Scoliosis: Life, Support and Friends

Muscle Spasm and Pain

2009-11-10T17:05:00.004+01:00

Which came first, the muscle spasm or the pain?

Every muscle in your body is attached to a bone, but just like the chicken and the egg, a muscle spasm can cause pain and pain can cause a muscle spasm!

Often, when we experience pain a muscle spasm pulls nearby joints out of place, causing a condition known as joint sublaxation. Similarly, if a joint is sublaxated, nearby muscles may spasm in response.

Does it matter which happened first?
Usually, by the time pain has caused you to look for help from the doctor or therapist the cycle of pain and spasm has already begun. Pain causes spasm which pulls joints out of alignment, which more spasm and more pain!

Ultimately, the body accommodates to this cycle and the muscles stay tightened in the contracted state. After two days of spasm, the muscles will adapt to their new unnatural painful state and resist relaxation. The pain may even subside a bit during this adaptation, but now the body is adjusting to the muscles and the joints that are now in improper positions. Individuals can live for years unaware of the problem (as I did!). Many people only seek help when the pain becomes intolerable.

The longer that a muscle is in spasm, the longer it takes to treat the area that is sublaxated. The muscle tissue actually resists the normal relaxed position of the bones. Therefore the longer the condition has been tolerated the more treatments are likely to be required, but not necessarily with all people. Once the pain and spasm cycle has been broken, your muscles can return to their natural pain free state.

Muscle Spasm & Other Conditions
Muscle spasm in specific muscles can have other effects on the body. For example, if the muscles of the neck go into spasm, it can lead to muscle tension headaches. Spasm in the scalene muscles (in the front of the neck) can put pressure on nearby nerves and blood vessels, resulting in numbness, pain or tingling in the arms or hands. Spasms of the small piriformis muscle in the buttocks can cause sciatica pain. If the diaphragm muscle spasms, hiccups may result.

When muscles in the bask spasm, spinal bones can be pulled out of alignment and the result can be interference with nerve function. Imbalances in the muscle groups can also lead to poor posture, which can cause further complications.

There are many conditions that result from these muscle spasms throughout the body. Also, once these conditions become normal for the body, other pressures will be place on internal organs giving rise to a mountain of further imbalances in the body.

Exercises to:
Treat Sciatica
General Mobility Exercises
Neck Exercises

We will continue this thread on Muscle Spasms and Pain and offer the best form of pain relief from experience with our members. If you have a particular treatment that you favour for muscle spasms, please write in and let us know!

The day-to-day issues

2009-11-06T09:58:00.009+01:00

Hey, fellow ScoNuts.

Sorry for my lack of posts, but minus the surgery, there's nothing very interesting about my day-to-day life. At least, nothing none of you aren't already painfully familiar with.

I moved in with my boyfriend, and he's being wonderful to me. He does everything for me, despite my protests; consequently, I have become even more sedentary (I didn't realize that was possible), so my pain has skyrocketed. I know I'm gaining weight, too. I still don't have insurance, but I have the option to buy a policy from the company that used to insure me. Of course, who's going to insure me with a spine like mine? At best, it'll be labeled a preexisting condition and excluded completely. So I have to apply and be approved for disability before I can go back to St. Louis, and God only knows how many years that will take.

Dr. Bones wanted me to wait ten more years, and now it looks like I might have to. :( I've got some tips about good disability lawyers, though, so I'm not without hope. I just know all too well how frustrating and drawn-out the process is.

My biggest problem now is trying to get stronger and healthier. Eating better is where I've decided start, then exercising. I have yet to find my exercise plan among all of the moving boxes. Everyone says walk, but I actually find that to be one of the most painful things to do, which leads to the issue of pain control. I really want to lose the extra weight I've been putting on and strengthen my muscles, which will lessen my pain, but the smallest things are excruciating to me now and make starting that process difficult.

I love my TENS unit, but the stickies are $60 a pack, and the way I use it, they don't last long. Insurance never covered much of the cost anyway, so I don't use the TENS much anymore. Thermacare heat wraps work great, but you can't adjust their position after you stick them on. I'm also starting to build up tolerance to my pills.

I've found having a drink to be an effective muscle relaxer, but it's not very practical as a long-term solution. And on, and on...

I'll try to post occasionally, but I don't feel like I have much to say now. I realized yesterday that I would be in St. Louis right now, had things gone differently. It's such a bummer. Catch me on Twitter, @oddcupcake. I'm a little bit more interesting there.

AIS - Nervous Systems

2009-11-04T23:13:00.002+01:00

Scoliosos Journal discusses the pathogenesis of adolescent idiopathic scoliosis in girls - a double neuro-osseous theory involving disharmony between two nervous systems, somatic and autonomic expressed in the spine and trunk: possible dependency on sympathetic nervous system and hormones with implications for medical therapy.

Authors: R Geoffrey Burwell, Ranjit K Aujla, Michael P Grevitt, Peter H Dangerfield, Alan Moulton, Tabitha L Randell and Susan I Anderson

Published: 31 October 2009

Anthropometric data from three groups of adolescent girls - preoperative adolescent idiopathic scoliosis (AIS), screened for scoliosis and normals were analysed by comparing skeletal data between higher and lower body mass index subsets. Unexpected findings for each of skeletal maturation, asymmetries and overgrowth are not explained by prevailing theories of AIS pathogenesis.

A speculative pathogenetic theory for girls is formulated after surveying evidence including:
(1) the thoracospinal concept for right thoracic AIS in girls;
(2) the new neuroskeletal biology relating the sympathetic nervous system to bone formation/resorption and bone growth;
(3) white adipose tissue storing triglycerides and the adiposity hormone leptin which functions as satiety hormone and sentinel of energy balance to the hypothalamus for long-term adiposity; and
(4) central leptin resistance in obesity and possibly in healthy females. The new theory states that AIS in girls results from developmental disharmony expressed in spine and trunk between autonomic and somatic nervous systems. The autonomic component of this double neuro-osseous theory for AIS pathogenesis in girls involves selectively increased sensitivity of the hypothalamus to circulating leptin (genetically-determined up-regulation possibly involving inhibitory or sensitizing intracellular molecules, such as SOC3, PTP-1B and SH2B1 respectively), with asymmetry as an adverse response (hormesis); this asymmetry is routed bilaterally via the sympathetic nervous system to the growing axial skeleton where it may initiate the scoliosis deformity (leptin-hypothalamic-sympathetic nervous system concept = LHS concept).

In some younger preoperative AIS girls, the hypothalamic up-regulation to circulating leptin also involves the somatotropic (growth hormone/IGF) axis which exaggerates the sympathetically-induced asymmetric skeletal effects and contributes to curve progression, a concept with therapeutic implications. In the somatic nervous system, dysfunction of a postural mechanism involving the central body schema fails to control, or may induce, the spinal deformity of AIS in girls (escalator concept). Biomechanical factors affecting ribs and/or vertebrae and spinal cord during growth may localize AIS to the thoracic spine and contribute to sagittal spinal shape alterations.

The developmental disharmony in spine and trunk is compounded by any osteopenia, biomechanical spinal growth modulation, disc degeneration and platelet calmodulin dysfunction. Methods for testing the theory are outlined. Implications are discussed for neuroendocrine dysfunctions, osteopontin, sympathoactivation, medical therapy, Rett and Prader-Willi syndromes, infantile idiopathic scoliosis, and human evolution. AIS pathogenesis in girls is predicated on two putative normal mechanisms involved in trunk growth, each acquired in evolution and unique to humans.

Download the complete article as a PDF and read more about the pathogenesis of adolescent idiopathic scoliosis in girls - a double neuro-osseous theory involving disharmony between two nervous systems, somatic and autonomic expressed in the spine and trunk: possible dependency on sympathetic nervous system and hormones with implications for medical therapy

Disability Living Allowance Under Threat

2009-10-23T16:41:00.003+02:00

Senior minister confirms DLA is under threat

Published: 15 October 2009

The truth is finally out. A senior government minister this week confirmed to the House of Lords that axing DLA has definitely not been ruled out, directly contradicting care minister Phil Hope’s earlier claim that DLA is safe

Last month we reported that care minister Phil Hope had told a Disability Now reporter in an off-the-cuff exchange at the Labour Party conference that:

"DLA is not under threat and people can be very happy".

