let alone Kyphosis (most people have never heard the word before). We need parents to be more educated in what to look for in their children to get more kids diagnosed at an earlier age. Everyone knows what Scoliosis is, but not the signs of Scoliosis.

As for a cause, when Scoliosis or Kyphosis is diagnosed during the teen or preteen years, usually there is no cause. In my daughter's case, we believe she has a condition called Charcot-Marie-Tooth (CMT) which has caused her Kyphoscoliosis. Even though this condition has affected many, many generations of my husband's family, no one even knew that Scoliosis and Kyphosis cancome from CMT until I stumbled across it myself. I think we all need to share our experiences with others and maybe we can educate others and help them avoid going through what everyone on this site is/has gone through.

Best of luck with your back.

Mary Lou

[LindaRacine]

While I don't think anyone knows for sure, it seems that most scoliosis specialists agree that posture, sleeping positions, carrying a backpack on one shoulder, etc. cannot cause scoliosis. There has been some discussion in the last few years, about the possibility of an infant's sleeping position causing scoliosis, but I don't believe there's been anything definitively published. Here are a few references on the subject:

From http://www.intelihealth.com:
One thing does seem clear: Sitting up straight in your chair or while walking will not prevent scoliosis. Improved posture may have other benefits, such as preventing muscular back pain or making your mother happy, but there is no evidence that consciously trying to improve your posture will have a long-term effect on the alignment or health of your spine.

From http://www.iscoliosis.com:
iScoliosis.com: Is it behavioral, do back packs or poor posture cause scoliosis?
Dr. Newton: It is not from any of those things that we know of; it seems to be a growth related phenomenon that occurs during adolescent growth. I don't believe there are any external causes, such as backpacks or poor posture that can cause scoliosis to develop.

From http://pediatrics.aappublications.or...100/1/e11#B10:
From monitoring trends in mortality, it has been shown that the change in sleeping position has not resulted in increases in other causes of death in infancy.1,2,5,8,9 Nevertheless, there remains the suspicion that other features of the child's health may be affected. The American Academy of Pediatrics Task Force listed the following reasons why prone sleeping had been thought to be better for infants10: a decreased likelihood of aspiration, reduced gastroesophageal reflux, less colic, less head molding and, in children with specific abnormalities such as the Pierre Robin syndrome, the risk of airway obstruction when supine. Advantages of prone position were described as improved pulmonary function, sleeping and psychomotor development, and the possible prevention of infant scoliosis.10,11 Consequently, the American Academy of Pediatrics Task Force was worried that encouraging parents to put the infants to sleep supine might affect the health of the child adversely though the evidence upon which some of the concerns were based was poorly documented.

[nikyergen]

Mary Lou,
I agree with you. I don't think the sleeping theory is true. As you know, my daughter, Crystal, is scheduled for the same surgery as your daughter on March 15, 2005. Kyphoscoloisis. I find myself going to her defense and my youngest daughters (she has kyphoscoliosis, too) defense when adults tell them to stand up straight. They, point blank, can't. If I would of known the symptoms when Crystal was 8 years old, we may not be having surgery in three and a half weeks. We didn't know better either. We find that once we explain the problem people are surprised and apologize for telling to stand up straight. Just for the records, Crystal sleeps on her side and the youngest sleeps on her back. Also, our middle daughter has scoliosis and is a wait and watch. Carolyn, you already know all this. But, Craig, these things just happen with these kids and nothing inparticular caused it. They won't even say my daughters have a genetic defect. So, what caused it. We have know idea and we aren't going to try to figure it out. We have three girls with back issues and are doing our best to get them corrected.

Crystal has severe asthma and has had many x-rays over 16 years. The doctors would ask if she had injured her back. I would say no and they would say okay, instead of wanting to look into it further. I wish I would of known then what I know now, I would of been pushy with the doctors and maybe we wouldn't be going to surgery in 3 and a half weeks.

Okay, I'll get off my soap box now. Craig, they are sure what causes some of these problems and aren't sure they will ever know. So, we just need to educate other parents to keep an eye on their children. Obviously, our public school system didn't do scoli checks either. This is something I may try to get brought into our schools.

