Scoliosis is defined as a lateral curvature of the spine which means that the spine curves sideways to one side or the other side – or both.

Normally a spine is straight when viewed straight on or from behind, but with scoliosis, the spine curves to the side in the shape of the letter “S” or “C”.

It can occur anywhere in the spine, but it is usually found in the lower and mid-back, which are called the Lumbar and Thoracic regions.

There are different forms of scoliosis, most of which have a known cause (E.g. a spine/vertebra injury, a congenital deformity, some of the syndromes, etc.) but by far the most common scoliosis has an unknown cause and is termed Idiopathic.

Idiopathic

Meaning “of unknown origin or cause”. This is the most common form of scoliosis, with an unknown cause. This may occur in early childhood or adolescence.

Congenital

This form of scoliosis typically results from a spinal defect present at birth and are usually detected at an earlier age than idiopathic forms of scoliosis.

Neuromuscular

This is spinal curvature that develops as a result of some kind of neurological or muscular disease, such as muscular dystrophy or cerebral palsy. This form of scoliosis also tends to progress much quicker than others.  

Signs of scoliosis

HOW IS SCOLIOSIS
DIAGNOSED?

If you are concerned that your or your child may have Scoliosis, Scheuermann’s disease, or other postural deformities of the spine, consult with your healthcare practitioner. They will request X-rays of the spine to confirm a diagnosis.

They may refer you, or you may request to be referred, to an orthopedic surgeon (particularly one who specialises in disorders of the adolescent spine), a physiotherapist, or an Orthotist for further treatment.

TREATMENT OPTIONS
FOR ADOLESCENT/JUVENILE IDIOPATHIC SCOLIOSIS?

TREATMENT OPTIONS FOR ADOLESCENT/ JUVENILE IDIOPATHIC SCOLIOSIS?

There are essentially 3 approaches:

Observation

Detecting and monitoring the deformity for signs of progression without treatment or intervention

Conservative treatment

Spine-specific or scoliosis-specific exercises and bracing. Either night-time, part-time of full-time bracing

Surgical management

Spinal rods and tethering

Scoliosis-specific physiotherapy and bracing have been proven as effective treatments, which are supported by clinical data and international research conducted. Several factors need to be considered though, such as skeletal maturity, the size of the curve, and other underlying conditions and factors. The condition may be monitored with X-rays, Physiotherapy may be advised, bracing either full-time or night-time, or at times surgery may be recommended. This applies to both Scoliosis and hyperkyphosis (Scheuermann’s).

Research conducted also suggests that some general types of fitness exercises can make the patient worse. However, specific methods such as the Schroth method, and SEAS Method, and others have shown favourable results in improving the condition. These methods are conducted by therapists trained in these methods.

The Schroth Method is a physiotherapy method that was founded and developed in Germany. It uses exercises customised to each patient to return the curved spine to a natural position. The goal is to de-rotate, elongate, and stabilize the spine in a three-dimensional plane.

SEAS, which stands for, Scientific Exercise Approach to Scoliosis, is an approach that was first developed in Italy during the 1990s. It’s a specific form of auto-correction or active self-correction. It is taught individually to each patient and is complemented by stabilization exercises that focus on neuromuscular control, proprioception, and balance.

RIGO-CHENEAU Brace

Idiopathic Scoliosis exists as a 3-dimensional deformity; the Frontal plane, Sagittal plane, and Transverse Plane. It, therefore, needs to be treated as a 3D deformity with all 3-planes of the deformity treated simultaneously.

There are only a few brace methods capable of managing all 3 dimensions of the deformity simultaneously. Peer-reviewed research has shown that without a doubt, 3D correction is more effective than 2D bracing at delaying progression, correcting the deformity, and preventing surgery for Idiopathic Scoliosis.

The Rigo-Cheneau brace design has a clinically proven ability to change the natural history of AIS (Adolescent Idiopathic Scoliosis). A new age of bracing is now available through advanced technology and computer-assisted design and manufacturing (CAD-CAM), which is the RSC, Rigo-Cheneau design.

The brace is manufactured individually, which offers a better fit and more comfort, and therefore, patients are more willing to embrace the treatment (based on Quality of Life studies).

Night-Time Back Bracing

New clinical studies have proven that night-time bracing can be effective for Idiopathic Scoliosis if patients are compliant and braced timeously.

Although the patient will probably be in the brace for a longer duration, the cosmetic element is less significant because the brace is only worn at night for plus/minus 8 hours. The major advantage of night-time bracing is that it has a low impact on the social and activity levels of the child.

In conclusion, which has been extracted from clinical research:

“The SpineCore brace did not prevent curve progression as effectively as the rigid 3D brace. Although it has the potential benefit of increasing mobility during brace wear, the SpineCor brace was associated with increased curve progression in comparison with the rigid brace. There is also a trend for increased risk of requiring surgery when the SpineCor brace is worn.”