(“DLA is not under threat . . . be very happy” says government minister)

Since then, however, there has been an alarming lack of official confirmation that DLA is not one of the disability benefits that the government intends to axe in order to fund the proposed new national care service.

The reason for that lack of confirmation is now clear: Phil Hope's 'don't worry, be happy' statement does not reflect government policy.

Lord McKenzie of Luton, parliamentary under-secretary of state for the DWP, was responding to a question from veteran disability campaigner Lord Ashley of Stoke, who had asked which disability benefits the government are 'considering integrating into the wider social care budget in England'.

Lord McKenzie replied:

"At this stage, we do not want to rule out any options and so are considering all disability benefits."

Later in the same debate, Lord Low of Dalston specifically referred to the "reported statement by the Minister for Care Services that disability living allowance is not under threat" and asked for confirmation that neither component of disability living allowance "is being considered as a possible source of funding for social care".

Once again, Lord McKenzie’s response was in direct contradiction of Hope's "be very happy" statement:

"My Lords, as I said in answer to the first Question, currently no particular benefit is ruled out of consideration."

The minister did go on to add, somewhat cryptically:

"We are conscious of the fact that DLA is overwhelmingly used by people who are under 65, and obviously care needs are overwhelmingly for people who are older."

Whilst there is still much – deliberate – uncertainty around their precise intentions, Lord McKenzie's statement represents the first clear admission by the government that axing DLA is a real possibility.

Had it not been for the thousands of emails and letters sent by Benefits and Work campaigners to MPs, disability organisations and the Big Care Debate website there is no doubt that the threat to DLA would have remained hidden behind a curtain of political spin until it was too late to do anything about it.

Now the truth is finally and officially out in the open and there's still time to for you to act.

Post your comments on the Big Care Debate website

Sign the No 10 petition DLA & AA Petition

You can read the whole transcript of the short debate on the They Work For You website

Assessment of Angle velocity in girls with AIS

2009-10-23T16:30:00.003+02:00

ScoliosisJournal report about Correction: Assessment of angle velocity in girls with adolescent idiopathic scoliosis

Authors: Ferran Escalada, Ester Marco, Roser Belmonte, Esther Duarte, Josep Ma Muniesa, Roser Boza, Marta Tejero and Enric Cáceres

Publiushed: 10 October 2009

Background
Although it has been demonstrated that the peak height velocity (PHV) is a predictive factor of progression in adolescent idiopathic scoliosis (AIS), little is known about the usefulness of angle progression in clinical practice. The purpose of this study was to establish a relationship between height and angle velocities, as well as to determine if peak angle velocity (PAV) occurs at the same time than PHV.

Methods
A retrospective study of a cohort of girls with idiopathic scoliotic curves greater than 10°. Data of 132 girls who participated in a previous retrospective study about growth in AIS were used to calculate height and angle velocities. Relationship between height and angle velocities was estimated by the use of a Linear Mixed Model.

Results
PHV and PAV take place simultaneously 1 year before menarche in progressive curves managed with a brace in AIS. Changes in angle velocity are influenced by changes in height growth velocity, in such a way that as from 6 months post-menarche, height growth velocity in this group of girls estimates curve progression velocity (β-coefficient -0.88, p = 0.04).

Conclusion
As from 6 months post-menarche, there is an inverse relationship between height velocity and curve progression in the group of AIS girls with progressive curves managed with a brace. Because height velocity is decreasing from 1 year before menarche, this finding corroborates that at the end of puberty, there is still a risk of progression in this group of girls despite bracing. The assessment of both height and angle velocity might be useful in clinical practice at the time of assessing brace effectiveness and how long bracing has to be indicated.

Correction
After publication of this work [1], we noted that we inadvertently failed to include the complete list of all coauthors. The full list of authors has now been added and the Authors' contributions and Competing interests section modified accordingly.

Competing Interests
The authors declare that they have no competing interests.

Authors' Contributions
FE conceived and designed the study, performed analysis and interpretation of data, carried the assessments and gave final approval of the version to be published. EM contributed to acquisition, analysis and interpretation of data and was involved in drafting the manuscript. RBe contributed to design, analysis and interpretation of data and reviewed the article critically for important intellectual content. ED and JMM revised critically for important intellectual contents. RBo and MT contributed to acquisition of data and analysis. EC participated in its design, revised critically for intellectual contents and gave final approval of the version to be published. All authors read and approved the final manuscript.

Read more about the assessment of angle velocity in girls with Adolescent Idiopathic Scoliosis

Medical Marijuana: The Debate Continues

2009-10-12T11:49:00.002+02:00

Medical marijuana debate has multiple dimensions: medical, political, personal

Linda Yelvington rattles off her list of ailments: Severe scoliosis. A prosthetic hip. Cervical degenerative disc disease. DeQuerin’s syndrome in both wrists. Arthritis. Breathing problems from diminished lung capacity because of scoliosis.

The 54-year-old woman then rattles off a list of painkillers she has taken for her health problems.

Author: Derek Spellman

Linda Yelvington rattles off her list of ailments: Severe scoliosis. A prosthetic hip. Cervical degenerative disc disease. DeQuerin’s syndrome in both wrists. Arthritis. Breathing problems from diminished lung capacity because of scoliosis.

The 54-year-old woman then rattles off a list of painkillers she has taken for her health problems.

“None of them are working right,” Yelvington said of the legal drugs, listing some of their side effects.

It has been several months since she has taken her preferred painkiller — marijuana — because it's not legal in Missouri, USA.

She contends it works just as well, if not better, with fewer side effects. Yelvington, who started taking marijuana years ago, is well-versed in studies about marijuana's medicinal use.

Asked if the issue of legalizing marijuana for medical use is personal or political for her, she replied, “I think it’s a compassion issue.”

Activists, meanwhile, are gathering support for a statewide initiative that would ask Missouri voters to approve medical marijuana.

The forthcoming debate will likely have two dimensions — one medical and political. Both will be personal.

‘Not harmless’

On the medical debate, both sides cite research and a roster of supporters to back their claims.

A local physician said a lot depends on whether the discussion is about someone who is terminally ill and in agony or whether it is about someone who will have to deal with the long-term effects of using the drug.

“Marijuana is not harmless,” added Matthew Miller, a medical oncologist from Freeman Health System.

The medical debate is also attended by a political debate about whether the marijuana issue is an act of compassion for the dying, or a Trojan horse for outright legalization of recreational use of the drug.

Yelvington, a member of the Joplin chapter of the National Organization to Reform Marijuana Laws (NORML), acknowledged that she would likely advocate for the outright legalization of marijuana even if she didn’t have medical problems. She also acknowledged that the debates over medical marijuana and outright legalization overlap.

Still, she and a number of activists said they believe the two issues can be separated to an extent. They also reject claims that one automatically leads to the other.

I must interject here: the people against Marijuana always claim that it will lead to Cocaine, Heroine, Crack etc. Let me throw a spanner into the works here, does tobacco lead to harder drugs? Smoking tobacco is worse than smoking THC's (found in Marijuana for pain). The people that move to harder drugs is usually due to something else not because they smoked dope - get real people! The people who are drug addicts are not usually people in chronic pain from an illness, all you need do is look around at the drug addicts and see for yourself! On another note the people who say we should not allow people in chronic pain to use Marijuana are usually pain free themselves so I ask -what do they know anyway? Are OTC drugs any better? Are the drugs prescribed by Drs any better for our health? Drs claim "drugs prescribed are herbal anyway because majority of the content is from a plant" well back at ya where Marijuana is concerned, this too is a plant that grows wild so why disallow people to use it?

But there are skeptics.

Notoriety
The Joplin area gained a measure of notoriety in recent years for marijuana activism. Joplin has been host to the Cannabis Revival and already seen one push to put a question to voters about lessening penalties for possession of the drug. That petition did not get the required number of signatures for the ballot.

