By using protocol from the International Scoliosis Research Center, a 47-year-old female’s mild Tertiary Scoliosis was reduced thirty-nine percent in 30 days with respect to the Cobb Angle measurements.
Scoliosis or “skoliosis” coined by Hippocrates has afflicted the human spine since the stone age.1 Medical treatment for scoliosis varies from “wait and see” to spinal fusion.
Determining method of treatment under standard medical protocol is specific for the severity of curvatures. One to twenty degrees of spinal curvature is treated by periodic radiographic assessment to monitor curvature progression. In curvatures of twenty-one to thirty-five degrees, medically speaking, the treatment includes bracing or casting of the patient’s torso. Curvatures of over thirty-five degrees are considered surgical candidates. The goal of treatment for bracing, casting, and surgery is to have no worsening of the curvature severity. Although the Milwaukee Brace, plaster casts, and the Boston Brace, have suggested improvements in halting curvature progression and short term rib hump improvements, these techniques are socially undesirable.
To contrast old medical standards, the International Scoliosis Research Center has set chiropractic protocol for scoliosis treatment. Anticipated results for spinal correction using chiropractic adjustments, heel lifts and traction, surpass the medical standard and expect as much as eighty percent correction in a patient’s curvature. Specifically, in curvatures that are between one and twenty degrees; an improvement of eighty percent in six months can be made. Curvatures of twenty-one to thirty-five degrees can improve as much as fifty percent in eighteen months. Even a curvature of thirty-five degrees or more can be improved twenty to thirty percent in twenty-four months.
By using exactly this protocol from the International Scoliosis Research Center, a 47-year-old female’s mild Tertiary Scoliosis was reduced thirty-nine percent in 30 days with respect to the Cobb Angle measurements.
The initial patient complaint, for which she sought relief, was left suboccipital headaches. The headaches were on and off for 33 years with a recent increase in pain frequency for two months. The patient has a history of high blood pressure and Asthma. The patient was treated the previous year chiropractically for low back pain. The only trauma described by the patient, prior to headache onset, is a bicycle accident in which she hit her head at the age of 10. On an Anterior to Posterior Cervical x-ray, the presence of a spinal curve was identified. At the patient’s request, a scoliosis x-ray was taken. Spinal curves were evident, therefore, via ISRC protocol, hanging AP thoracic and hanging AP lumbosacral views accompanied the weight bearing AP thoracic and AP lumbosacral views. Initially, a cervicothoracic physical exam was given with a cervical and scoliosis radiograph series. The cervico-thoracic physical exam revealed posterior neck and suboccipital tenderness. Palpation also revealed a body left C2 vertebra and a left Listhesed C1 vertebra. Abnormal findings included high right mastoid, high right shoulder, increased left arm gap and a 5-pound left weight shift on the bilateral weight scales. Cervical range of motion, upper extremity deep tendon reflexes and Cervical orthopedic tests were unremarkable.
A Cervical x-ray series included: AP Lower Cervical, AP Open Mouth, and Lateral Cervical Neutral views. The radiographs confirmed the cervical misalignments at segments cervical one and two. The AP Lower Cervical view revealed evidence of a Thoracic Curvature. The Scoliosis x-rays included: AP Thoracic and AP Lumbosacral, and a Lateral Lumbosacral view. AP Thoracic and AP Lumbosacral hanging views were taken to assess the spinal curve flexibility.
The hanging film was taken because ISRC procedure has a premise that if the spine is flexible to the stress of gravity it will also be flexible to treatment. A fifty percent improvement in the curvatures, when comparing standing and hanging films, indicates some degree of correction can be achieved during treatment when following ISRC procedures.
Scoliosis baselines and future assessments are measured from the initial radiographs, therefore, extreme effort is taken to position any Scoliosis patient in midline with the Central Ray. According to International Scoliosis Research Center protocol, significant x-ray markings include: measurements of the sacral inferiority, vertical coccyx, and pubic symphysis deviation from the S2 tubercle, obterator equality, femur inferiority and Cobb Angles.