Gutman et.al. Spine J. 2016

Untreated or failed treatment
in adult patients

Braces designed on CAD-CAM systems, are lightweight and comfortable and are available for adults who suffer from scoliosis, either from previously undetected scoliosis which went untreated, or where conservative treatment failed. Mostly, these patients are not surgical candidates and suffer from significant pain and deformity. Highly effective braces for both scoliosis and kyphosis are made to the patient’s measurements and are low profile and lightweight. They can be worn under clothing and are easily donned and doffed (taken off and put back on) by the patient.  

Unlike adolescents who are skeletally immature, adult bracing cannot correct the curve but does help to realign the spine and helps to improve balance and stability. 

FREQUENTLY ASKED
QUESTIONS

What causes Scoliosis?

The most common type of Scoliosis is Idiopathic, which has no known cause, and other causes of Scoliosis include: 

  • Heredity
  • Cerebral Palsy 
  • Spinal muscular atrophy 
  • Spinal Bifida 
  • Achondroplasia
  • Muscular dystrophy
  • Osteoporosis
  • Obesity 
  • Spinal Infections
  • Spinal Tumors
  • Arthritis 
  • Spinal cord trauma from an injury 

Scoliosis found in adults may be a case of pediatric Scoliosis that was undiscovered until adulthood. 

How can I prevent Scoliosis?

Because the cause of idiopathic scoliosis (the most common type of scoliosis) is not known, there is no known way to prevent the problem. Parents often ask what they could have done to prevent Scoliosis, or if bad posture or heavy backpacks could have caused their child’s Scoliosis. While heavy backpacks can aggravate existing idiopathic scoliosis and bad posture may be associated with other spine and back conditions, they don’t cause Scoliosis. 

What is Scoliosis?

Scoliosis is a lateral (side) curvature of the spine and is a common spine condition that usually develops in early adolescence. It can occur anywhere in the spine, often in the lower and mid-back. Most cases of scoliosis are idiopathic, which means that the cause is unknown, and it also tends to run in families. 

What is “idiopathic scoliosis”?

The most common type of Scoliosis is idiopathic. The meaning of idiopathic is “of unknown cause or origin”. Several suggestions have been put forward as to what may cause idiopathic scoliosis, but no known cause has been identified to date. The spine won’t be able to straighten voluntarily, and the condition is usually progressive – meaning that the spine will continue to bend to the side unless it is managed and controlled.

Is Scoliosis dangerous?

There are a lot of variances within the condition itself to take into account. Most cases of scoliosis are mild, but some curves can worsen as children grow, and severe scoliosis can be disabling. In general, Scoliosis is not life-threatening, but it can lead to considerable deformity and complications.

Are scoliosis braces uncomfortable?

Each brace is manufactured individually to offer a better fit and more comfort. The first couple of days may be a bit uncomfortable, and some adjustments may need to be made. Much like new shoes that need a little bit of “wearing-in”, you get used to the back brace.

What Is a Scoliosis Brace?

A scoliosis brace is a rigid plastic vest fitted around the torso, and has straps that will keep the brace in place. There are different types of braces, and it may also be called orthotic or orthosis. Qualified Orthotists will work with adults, parents, and their children to choose the most appropriate brace that will likely give the best outcome for the curve.

What is it called when your back is not straight?

A typical spine, when viewed from behind, is straight from the neck to the buttocks. In a back affected by scoliosis, the spine is not straight up and down. Scoliosis causes the spine to form a curved line in the wrong direction, and the spine may curve to the left or right.

What is 3-dimensional bracing?

Scoliosis is a three-dimensional abnormality, and therefore brace correction should be 3D too. Idiopathic scoliosis has a rotational component to it, which is what causes most of the visible deformities. To treat this as one-dimensional (the curve as viewed from the front or back), and ignore the other two dimensions, may resolve one of the dimensions but leaves deformities in the other two planes. That is why a spine deformity caused by scoliosis should be observed and treated from three dimensions.

Although many Orthotists may consider it adequate to only focus and treat the main deformity, international guidelines have consistently recommended the simultaneous treating and addressing of all three planes. That is why a spinal deformity caused by Idiopathic-scoliosis should be treated as a three-dimensional deformity.

How would you measure a patients' compliance with non-surgical treatment?

A thermal data recording device, which is about the size of a watch battery, is implanted into the brace. The data recording device will read and log the data, to read temperature over time. As the brace is being worn, the device records a temperature reading at regular intervals. The data is downloaded and viewed in a graph format when the patient comes for a check-up. The data then gives us an indication of the timeframes the brace is being worn. We have also found that this has a remarkable effect on patients’ compliance, and it helps the Orthotist (and parents) to determine the compliance level of the patient.