Missouri Southern State University recently ranked No. 20 on High Times magazine's list of the top 20 colleges for marijuana activism. And earlier this year, the then-mayor of Cliff Village, south of Joplin, claimed that his board of trustees had passed a "symbolic" ordinance that would have legalized the drug inside the village for medical use, although a number of residents later disputed whether that ordinance was ever actually passed.

Yelvington, who moved to Goodman from Kentucky in March, said she first experimented with marijuana decades ago, as many others did.

"I didn’t equate it with pain relief at the time," she said, although in later years she said she discovered it worked better for her as an antiphlegmatic and for curbing depression and muscle spasms.

But now that she is lives in Southwest Missouri, she turns to legal painkillers.

"I have to, because I can’t have medical marijuana in Joplin," she said.

Yelvington said she has family in Missouri and she would like to stay, but she has not ruled out moving to California, Colorado or New Mexico, which have medical marijuana laws in place. Ten other states also allow some form of medical marijuana, according to NORML.

But even in states that have legalized medical marijuana, it is still technically illegal for doctors to prescribe their patients marijuana under federal law, according to Keith Stroup, the legal counsel and founder of NORML. Instead, in those states, patients must have proof that doctors "recommend" marijuana for their patients.

But the patient is still "left to your own imagination" in how they go about obtaining the marijuana, Stroup said.

A few states allow the operation of not-for-profit "dispensaries" that act as cooperatives to supply patients, but otherwise a patient either must grow the plant themselves, have a designated caregiver cultivate the plant or obtain it on the black market, Stroup said.

Even patients in those 13 states who use medical marijuana are still violating federal law, Stroup said. The practical effect, though, is one of sparing the patients from penalties under local and state laws, which spares them from federal investigation. More than 99 percent of marijuana cases are handled on the state and local level, he said.

I hope this lady wins her fight against medical marijuana and I also hope the people who are against can just stop to think for one minute how they would cope if they had chronic pain to fight every day they woke up!

I had Scoliosis surgery 20 years ago and I have suffered as a result ever since, all I have ever been offered is pills, pills and more chuffing pills. I have tried marijuana for pain and have to agree that it works better for muscle spasms (a common complaint of mine).

Well, crap.

2009-10-02T07:50:00.003+02:00

Well, my fame as a blogger seems to be short-lived. Unfortunately I've lost my health insurance, and I won't be having surgery after all. I found out about two weeks ago, but it's been hard to organize my thoughts since then. At first I was extremely relieved, which really surprised me. I hadn't realized I was that scared. Now I'm just crushed. I'm really depressed about it. I had a muscle spasm an hour ago, and it lasted over 15 minutes. I can finally move again, but it's still hurting. Oh, well. Dr. Bones wanted me to wait ten years anyway. Hopefully Dr. STL will still be practicing in ten years.

Brace Treatment: Scheuermann's Disease

2009-09-30T15:29:00.002+02:00

Scoliosis Journal report about brace treatment for patients with Scheuermann`s disease - a review of the literature and first experiences with a new brace design

Authors: Hans-Rudolf Weiss, Deborah Turnbull and Silvia Bohr

Published: 29 September 2009

Background
In contemporary literature few have written in detail on the in-brace correction effects of braces used for the treatment of hyperkyphosis. Bradford et al. found their attempts effective, treating Scheuermann's kyphosis with Milwaukee braces, but their first report did not specifically focus on in-brace corrections. White and Panjabi's research attempted to correct a curvature of > 50 degrees with the help of distraction forces, but consequently led to a reduction in patient comfort in the application of the Milwaukee brace. In Germany they avoid this by utitlising braces to treat hyperkyphosis that use transverse correction forces instead of distraction forces. Further efforts to reduce brace material have resulted in a special bracing design called kyphologicTM brace. The aim of this review is to present appropriate research to collect and evaluate possible in-brace corrections which have been achieved with brace treatment for hyperkyphosis. This paper introduces new methods of bracing and compares the results of these with other successful bracing concepts. Materials and methods 56 adolescents with the diagnosis of thoracic Scheuermann's hyperkyphosis or a thoracic idiopathic hyperkyphosis (22 girls and 34 boys) with an average age of 14 years (12-17 yrs.) were treated with the kyphologicTM brace between May 2007 and December 2008. The average Stagnara angle was 55,6 degrees (43-80). In-brace correction was recorded and compared to the initial angle using the t-test.

Results
The average Stagnara angle in the brace was 39 degrees. The average in-brace correction was 16.5 degrees (1-40 degrees). The average percentage of in-brace correction compared to the initial value was 36%. The differences were significant in the t-test (t = 5.31, p < 0,001). To make these results comparable to other studies, the kyphosis angle of 25 degrees was set to 0 for our sample in order to achieve a norm value adapted (NVA) percentage of in-brace correction. By doing this a correction of 54.1% was achieved. There was no correlation between the percentage of in-brace correction and the age of the patient, but a highly significant correlation between percentage of in-brace correction and the initial Stagnara angle.

Discussion
If we assume that outcome of brace treatment positively correlates with in-brace correction, the treatment should be initiated before the curvature angle exceeds 50 - 55 degrees in a growing adolescent. In scoliosis bracing, if the average in-brace correction equals > 15 degrees, then it is predicted that the result will lead to a final correction. Applying this to hyperkyphosis patients, the average in-brace correction with this brace was also > 15 degrees. We therefore estimated to achieve a favourable outcome using this brace type (once compliance was attained) especially when comparing the correction effects achieved with this new approach to the correction effects reported upon using the Milwaukee brace. The latter brace has been shown to lead to beneficial outcomes in long-term studies with comparable in-brace corrections.

Conclusions
Conservative treatment of Scheuermann's hyperkyphosis in international literature is generally regarded as an effective treatment approach. Physiotherapy and bracing are the first-line treatments for this condition. An average in-brace correction of > 15 degrees as was achieved using the kyphologicTM brace predicts a favourable outcome. The kyphologicTM brace leads to in-brace corrections comparable to those of the Milwaukee brace, which has previously been shown to provide beneficial outcome in the long-term. A prospective follow-up study seems desirable before final conclusions can be drawn. Future studies should focus more on thoracolumbar and lumbar curve patterns, because these patterns may predict chronic low back pain in adulthood with reduced quality of life of the patients and high costs with respect to medical care and occupational sickness leave. Surgery according to international literature is rarely necessary in this condition.

Download the completed full version about brace treatment for patients with Scheuermann`s disease - a review of the literature and first experiences with a new brace design

ScoliScore (TM) - Axial Biotech

2009-09-28T17:38:00.005+02:00

Axial Biotech declared some news today via PRNewswire, I would like to share that with you. I don´t have much to say about this as I am no Dr!, however, Wow - I have been reading about DNA tests being linked to treatment for Scoliosis and disease progression but now it looks like we are really rocking!

I look forward to following Axial in their developments of DNA.

Axial Biotech Announces Commercial Availability of SCOLISCORE(TM) AIS Prognostic Test

The first marketed product of Axial's pipeline of personalized diagnostics for spine disorders

SALT LAKE CITY, Sept. 24 /PRNewswire/ -- Axial Biotech, Inc., a company personalizing spine care through the development of molecular diagnostics, announced today that its SCOLISCORE(TM) AIS Prognostic Test is now being made available to spine specialists in the United States. SCOLISCORE is a saliva-based genetic test designed to predict the risk of progression of scoliosis, an abnormal lateral curvature of the spine. Spine surgeons from 40 medical centers throughout the U.S. were introduced to the test and have been defining its clinical use since December 2008. DePuy Spine, Inc. will market the test for Axial and will feature SCOLISCORE at the Scoliosis Research Society (SRS) Annual Meeting taking place this week.

One hundred thousand children are diagnosed with scoliosis every year in the U.S. and must be followed on a consistent, often quarterly basis, to determine and assess disease progression. The SCOLISCORE Test is designed for male and female patients diagnosed with Mild (10-25 degree Cobb Angle) Adolescent Idiopathic Scoliosis (AIS) who are from 9 through 13 years of age, and who are self-reported as Caucasian (North American, South American, European, Eastern European, Middle Eastern, Southwest Asian Descent).