The remarkable x-ray findings included pelvic misalignments as well as three measurable Cobb Angles. Pelvic misalignments included a 5mm low left sacrum, an 8mm low left iliac crest, a 7mm low left femur, a 5mm right deviated pubic symphysis when L of the S@ tubercle and a 4mm right coccyx deviation when assessed similarly to S2 tubercle. The measurable Cobb Angles included the following: left convex L4-T12 curve of 12°, right convex T12-T6 of 6°, and a left convex T8-T1 curve of 5°. Vertebral body rotation to the curve convexities were evident. (Figure One).
ISRC Protocol & Treatment
Using specific treatment protocol, in accordance with the International Scoliosis Research Center, a treatment plan was made to achieve curvature correction. Treatment included insertion of a heel lift on the side of sacral inferiority, specific diversified adjustment to subluxated vertebra and a two minute Hogan Basic Contact to the side of sacral inferiority.
The 47-year-old female was given nine of ten treatments initially planned in the first 30 days. A 5/16 inch left heel lift was instituted the first day of treatment. During each office visit, the treatment received included left Logan Basic and specific diversified treatment for vertebral misalignments. The patient was instructed to stretch the spine an accumulation of two minutes per day to improve spinal flexibility by hanging by her hands from a horizontal bar in accordance with ISRC protocol.
Radiographic re-examination was done after 30 days of treatment to determine if the Scoliosis treatment plan should be continued.2 Pelvic alignment improved as well as the Cobb Angle measurements. The original 5mm inferior left sacrum improved to 2mm left inferior. The left femur originally was 7mm low and improved to 3mm low left. An original 4mm right deviation of the coccyx changed to 0mm deviation. The pelvis is the foundation for the spine, therefore, its improvement is noteworthy when analyzing Cobb Angle changes.
The Cobb method is the standard by which Scoliotic curves are measured.3 The left convex L4-T12 curve of 12° on initial exam improved to 4°. The right convex T12-T6 curve of 6° initially, measured 7° on re-exam. The left convex T8-T1 curve of 5° initially, measured 3° on re-examination. The initial total amount of measurable curve was 23°. The final amount of measurable curve was 14°. This equates to a 39% curvature improvement in 30 days. Continued treatment and follow-up evaluation of this patient was unavailable due to unrelated surgical complications. (Figure Two).
Scoliosis is the deviation of the spine from the midline combined with vertebral body rotations. The reduction of the Scoliotic Curve without surgical intervention is noteworthy, and a 39% reduction of Cobb Angles in 30 days warrants controlled testing procedures. Although with a clinical setting, the variables are numerous. This type of curvature improvement using ISRC protocol has been achieved in several other patients. It appears to be the norm to achieve some degree of curvature improvement rather than the exception. If ISRC procedure will give similar results in other cases, controlled research needs to be performed. Which curvature types this techniques shows improvement to is also a major factor to be analyzed by research.
The major factors for success in curvature improvement also needs to be assessed to determine if these procedures can be purified. The hypothesis for success of the procedures from this clinician focus on the force of gravity. Due to larger anterior weight of the Lordotic Vertebra and larger posterior weight of the Kyphotic Vertebra, no spinal curve can be reduced for more than a few hours through spinal adjusting alone. The disc plain of any vertebra in a scoliotic curve is off horizontally except for transitional vertebra. Therefore, the most weighted area of the vertebra will be inclined to rotate downhill, as the vertebra is subjected to the force of gravity. Unless a horizontal sacral base is available for the spinal column to rest on, the next superior vertebra will become misaligned or, if appropriate, subluxated as soon as the spinal musculature becomes too fatigued to fight the forces of gravity. Heel lift application and Logan Basic treatment are designed to level the sacrum. As the spine levels to horizontal from the most inferior mobile segment to the next superior segment, the vertebra can be adjusted chiropractically with anticipation of maintaining the post-adjusted position for more than a few hours even though the force of gravity is not variable.
The exchange of chiropractic treatment for torso bracing and casting is not currently accepted by the scientific community. However, if this technique proves to not only stabilize spinal curves, but reduce them, torso bracing and casting will be used only when initial chiropractic treatment, with International Scoliosis Research Center’s protocol for Scoliosis, has been unsuccessful.s
1 Clinical Symposia; CIBA Pg. 2.
2 Scoliosis Manual; R.B. Mawhiney, D.C. Pg. 60.
3 Scoliosis Manual; R.B. Mawhiney, D.C. Pg. 60.