What are the neurophysiological basis of the current treatments of scoliosis? There is no basis in neurophysiology for the treatments of scoliosis. The treatment for scoliosis is purely symptomatic and is addressed with the wear of either a tutor, brace or surgery (Harrington rod). Scoliosis, which is an abnormal curvature of the spine, typically curves into a ‘C’-shape or ‘an S’-shape which can be identified by looking at the back. Since your back is curved and you tend to tilt to one side or one of your shoulders could be lower than the other, a common question pops up, “If I have poor sitting posture where I tend to lean on something, will I develop scoliosis?”.
The short answer is no. Scoliosis does not come from any types of sports involvement, backpacks, sleeping positions, or minor leg length differences. The most common form of Scoliosis is Idiopathic Scoliosis, which basically means cause unknown. That means that researchers do not know what causes scoliosis.
For Posturologists, scoliosis is a pathology of the postural system. The scapular and pelvic girdles are the buffer systems of posture and in many cases of scoliosis it seems that they have stopped playing their buffer roles at the level of the spinal cord.
Here is what we know about scoliosis;
-We do not know at what age it starts
-It is more frequent with females (9 women for 1 man)
-If it starts before puberty it will always be a significant scoliosis
-If there is a genetic factor, the subject will have more changes of developing scoliosis than others.
-Anyone can have scoliosis
-Scientists have never identified a specific gene for scoliosis.
A recent study done by FOURNIER demonstrated that in 254 cases of scoliosis all had an ocular participation. I think that it is interesting to note that there is no known cases of scoliosis in children that are born blind (DUBOUSSAIS).
Posturology have allowed us to demonstrated that scoliosis could be separated into two groups; the first group is where the pelvis is excluded from the scoliosis participation and the second group where the pelvis is participating in the scoliosis process.
Shown in the below picture;
- The iliac crest does not have the same orientation;
- The Shenton lines are asymmetrical;
- And the obturator foramen do not have an identical form.
Force plates have allowed us to measure the postural peaks of excluded and included pelvis. It is well known and understood in Posturology that the treatment protocol with patients with scoliosis will be treated differently from the first group to the second.
-In the first case where the pelvis is participating, subjects react better to treatment, should be it through corsets, rehabilitation or techniques of postural reprogramming. With included pelvis, the Deriver de Fourier show an abnormal peak between 0.2 to 0.6. The more important the peaks, the worse the scoliosis.
-In the second case where the pelvis is not participating, subjects do not react well to stretching methods. On force plates the Deriver de Fourier show abnormal vestibulo-spinal reflexes and peaks between 0.2 and 2, which suggests that there probably exists a proprioceptive non-maturity.
When looked at in the frontal plane, subject with excluded pelvis show uneven lateral shifts of the head and thorax. Scoliosis cases with excluded pelvis are the most serious, they have the most evolutive nature in our series and are the most difficult to treat
Some authors such as Duval Beaupere believed that at the end of puberty scoliosis increased and stabilized itself. We now know that this is untrue. Scoliosis will continue to evolve between 0.5 to 2 degrees per year, which is the equivalent to 10 degrees over 20 years (0.5%) and 40 degrees (2%).
In term of proprioceptive maturity and scoliosis we have put a hypothesis that permits us to understand why anyone can develop scoliosis, and why subjects with heredity of scoliosis, have more changes of developing it.
-The first hypothesis is; if an asymmetry of ocular motricity (lack of convergence) of one eye exists before the age of 7 ½, there will be a delay in proprioceptive maturity and anyone can develop scoliosis.
-The second hypothesis is; only the subjects who have a heredity in proprioceptive maturity could develop scoliosis after the age of 7 ½, if an asymmetry of ocular motricity exists. These two hypotheses explain why it is possible for anyone to develop scoliosis before the age of 16 ½.
1) The first treatment is Postural Recalibration ;
2) A brace should be worn for scoliosis above 35 degrees, if posture is not corrected the brace will not work well with excluded pelvis ;
3) Proprioceptive reeducation (scoliosis with excluded pelvis should NOT be stretched) ;
4) In the future, if we are able to make the difference between those two types of scoliosis, we will probably find a gene pathology that induces proprioception problem, with the possibility of doing prevention though Postural Recalibration and proprioceptive reeducation.
The Posturepro Team