"The SCOLISCORE Test, along with other diagnostic testing and clinical examination, enables the physician to confidently recommend a personalized treatment regimen for each patient at the first sign of the disease," said John Climaco, president and chief executive officer of Axial Biotech. "SCOLISCORE and other tests in our product pipeline have the potential to completely transform treatment paradigms and ultimately to lead to improved and more efficient patient care."

The development of the SCOLISCORE Test required more than six years of development by Axial researchers and involved DNA samples collected from more than 9,500 individuals at more than 100 clinical sites throughout the world. SCOLISCORE utilizes 53 DNA markers found to be linked to the progressive form of scoliosis. To identify these DNA markers from nearly one million potential targets, Axial researchers leveraged its proprietary, world class genealogic database called GenDB, which contains information on more than 30 million ancestors and descendants of the original Utah pioneers. The test has been validated in three studies with approximately 800 patients with AIS.

"Axial is the first mover into molecular testing for spine disorders, representing a near-term opportunity that rivals the market size of diagnostics for breast cancer," added Climaco. "We have broken the code to scoliosis, and we are uncovering the important role genetics play in other spinal disorders. We are applying our research capability to identify genetic links that could potentially expand applications in scoliosis and also serve as a basis for a predictive test for the treatment of those suffering from degenerative disc disease."

About Axial Biotech
Axial Biotech, Inc. is advancing first-of-a-kind molecular diagnostics that answer key clinical questions in spine care, allowing for more accurate and personal treatment decisions for spine disorders. Axial markets the SCOLISCORE(TM) AIS Prognostic Test, the first and only test that utilizes the genetic blueprint of progressive scoliosis to enable physicians to identify which patients are likely to progress to a severe curvature. Using the same approach that led to the successful development of the SCOLISCORE AIS Prognostic Test, Axial is currently developing a predictive test for surgical outcomes for patients with degenerative disc disease. Axial is a privately held, venture-backed molecular diagnostics company founded in 2003 by a group of internationally recognized spine surgeons and geneticists.

SOURCE: Axial Biotech, Inc.

Superfoods?

2009-09-24T13:04:00.003+02:00

It’s really hard to tell what to eat these days, one minute something’s good for you, next it might just as well be poison.

Sales of blueberries, walnuts and spinach and other more esoteric things like goji berries, spirulina and chlorella have taken off in the past few years as, everywhere you look, something seems to be telling you about their particular 'health' benefits. Eat them, we're told, to help reduce the risk of cancer and heart disease. But where’s the science?

Actually, there is no definition of superfood. It gets applied to foods from oats to walnuts, spinach to yoghurt, turkey to watercress and beetroot. Meat and fish contain protein and other nutrients. Fruit and vegetables also contain essential vitamins, minerals and other phytochemicals (bioactive non-nutrient components) that are good for health. Labelling some as superfoods could give the impression that they are more health-enhancing than others.

The fruits and vegetables given the superfood tag tend to be high in antioxidants such as vitamin C. The flavonoids, responsible for the colour of dark fruits such as blueberries, and other plant chemicals such as beta-carotene, are also known for their antioxidant properties. This is why brightly coloured fruit and vegetables are considered especially beneficial.

Opinion, based on scientific research, is that because antioxidants are especially effective at combating free radicals - harmful molecules that damage cells and DNA and can contribute to ageing, heart disease and cancer - they make fruit and vegetables particularly good for health.
But phytochemicals, also present in less brightly coloured fruit and vegetables not classed as superfoods, could also act in other ways to protect against disease. Scientists investigating the different ways phytochemicals can act believe too much importance may have been attached to antioxidant activity, and not enough to the other beneficial effects of phytochemicals.

Can all these claims be legal? Following EU legislation introduced in 2007 to prevent unsubstantiated health claims being made for foods, terms such as 'superfood' have to be backed by evidence explaining why the food is healthy and no foods will be allowed to claim they are 'good for your heart', 'help lower cholesterol' or are one of the growing list of 'superfoods', without scientific backing.

During the period before the legislation comes into force, food producers must prove that any claims can be backed up by evidence. Products that are high in calcium, for instance, can legitimately claim that calcium is good for bones. Oats have been shown to help reduce cholesterol as part of a low-fat diet and this claim could be made on a product. So by this time next year, there may be a centralised list of approved claims available for all to use across the European Union.

Eating exotic foods may offer health benefits we don't yet understand. But just because they're eaten in other parts of the world where there is a lower incidence of certain diseases, however, doesn't mean that they'll give the same protection to those following a very different diet and lifestyle in the UK. It may also be that what's important is how a particular food works in combination with other foods.

Eating one so-called superfood to the exclusion of other fruit or vegetables may limit the benefits. Even if certain foods were proved to be much higher in nutrients than others, it's important to eat a range of foods because no food can be super on its own.

Most people fail to meet the target of five portions of fruit and vegetables a day. As long as we don't reject some fruit and vegetables in favour of more fashionable ones, publicity that encourages consumers to eat more fruit and vegetables is to be welcomed.

Scoliosis in Ireland - Hospital Wait Times

2009-09-22T13:52:00.002+02:00

The Irish Medical Times have reported about the backlog at the Crumlin Hospital. There are currently a backlog of 70 operations to correct spinal deformity and by February 2010 this backlog is expected to be cleared, with children due to be operated upon from later this month.

His report below gives a greater description of the situation, written by Gary Culliton

A new initiative to address the waiting list has been agreed between the HSE and Our Lady’s Children’s Hospital in Crumlin; Temple Street; Tallaght; and Cappagh National Orthopaedic Hospitals, in collaboration with consultant orthopaedic surgeons.
Click here

The surgery for the 70 patients, who have had all of their pre-operative assessments completed, will be undertaken at either of the four above hospitals ‘as appropriate, based on the particular clinical needs of each patient’, IMT has been informed.

The hospitals have communicated with the patients and their families regarding the arrangements.

According to the Dublin critical care paediatric ICU report published last year, which looked at the facilities in Temple Street, Tallaght and Crumlin hospitals, major structural deficiencies in the service remain, and campaigners point out these will not be resolved simply by clearing the waiting list.

While the HSE is aware of a chronic shortage of paediatric consultant anaesthetists at Crumlin, extra anaesthetic cover should allow surgical teams to increase productivity in the orthopaedic area by between 25-30 per cent.

According to sources at Crumlin, if the Executive was to sanction the appointment of key anaesthetic staff, throughput of scoliosis cases could reach two to three cases per week — the level needed to cope with current demand. However, specialist beds would also need to reopen, they add.

The hospital has raised funds through donations and work that its surgeons carry out in Cork. In addition, a company has offered to provide implants free of charge to 30 children — a benefit worth between € 300,000 and € 600,000.S

Angle Velocity in Girls with Adolescent Idiopathic Scoliosis

2009-09-22T13:28:00.004+02:00

Scoliosis Journal reported an assessment of angle velocity in girls with adolescent idiopathic scoliosis

Authors: Ferran Escalada, Ester Marco, Roser Belmonte, Esther Duarte, Josep M Muniesa, Marta Tejero, Roser Boza and Enric Caceres

Published: 16 September 2009

Background
Although it has been demonstrated that the peak height velocity (PHV) is a predictive factor of progression in adolescent idiopathic scoliosis (AIS), little is known about the usefulness of angle progression in clinical practice. The purpose of this study was to establish a relationship between height and angle velocities, as well as to determine if peak angle velocity (PAV) occurs at the same time than PHV.

Methods
A retrospective study of a cohort of girls with idiopathic scoliotic curves greater than 10o. Data of 132 girls who participated in a previous retrospective study about growth in AIS were used to calculate height and angle velocities. Relationship between height and angle velocities was estimated by the use of a Linear Mixed Model.

Results
PHV and PAV take place simultaneously 1 year before menarche in progressive curves managed with a brace in AIS. Changes in angle velocity are influenced by changes in height growth velocity, in such a way that as from 6 months post-menarche, height growth velocity in this group of girls estimates curve progression velocity (beta-coefficient -0.88, p= 0.04).