Nikki

[Mary Lou]

Hi Nikki,

How are your nerves? Are you and Crystal ready for surgery? I'll be thinking about you guys and praying for you on the 15th.

I never thought about Jamie's sleeping position until you mentioned the way your girls sleep. Jamie has always been a back sleeper, even before her surgery.

It is funny you mention the school screening. Our school district checks the kids in seventh grade. Jamie was diagnosed in August before the school checked them in October, I think. Jamie is a young eighth grader as she only turned 13 this past August and most of her friends were getting ready to turn 14 or were already 14. If we had kept her out of school until she was five, she would never have been screened at school until it was way to late for her. Her curvatures would have been in the surgery range immediately upon diagnosis. I asked the school about their policy and they said they don't check before seventh grade because they require kids to get a physical before entering sixth grade so they assume the doctors are checking their backs. Interesting, huh?

Thankfully our family doctor checks my girls' backs yearly and he is the one who diagnosed Jamie.


Mary Lou

[Celia]

Hi,

I have to agree with Craig to a certain extent. I'm not saying that sleep position CAUSES scoliosis, but if a child is genetically predisposed to getting scoliosis, sleep position could aggravate the problem. Isn't that the logic behind night time bending braces ? I recently came across the following article on growth and sleep:

CHICAGO (Reuters) - The perception that children seem to grow taller overnight is likely true, researchers said on Thursday.



Related Links
• Study abstract: Growing Pains (Journal of Pediatric Orthopaedics)


Scientists at the University of Wisconsin's School of Veterinary
Medicine in Madison placed sensors on the leg bones of lambs to
monitor bone growth in the animals. Ninety percent of bone growth occurred when the animals were sleeping or otherwise at rest, according to the study published in the Journal of Pediatric
Orthopedics. "We observed this noncontinuous pattern of growth, but what was really interesting was that the bones were growing only when the animals were lying down, and almost no growth occurs when the lambs are standing or moving around," study author Norman Wilsman said.


He reasoned that growth plates consisting of soft cartilage at the
ends of bones become compressed when walking or standing, preventing growth. When lying down, the pressure on the growth plates is off and the bones elongate.


Co-author Kenneth Noonan said: "This is a study that points out that growth is not a continuum. There are growth spurts, which may occur within the daily life of lambs and possibly humans too."


Previous research has shown children grow in spurts that may last just a few days. Children sometimes complain of intense growing pains at night that emanate from the ends of their lower extremities where the growth plates are, Wilsman said. There is no treatment for growing pains.



Celia

[LindaRacine]

Isn't that the logic behind night time bending braces

I don't think so, although again, I don't think anyone knows for sure.

This is from the SRS Bracing Manual:

"Sidebending Theory

The factors contributing to the success of time-modified sidebending are unclear. Stretching the concavity and possibly a physiological contracture on the convexity of the curvature appears to play a role. Visuospatial impairment, EEG, and learning deficit disorders have all been identified in patients with scoliosis. Vestibular, cerebellar and posterior column function may be challenged by re-orientation of body position.

In theory, bending of the spinal column should add tensile and opposite compression forces to the vertebral epiphyses compared with forces at work in the upright posture. The benefits of uncompromised postural muscle tone during upright activities and the opportunity for the patient to remain athletically active during their brace course may enhance the phenomenon of spontaneous curve correction that occurs on a day-to-night basis.

All bracing systems depend on the nocturnal wear component as part of their programs. There are no harmful physiological, biomechanical, or clinical effects noted in the nocturnal wear program. With documented successful outcomes, the positive aspects of the Charleston Bending Brace system are evident even if the reasons for success are not entirely clear."

--Linda

[Celia]

Linda,

You're pretty thorough ! When was that SRS paper written ? They say:

"With documented successful outcomes, the positive aspects of the Charleston Bending Brace system are evident even if the reasons for success are not entirely clear."

