Elise Browning Miller: Founding Director of the California Yoga Center in Mountain View and Palo Alto, California, Ms. Miller is an expert in the use of Yoga to manage the effects of Scoliosis. Her book, Yoga for Scoliosis: A Path for Students and Teachers is considered the “ultimate textbook for understanding the benefits yoga offers to those with Scoliosis. Elise Miller’s books are highly recommended for both Teachers and students.
Definition of Scoliosis
Scoliosis is an abnormal lateral curve of the Spine with rotational component. A spine with Scoliosis has shifted laterally forming an “S” or “C” shaped curve, and with that curve, the spine is is rotated.
Testing for Scoliosis
The Adams Forward Bend test is used to determine if you have a structural scoliosis. in this simple examination, you bend forward with a rounded spine. Any significant asymmetry between the two side of the spine where one sided for the rib cage is higher than the other, or a bulge in the lumbar area these are indicative of Structural Scoliosis.
If there appears to be asymmetry with the shoulders, back muscles or hips while you are standing, yet when you are bending forward the spine appears aligned in the center of the body with little or no rotation, this is indicative of a functional scoliosis.
Doctors will initially take a detailed medical history and may ask questions about recent growth. The Doctor will likely test using the Adams Forward Bend test.
Your doctor may also perform a neurological exam to check for:
- Muscle weakness
- Abnormal reflexes
Plain X-rays can confirm the diagnosis of scoliosis and reveal the severity of the spinal curvature. The severity is measured according to the Cobb Angle Measurement.
While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include:
- Sex. Girls have a much higher risk of progression than do boys.
- Severity of curve. Larger curves are more likely to worsen with time.
- Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do C-shaped curves.
- Location of curve. Curves located in the center (thoracic) section of the spine worsen more often than do curves in the upper or lower sections of the spine.
- Maturity. If a person’s bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effect in children whose bones are still growing.
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.
Q: Dr. Levine, is it possible for an adult, a person 21 years of age or older, to suddenly “get” scoliosis?
A: It’s possible but extremely rare. When it happens, it is usually because the patient has experienced some sort of trauma, such as a fractured spine, or because the person develops a neuromuscular condition like muscular dystrophy, or a metabolic condition like osteoporosis that softens the bones. Most often, however, adult scoliosis develops in adolescence, and is the “idiopathic” variety, which means it occurs for no apparent reason.
Q: Will untreated adult scoliosis get worse year after year?
A: I’ve followed patients for over twenty years, and have found that probably 60% of adult patients do not get worse. Of the remaining 40% about 10% show a very significant progression, while the other 30% will show a very mild progression, maybe less than one degree per year.
Q: Are there any factors that can decrease or increase one’s risk of progression?
A: Yes, there are. The person who is sedentary and overweight is inviting problems.
Q: What treatments are available for adults with scoliosis?
A: First, one has to understand that many adults who have scoliosis never require treatment; they do not have obvious deformities or breathing problems, and they have no pain. But when an adult has a curvature that is approximately 50 degrees or more, then we begin to consider the possibility of spinal fusion surgery.
Source: National Scoliosis Foundation