Conclusions
As from 6 months post-menarche, there is an inverse relationship between height velocity and curve progression in the group of AIS girls with progressive curves managed with a brace. Because height velocity is decreasing from 1 year before menarche, this finding corroborates that at the end of puberty, there is still a risk of progression in this group of girls despite bracing. The assessment of both height and angle velocity might be useful in clinical practice at the time of assessing brace effectiveness and how long bracing has to be indicated.

Download a full complete version in PDF about the Angle Velocity in Girls with Adolescent Idiopathic Scoliosis

Scoliosis Treatment of Thoraco Lumbar Curves

2009-09-21T21:48:00.004+02:00

Scoliosis Journal have reported about the treatment of thoraco-lumbar curves in adolescent females affected by idiopathic Scoliosis with a progressive action short brace (PASB): assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria.

Authors: Angelo G. Aulisa, Vincenzo Guzzanti, Marco Galli, Carlo Perisano, Francesco Falciglia and Lorenzo Aulisa

Published: 18 September 2009

Background
The effectiveness of conservative treatment of scoliosis is controversial. Some studies suggest that brace is effective in stopping curve progression, whilst others did not report such an effect. The purpose of the present study was to effectiveness of Progressive Action Short Brace (PASB) in the correction of thoraco-lumbar curves, in agreement with the Scoliosis Research Society (SRS) Committee on Bracing and Nonoperative Management Standardisation Criteria.

Methods
Fifty adolescent females (mean age 11.8 +/- 0.5 years) with thoraco-lumbar curve and a pre-treatment Risser score ranging from 0 to 2 have been enrolled. The minimum duration of follow-up was 24 months (mean: 55.4 +/- 44.5 months). Antero-posterior radiographs were used to estimate the curve magnitude (CM) and the torsion of the apical vertebra (TA) at 5 time points :beginning of treatment (t1), one year after the beginning of treatment (t2), intermediate time between t1 and t4 (t3), end of weaning (t4), 2-year minimum follow-up from t4 (t5). Three situations were distinguished: curve correction, curve stabilisation and curve progression. The Kruskal Wallis and Spearman Rank Correlation tests have been used as statistical tests.

Results
CM mean value was 29,30 +/- 5,16 SD at t1 and 14,67 +/- 7,65 SD at t5. TA was 12.70 +/- 6,14 SD at t1 and 8,95 +/- 5,82 at t5. The variation between measures of Cobb and Perdriolle degrees at t1,2,3,4,5 and between CM t5-t1 and TA t5-t1 were significantly different. Curve correction was accomplished in 94% of patients, whereas a curve stabilisation was obtained in 6% of patients.

Conclusion
The PASB, due to its peculiar biomechanical action on vertebral modelling, is highly effective in correcting thoraco-lumbar curves.

Download a complete version of this as a PDF which talks about the treatment of thoraco-lumbar curves in adolescent females affected by idiopathic Scoliosis with a progressive action short brace (PASB): assessment of mentresults according to the SRS committee on bracing and nonoperative management standardization criteria.

Scoliosis: AIS Bracing and Exercises SOSORT

2009-09-10T20:02:00.003+02:00

ScoliosisJournal have reported on the effectiveness of complete conservative treatment for adolescent idiopathic scoliosis (bracing and exercises) based on SOSORT management criteria: results according to the SRS criteria for bracing studies - 2009 SOSORT Award Winner

Authors: Stefano Negrini, Salvatore Atanasio, Claudia Fusco email and Fabio Zaina

Published: 4 September 2009

Background
The SRS criteria give the methodological reference framework for the presentation of bracing results, while the SOSORT criteria give the clinical reference framework for an appropriate bracing treatment. The two have not been combined in a study until now. Our aim was to verify the efficacy of a complete, conservative treatment of Adolescent Idiopathic Scoliosis (AIS) according to the best methodological and management criteria defined in the literature.

Methods
Study Design. Retrospective study. Population. We included all AIS patients respecting the SRS inclusion criteria (age 10 years or older; Risser test 0-2; Cobb degrees 25-40 degrees; no prior treatment; less than one year post-menarchal) who had reached the end of treatment since our institute database start in 2003. Thus we had 44 females and four males, with an age of 12.8+/-1.6 years at the commencement of the study. Methods. According to individual needs, two patients have been treated with Risser casts followed by Lyon brace, 40 with Lyon or SPoRT braces (14 for 23 hours per day, 23 for 21 h/d, and seven for 18 h/d at start), and two with exercises only (1 male, 1 female): these were excluded from further analysis. Outcome criteria. SRS (unchanged; worsened 6 degrees or more; over 45 degrees at the end of treatment; surgically treated; two years' follow-up); clinical (ATR, Aesthetic Index, plumbline distances); radiographic (Cobb degrees); and ISICO (optimal; minimal). Statistics. Paired ANOVA and t-test, Tukey-Kramer and chi-square test.

Results
Median reported compliance during the 4.2+/-1.4 treatment years was 90% (range 5-106%). No patient progressed beyond 45 degrees, nor was any patient fused, and this remained true at the two-year follow-up for the 85% that reached it. Only two patients (4%) worsened, both with single thoracic curve, 25-30 degrees Cobb and Risser 0 at the start. We found statistically significant reductions of the scoliosis curvatures (-7.1 degrees): thoracic (-7.3 degrees), thoracolumbar (-8.4 degrees) and lumbar (-7.8 degrees), but not double major. Statistically significant improvements have also been found for aesthetics and ATR.

Conclusions
Respecting also SOSORT management criteria and thus increasing compliance, the results of conservative treatment were much better than what had previously been reported in the literature using SRS criteria only.

Download the PDF for the full version of this study regarding the effectiveness of complete conservative treatment for adolescent idiopathic scoliosis (bracing and exercises) based on SOSORT management criteria: results according to the SRS criteria for bracing studies.

Scoliosis: Braces and Plaster Casts

2009-09-07T17:04:00.009+02:00

Braces and Plaster Casts
Orthotic management of spinal disorders dates back at least to the Middle Ages. Some of the concepts underlying those primitive devices, notably three-point forces, remain valid today. Fabrication materials have progressed from metal and leather to light weight thermoplastics allowing many new designs and a new level of comfort for the patient.

Braces help control the curve as you or your child grows. These braces are sometimes prescribed post surgery, along with plaster jackets. I had a plaster cast for 7 months after my Harrington Rod surgery. They are designed to protect the back while the tiny bone ships used for grafting fuse to form a solid bone mass. Unfortunately for me my bone chips have not all formed a solid mass and I now have terrible problems with my donor site.

There are many different braces in use today, however, they all present similar problems in finding clothing that is both comfortable and trendy!

The Milwaukee Brace
Developed by Drs Al Schmidt and Walter Blount of Milwaukee. Since the 1960s back to the days of Pare in France and was carried on being used until the 1980s where the negative side set in. However this brace plays a very valuable role in the surgical and non-surgical management of spine deformities. Consists of metal uprights attached to pads at the hips, rib cage, and neck and can be very uncomfortable and in some cases is required to be worn 24/7 and of course can have physiological effects.

It is a custom made pelvic girdle from which three upright bars connect to a padded ring or collar round the neck.

The Cotrel Brace
This is similar to the Milwaukee Brace but it does not have the nexk or chin pieces

The Boston Brace
In the early seventies, the most popular of the TLSO (thoracic lumbar sacral orthosis) systems, the Boston Brace, was developed by Dr. John Hall and Mr. William Miller of The Boston Children's Hospital, it was the first brace to utilise symmetrical standardized modules eliminating the need for casting.

The Boston Brace is a moulded plastic brace and is shaped to fit the individual. It does not usually have a superstructure or neck piece it is less noticeable than the Milwaukee.

What should you wear under your brace?
All types of braces have a cotton seamless vest or t-shirt that is worn underneath and next ot the skin. Marks & Spencer, Pollards or Cotton On are all companies that provide seamless t-shirts with either long ot short sleeves, you can also get flat or seamless underwear. A body shaper or stocking are also suitable for the boys. Any departmental store offers under or leisurewear. You must make sure this fits snugly, this is to prevent it from wrinkling and annoying you when it rides up, if it is too large you will experience chafe and rubbing. You MUST buy cotton, synthetic such as nylon or polyester get hot and sticky and sore areas could develop.