It's curious they don't know why the Charleston Bending Brace works - it seems pretty elementary to me, but then I'm not a doctor - I don't look for complicated reasons such as: "bending of the spinal column should add tensile and opposite compression forces to the vertebral epiphyses compared with forces at work in the upright posture" I wonder what the manufacturers of the brace have to say ?

Another point I'm at odds with is:

Visuospatial impairment, EEG, and learning deficit disorders have all been identified in patients with scoliosis.





Celia

[LindaRacine]

Celia...

According to the SRS website, the paper was updated in 2003.

--Linda

[gruvin84ss]

double jointedness and a head forward posture(chicken neck - out in front of body instead of over shoulders like it should be) are risk indicators for scoliosis.

Check out this download on scoliosis:http://www.clear-institute.com/pdf/S...-Dr_Woggon.pdf

[Shaun26]

Sleep position is important and it is a feature currently ignored by professionals in this area of research. When the body is young and fluid, the configuration one sleeps in for a good 3rd to half of their life in their young years can assist in the rotation of a damaged spine or a spine prone to twisting.

This is rational very basic thinking yet it continues to allude professionals. It's one more reason why progress hasn't been made.

After years of thinking about influences on my scoliosis, one of the conclusions I came to was like yours... sleeping pattern.

Things like sleep patterns, sports bags, and daily physical routines must also be taken into consideration. When I was younger, I would always sleep with my body in a certain configuration. It felt comfortable this way, and incidentally, my spine developed a curve that is reminiscient of the configuration my body had when I slept. Did my sleeping pattern cause the scoliosis or did I feel more comfortable sleeping this way because I already had developed scoliosis all those years ago and didn't know it? I don't know, however it makes rational sense that it would be one of a myriad of influences. To disregard sleeping pattern in the development of scoliosis is atrocious.

[Shaun26]

Hi,

I have to agree with Craig to a certain extent. I'm not saying that sleep position CAUSES scoliosis, but if a child is genetically predisposed to getting scoliosis, sleep position could aggravate the problem. Isn't that the logic behind night time bending braces ?

Yes it is. Plain and simple.

[Mom37]

I agree with Craig and Celia that sleep position can play a factor in aggravating spine curvature further. The braces force correct positioning and so it stands to reason sleeping balled up over time could be a hinder to a curved spine. Somewhere on this forum or the spine kids forum someone addressed the issue of posture and stated they collected old medical books from all over and older ones mention posture, particularly doctors outside of the US I believe. I don't remember where I saw as it was about 4-6 weeks ago when I first came on to the forum. So now they say they don't know, but it could be a factor from what I am hearing and believe.

[Karen Ocker]

My experience:
I always slept flat on a firm mattress, never curled on one side or another, always favored sleepng flat with NO pillow.
Go figure.

Scoliosis in: mother, sister, brother, girl cousin, and on my father's side a cousin's daughter had scoliosis (surgery).

I think this sleeping position theory is barking up the wrong tree. Fifty + years ago it was believed that, perhaps: schoolbags, mattresses, posture caused scoliosis. Wished it was that simple.

So many people in the world sleep in hammocks and poor bedding, as well as tiny spaces in cramped rooms.
Why don't all those people have kyphosis/scoliosis?

Dr. Boachie said in Ghana, a very poor country, the incidence of scoliosis is the same as here.

[The Professor]

I think this sleeping position theory is barking up the wrong tree. Fifty + years ago it was believed that, perhaps: schoolbags, mattresses, posture caused scoliosis. Wished it was that simple.

I concur. As a child and all the way through my 20s, I slept on my back, maybe 1 pillow.

Fifty years ago (even twenty years ago) scoliosis was thought to be a result of poor posture, but that's mostly just a matter of anecdotal evidence, not empirical evidence.

IMHO, if a kid has abnormal posture, it's not that they're not trying to stand up straight, they can't! My mother harped on my posture as a child-- but it's not like I wasn't trying to stand up straight or was intentionally rolling my feet inward as I walked. All those clues... and they don't pick this up until I'm in my mid 30s? Geez.