Females may continue to wear a bra.

For the Milwaukee Brace the nck piece could be causing you problems so I would suggest a polo neck sweater or a scarf as a good solution. Hooded cardigans and duffel coats will also help hide the metal from the back. Or if you are like and have the "I don't give a stuff what people think about me" attitude then you don't need to worry about hiding it.

What can you wear to cover your brace?
Usually clothes 1 or 2 sizes larger are required and, for some, elastic waistlines - although some shapes will not suit elasticated wasitlines, mine doesn't! Baggy tops, like Kaftans worn with elasticated waisted jeans or lycra leggings are fashionable and comfortable, you may even find linen trousers are suitable and fit well, leaving you to explore other options for tops.

Long skirts are also comfortable and you can get many hippy style skirts that look great with various tops. Avoid silks!

Leggings and jodhpurs worn under the brace provide extra comfort.

Plaster Casts
Mine was fitted with a nice lining for comfort although I did use to find that the plaster rubbed under my arms when it was hot so what we used to do was cut out old shoulder pads and then place them over the plaster cast section where the arm pits are, that would keep me fresh and clean as these were easily washed and also stop any rubbing and chafe.

I wore mini skirts that had complete elasticated waists with t-shirts and blouses.

Another tip while wearing a plaster cast post surgery is to eat small meals more often, I used to find that if I ate a lot I would feel very uncomfortable and this is not a nice feeling when stuck inside a plaster.

We also had a wet flannel to hand as I was wearing my plaster during the summer months so I was getting very hot and as I could not shower or bath for 7 months it would get un-bearable at times. So I would lay on the floor, breathe in so my Mum could rub the wet flannel up and down my stomach to cool me.

Hope these tips have helped and if you have more then please send them in.

Scoliosis Treatments: SPoRT Brace Treatment

2009-09-02T10:41:00.003+02:00

Scoliosis Journal report on how to improve aesthetics in patients with Adolescent Idiopathic Scoliosis (AIS): a SPoRT brace treatment according to SOSORT management criteria

Authors: Fabio Zaina, Stefano Negrini, Claudia Fusco and Salvatore Atanasio

Published: 1 September 2009

Background
Aesthetics is a main goal of both conservative and surgical treatments in adolescent idiopathic scoliosis (AIS). Previously, we developed and validated a clinical scale - the Aesthetic Index (AI)--in order to measure aesthetic impairment and changes during treatment. Aim: To verify the efficacy of bracing on aesthetics in AIS. Study Design: Prospective Cohort Study. Population: Thirty-four consecutive patients, age 13.2+/-3.7, initial Cobb Angle 32+/-12degrees, ATR 10+/-4degrees Bunnel, 11 males.

Methods
Patients with AI scores of at least 5/6 were included. Each of them had a brace prescription (18 to 23 hours per day), according to the SPoRT concept. AI was measured again after six months and at the end of treatment, and then the pre- and post-treatment scores compared. The Wilcoxon test was performed.

Results
Twenty-nine patients out of the 34 included completed the treatment and had six-month and final results; four patients were lost during the treatment, and one was fused. At baseline, median AI was 6 (95% IC 5-6) but the score decreased to 3 (95% IC 0-5; p<0.05) after six months with brace, and this value was maintained in the 29 who completed the treatment (95% IC 1-6; p<0.05 with respect to the baseline).

Conclusion
Aesthetics can be improved in a clinically significant way when the brace treatment is performed according to the SPoRT concept and by following the SOSORT management criteria. This is a relevant result for patients and a major goal of scoliosis treatment, be it conservative or surgical. The use of a more sensitive tool like TRACE could more easily detect the clinical changes; nevertheless, AI proved sensible enough that its use in everyday clinical practice can be suggested.

Download the PDF document which gives a more detailed description relating to aesthetics in patients with Adolescent Idiopathic Scoliosis (AIS): a SPoRT brace treatment according to SOSORT management criteria

Boston Brace treatment in Adolescent Idiopathic Scoliosis

2009-09-01T10:54:00.002+02:00

Scoliosis Journal recently reported the following article which talks about the long-term outcome after Boston brace treatment in adolescent idiopathic scoliosis.

Authors: Johan Emil Lange, Harald Steen and Jens Ivar Brox

Published: 26 August 2009

Background
Few studies have evaluated long-term outcome after bracing using validated quality of life outcome. The aim of the present study was to evaluate the long-term outcome in adolescent idiopathic scoliosis (AIS) 12 years or more after treatment with Boston brace.

Methods
109 (80 %) of 135 patients (7 men) with AIS treated with Boston brace at a mean of 19.2 (12-28) years previously responded to long-term follow-up examination. All patients (n = 109) answered a standardised questionnaire including demographics, work status, treatment, Global Back Disability Question, Oswestry Disability Index (ODI) (100-worst possible), General Function Score (GFS) (100 - worst possible), EuroQol (EQ-5D (1 - best possible), EQ-VAS (100 - best possible)) and Scoliosis Research Society -22 (SRS - 22) (5 - best possible). Clinical and radiological examination was obtained in 86 patients.

Results
The magnitude of the primary prebrace major curve was in average 33.4 (range 20 - 52) degrees. At weaning and at the last follow-up the corresponding values were 28.3 (9 -56) and 34.2 (8 - 87) degrees, respectively. The mean age at follow-up was 35 (27 - 46) years. Work status was: full time (80%), on sick-leave (3%), on rehabilitation (4%), disability pension (4%), homemaker (7%), students (2%), 7 % had changed their job because of back pain. 88% had had delivered a baby, 55% of them had pain in pregnancy. Global back status was excellent or good in 81 %. Mean (standard deviation) ODI was 6.4 (9.8), GFS 5.4 (10.5), EQ-5D 0.84 (0.2), SRS-22: pain 4.2 (0.8), mental health 4.2 (0.7), self-image 3.9 (0.7), function 4.1 (0.6), satisfaction with treatment 3.7 (1.0). 28 % had taken physiotherapy for back pain the last year and 12 % had visited a doctor.

Conclusion
Long-term results were satisfactory in most patients with AIS treated with the Boston brace.

Download the article on PDF on Boston Brace and Adolescent Idiopathic Scoliosis

'Human tortoise' girl comes out of her plastic shell after 12 YEARS

2009-08-30T23:28:00.004+02:00

The Daily Mail report about a 14 year old girl, Megan Parker, 14, who was diagnosed with hemi-vertebrae and curvature of the spine at just six weeks old and had to have over 40 operations to correct her twisted back!!!!

She was forced to permanently wear a specially-made body shell to correct her posture and keep her neck upright.

Every time she grew medics were forced to open up her back again to stretch the titanium rods screwed into her to keep her spine straight.

But after a lifetime spent in her shell she has finally broken free after racing to recovery - and has even taken up go-karting.

Nowadays Meg, who wants to be a singer, can be spotted zooming around her local track - a far cry from the pace suggested by her old nickname.

Megan, who lives in Colchester with full-time mum Tina, 39, and specialist car mechanic dad Robert, 43, said being without the cast had totally changed her life.

She said: 'There is so much that I want to do now, but I have to take things steady because it's still early days.

'It has completely opened up the world to me being without the shell. I could never wear girly clothes before because the cast was so big and now I can because I don't feel people are staring at me anymore.

'Until a few months ago I had never had my hair cut at a salon because I could never bend my head over the sinks.

'I do feel like there is a part of me missing without the cast. It feels a bit strange my outer shell not being there because it has been a part of me since I was very little.

'I sometimes get upset when I think about everything I have been through. But when I look where I am now it just shows why you should never give up hope.'

When Megan was born on May 5, 1995, in Colchester Maternity Hospital by emergency Caesarean because she had heart problems.

But there was no clue that there was anything else amiss until she came out and doctors noticed there was something wrong with her neck.

Scans taken at six weeks revealed her curved spine, a condition called scoliosis, so she was scheduled for the first of many operations in November that year at Great Ormond Street.

It was then her parents were told if the surgery had not been done her internal organs would have been crushed by her back curving and she could have died by the age of five. (I have been across many forums on the internet with many folk who claim that Scoliosis cannot do this to a person, well how wrong they are!!!!)

During the procedure medics removed a rib and used pieces of it to fuse into and straighten her spine.

It was then the 4lb plaster body shell that would house her body was fitted onto her.
Over the next eight years it would be taken off on 24 occasions, each time only ever in Royal National Orthopaedic Hospital in Middlesex when she was put on a traction table and stretched.

Once the procedure was over she would be put back into a new plaster shell and let to go home.

At the age of eight Megan was fitted with two titanium rods running from four inches up her spine to the top her neck.

She was also fitted with a new smaller body brace and had to have a further 12 ops to extend the rods as she grew in height.

But after an operation on May 13, 2008, she had her spine fused and given permanent rods.

And just six months ago medics gave her the news she had been waiting for her whole life - she did not have to wear a shell again.

The body cast meant Megan never crawled as a baby, having to get about by shuffling around on her bottom until she grew older, when she had to be pushed in a buggy.

At the age of seven she was given a wheelchair which she had to rely on to get around until she had the cast removed, now she only has to occasionally use it.

But her heavy shell meant she had never been able to enjoy a summer until this year.
The plaster made it too hot to go outside and she had to be careful never to get the cast wet.

Royal National Orthopaedic Hospital clinical nurse specialist Susan Lister has treated Megan since she was a baby.

She said the teenager and her family had to be credited with battling against the odds.

She said: 'While scoliosis is not that unusual, the severity of Megan's condition was. If she hadn't have had all the surgeries her respiratory system would have deteriorated and her stomach would have suffered too.

'She could have died early because her lungs would have been compressed so much.

'Megan has recovered better than expected and its her fortitude and courage that have seen her through some hard times.

'She has had wonderful support from her parents and coupled with her bravery it has got her through - a lot of people would have given up.

'She will have tobe monitored quite closely, but we hope that the worst is behind her now.

'A lot of her recovery is simply down to Megan and the biggest credit should go to her and her family.'

Mum Tina said the transformation had been nothing short of miraculous. She said the doctors who had treated her had given her a chance to live a normal life again.

She said: 'She is my miracle girl, she's been through so much and we're delighted she is now out of her shell.

'The surgeons have been incredible and have transformed her life - their work has made sure she can play with her friends and do sport she has always wanted to.

'Driving a go kart was one of the first things she had wanted to do and it brought tears to our eyes when she finally did it.

'I feel like my little girl has finally come out of her shell - in both ways.

'She is still frightened a bit of being knocked and bumped but she is gaining confidence every day, she is like a different person now.'

The pros and cons of post-op life

2009-08-25T09:36:00.006+02:00

I'm still counting down - 75 days left.

Things to look forward to after surgery, other than pain relief:
1. Having a bra that fits properly.
2. Wearing any pair of shoes I want, without having to get an expensive lift put on.
3. Not having my legs fall asleep all the time (hopefully).
4. Sleeping better!
5. No more limping!
6. No backaches from doing the laundry or dishes, showering, or anything else that requires standing for long periods.
7. Better posture.

Things to dread:
1. The insane medical bills.
2. Changes in my ability to bathe, dress, and move.

Other than the money ($50,000 and up), everything else I can deal with. At least, I think so. I'm currently fused from T10-L3. It's going to be revised and continued, from T4-S1. Does anyone out there have a fusion this complex? I really want to know what it's like to be fused this much, so I know what to expect. Comment me here or hit me up on Twitter, @oddcupcake.

Scoliosis Arthrodesis & Posterior Titanium Instruments

2009-08-19T22:37:00.003+02:00

Scoliosis Journal reports about adolescent idiopathic scoliosis (AIS) which is treated with arthrodesis and posterior titanium instrumentation: 8 to 12 years follow up without late infection

Authors: Franz J Mueller and Herbert Gluch email

Published: 12 August 2009

Background
There are no data in the peer-reviewed literature regarding long term results in patients treated for AIS with a posterior titanium instrumentation. Therefore we assessed the outcome in 50 patients treated by titanium implant.

Methods
A total of 50 patients with a mean age of 16.6 years were treated. In all patients, titanium hooks and pedicle screws were used in combination. The demographic data and the pre- and post-operative radiographs of all 50 patients were re-examined, and 49 of the 50 patients (98%) attended a radiological and clinical follow up-examination on average 10.1 years post-operatively. The clinical results were recorded by means of the SRS 24 questionnaire.

Results
In the frontal plane, the mean pre-operative thoracic and lumbar curve had been 62.4º and 43.5º respectively, post-operatively the curves were reduced to 26.9º and 16.3º, resulting in a correction rate of 56.9% for thoracic and 62.5% for lumbar curve. At the follow up-evaluation, the Cobb angle of the thoracic and lumbar curve was 31.0degrees and 21.3degrees respectively, giving a final correction rate of 50.3% for thoracic, and 51.0% for lumbar curve. 7 of the 50 patients (14.3%) had undergo revision surgery for complications, but complete implant removal was necessary in only one case. Analysis of the SRS 24 questionnaire showed an average score of 95.8 points.
Conclusion

Posterior titanium instrumentation is a safe and effective procedure in the surgical correction of AIS. In this retrospective study with small patient number, it shows favourable long-term results; in particular, the loss of correction is low, no late infection occurred and there was a very high survival rate of the implant itself.

Download the PDF to read more about (AIS) which is treated with arthrodesis and posterior titanium instrumentation:

Cypriot Government step in with Shriners

2009-08-12T17:09:00.004+02:00

Shriners Hospital for Children has been operating on and supporting children with Scoliosis for many years and not just from a surgical point of view, financial as well.

A Little About Shriners
Shriners Hospitals for Children is a one-of-a-kind international health care system dedicated to improving the lives of children by providing specialty pediatric care, innovative research and outstanding teaching programs.Children up to the age of 18 with orthopaedic conditions, burns, spinal cord injuries and cleft lip and palate are eligible for admission and receive all care in a family-centered environment at no financial obligation to patients or families.

Over the past 30 years Shriners has been treating Cypriot children with Scoliosis, free of charge.

Just recently Shriners has met with the health minister seeking financial support to help operate on Cypriot children, due to the current economic climate, Shriners can no longer afford to operate on these children due to the cost of the surgical hardware that is require for spinal surgery of this magnitude.

Children are usually sent to Massachusetts at the expense of the Paraskevaides Foundation.

George Christodoulou is the medical liaison between Cyprus, the Paraskevaides Foundation and the Shriners Hospitals. George met with Mr Vakanas, spokesman for the Ministry of Health, to discuss the financial implications of these surgeries.

The Cyprus Mail reported the following:
He explained “The ministry have requested that a medical record come from us and an application form from the parents of the children. This is so that they can process the money needed for the surgical hardware.” He said the ministry were ‘very helpful’ and the meeting was ‘very encouraging.’ Christodoulou stressed that “all other medical expenses remain free.”

He added that he hopes the parents of children with scoliosis would be made aware of this development so that they can take the necessary steps to improve their children’s quality of life.

Mr Nasos Athanasiou, spokesman for the Paraskevaides Foundation, said: “I am very optimistic about the help from the Cyprus government. As I understand it the ministry have promised to help, provided that the parents bring papers to justify this assistance. This will no doubt depend on the financial situation of the family. I am sure that the ministry will make the parents aware of what they have to do to apply for assistance.”

He added that the Foundation will continue to fund the children’s travel expenses “for as long as the need is there.” Christodoulou said of the Paraskevaides Foundation: “Everything we do for these Cypriot children is all thanks to them. Without them this programme would not exist.”

Scoliosis is an abnormal lateral curvature of the spine which can be extremely painful. Severe cases of scoliosis can lead to diminished lung capacity, increased pressure on the heart and restricted physical activity. In adolescents scoliosis can cause the hip and leg proportions to become misaligned. According to Christodoulou Cyprus has the highest per capita rate of scoliosis worldwide. The surgery for scoliosis involves placing a rod either side of the spine to straighten it. These rods, which cost between $13 000 and $25 000 (€9000 to €17500) are the surgical hardware in question.

Shriners Hospitals have helped more than 3,000 Cypriot children free of charge since 1980 but since the global recession they have had to cut their budget to keep six of their hospitals open. This resulted in the need for financial assistance to pay for the platinum parts needed to straighten the spines of scoliosis patients.

Shriners Hospitals are dedicated to making a difference in the lives have children. Since 1922 they have helped more than 865,000 children, free of charge.

Last week Athanasiou commented ‘It is a mark of the times that for the first time in 30 years Shriners have had to ask for financial help.’

Source: Cyprus Mail

Scoliosis & Exercises with Rick Kaselj

2009-08-12T16:04:00.004+02:00

Scoliosis & Exercises Interview

I was approached by Rick Kaselj in June time of this year, he wanted to interview me regarding the subject of Scoliosis, how I manage, what exercises I do, what advice I would give to exercise experts that are designing work outs for people with Scoliosis.

You may listen to the interview by clicking the link "Scoliosis & Exercises Interview" embedded within this post (this is an mp3 and should play in your browser).

I have never been interviewed before and I was very nervous but anything to help people with Scoliosis is good with me, I am happy to share my thoughts and feelings when it comes to Scoliosis and life.

I have to say I do not like the sound of my voice on the MP3 but I don't think I am alone with not liking the sound of your own voice! I will let you decide if I sound OK or not ;)

Some information about Rick and his profession are listed below

I would like to thank Rick for the experience and also to thank him for being patient with me!

Rick Kaselj
Rick Kaselj specializes in active rehabilitation and fitness. He works in one-on-one and group rehabilitation settings, training people who have been injured at work, in car accidents and during sport activities. His clients and group exercise participants include a wide variety of individuals from healthy and special populations.

Rick has combined his work experience and passion for research to develop a variety of courses and presentations for fitness professionals, kinesiologists and healthcare providers.

He runs a website called "Healing Through Movement" which offers quality experiences to the public and fitness/healthcare professionals through entertaining and educational presentations, writing and photography.

Scoliosis, Muscles & Lumbar Pain

2009-08-12T14:05:00.004+02:00

I am now 3 days into taking my new treatment and while I have not noticed any significant changes in my body I think it is too early to tell, I was told I may need a double dose to get me started so we will wait and see.

It would appear I am going to have a run of bad luck with the old Twisted Spine! My go faster stripes are not working and I am slowing down. I am having considerable amounts of pain in my lumbar, right where my donor site scar is, I cannot relax without feeling HUGE pressure on the scar, which is very painful and makes me catch my breath.

I even had problems on the toilet this morning and that just gets me frustrated, the simplest of actions that any normal person takes for granted is such an effort for me this week and I end up getting really pissed off!!!!!!!

I had to drive my Mother to the airport earlier because Chris is up to his eyes with work so he needed to stay home and finish his "to do list", I have to say it was the most painful drive of my life, I have struggled with driving over the years but today was OMG, the slighest bump made my eyes water, I am thankful we have an automatic, makes my life a little easier when driving. Over the years I have started to hate cars more and more, I struggle to get in and out of them, the position I sit in while in the car is just all wrong and if I need to reverse I hate it because my body needs to be at an awkward angle while I check that nobody is there so I don't smack into them, the Spanish have a tendency of driving through no entries or in car parks they just all of a sudden appear so you need your wits about you - driving in Spain has always been a joke, the Spanish cannot drive - simple! (I know I cannot tar them all with the same brush but they are not a patch on English drivers!).

I am now working in bed for the next 2 days to rest and recover, I need to slow down and stop enjoying myself, I don't know if other Scoliosis patients out there suffer from "Over Compensation Syndrome" (I will talk about this syndrome later)? I know that I am a classic patient for Overcompensation Syndrome and my husband is always ribbing me about this, perhaps this is what happens to me, I go about daily life with my syndrome, push myself to the limits and then my back has no choice but to ground me!

Classic signs of Overcompensation Syndrome are:
1. Denial of emotions when faced with adversity
2. Manifestation of hard-working, type A personalities with perfectionist inclinations
3. Independent, sometimes aloof, natures that may make it difficult for them to work in social or business groups
4. Discomfort when forced to rely on others, sometimes to extreme levels indicating a complete lack of trust of people
5. Overachievement that makes them push to be at the top of their professions and overcompetitiveness in wanting to be the best at every pursuit, no matter how trivial
6. Inability to relax and not be productive
7. Extremely negative reactions to criticism and out-of-proportion fears of failure
8. Participation in high-risk, overstrenuous activities such as sky diving or motorcycle racing
9. Inability to deal with anger and stress constructively
10. Extreme sensitivity about personal appearance and compulsive adaptation of clothing to hide remaining deformities
11. Stoical, stiff upper lip approaches to their own medical problems (or, in contrast, excessive, out-of-proportion fear of medical procedures), and
12. Refusals to listen to their bodies and slow down in response to pain in efforts to avoid appearing "contaminated" with a disability or deformed condition

So, let's take it from the top regarding myself

Overcompensation Syndrome vs Simone Icough
1: I do not deny my emotions, I let all them out, good or bad!
2: I am very hard-working and don't know when to stop, can sometimes be a problem!
3: I am very independent, although I would not say I find it difficult to socialise
4: I do find it very difficult to lean on others, prefer to do things myself, almost as if I don't deserve the help "I should be able to manage"
5: I am VERY competitive and I am always striving to be the best
6: Inability to relax is a definiate one for me but I am productive every day
7: I have huge fears of failure and in my current profession I have not failed yet but I always dread the day that I "might"
8: I do not participate all the time but I did go snow boarding years ago even after I was told I should not, I decided I only had Scoliosis and it would be fine (blush), hate having to be the one who misses out as it seems like it is always the case
9: I can deal with anger and stress, although when stressed I tend to rant and rave at those who have upset me before and I failed to tell them
10: I don't think I am too bad where my appearance is concerned but I do worry sometimes, I always make sure I look OK and don't like people seeing my twisted-ness unless they are close to me, I constantly hate my stomach and am always comapring to my "normal" friends
11: I certainly fit this category and if someone asks me how I am, I shrug and say "yeah I am good" as it isn't there or doesn't matter
12: This is me all over, I refuse to rest, always having something to do, always busy!

To read extensively about Overcompensation Syndrome that was written by Elizabeth Mina, visit my website and learn something more about yourself as a Scoliosis Patient!

Vitamins, Minerals, Muscles & Scoliosis

2009-08-09T20:03:00.004+02:00

Our bodies need small amounts of essential nutrients in order to work properly.

Before I continue with the reason why I started this blog I wanted to explain the types of vitamins and minerals.

Fat Soluble and Water Soluble Vitamins:

Fat Soluble Vitamins
Fatty foods that contain fat soluble vitamins are:
Butter
Lard
Vegetable Oils
Dairy Foods
Liver
Oily Fish
Animal Fats
Vitamin A
Vitamin D
Vitamin E
Vitamin K

Our bodies need these vitamins daily to function properly. However, you don't need to eat foods containing them every day. Our bodies store vitamins in our liver and fatty tissues for future use. If you have more fat soluble vitamins than required, this would be harmful.

Water Soluble Vitamins
These vitamins are not stored in our bodies so we need them more frequently. Our bodies do not store water soluble vitamins we get rid of them when we urinate. These vitamins are not harmful.

Water Soluble Vitamins
Fruit
Vegetables
Grains
Vitamin B6
Vitamin B12
Vitamin C
Biotin
Folic Acid
Niacin
Pantothenic Acid
Riboflavin
Thiamin

Water Soluble vitamins can be destroyed by air and heat, they can also be lost in cooking, so don't over cook your vegetables like your Nan used to when you were a child! LOL. I would suggest steaming vegetables or eating raw, in fact we should all eat raw food every day (says Gillian McKeith!)

We need minerals also to function properly and they are found in the form of food.

Minerals
Meat
Cereals
Bread
Fish
Milk
Dairy Foods
Vegetables
Fruit
Dried Fruit
Nuts

Why do we need minerals?
We need minerals for:
Building strong bones and teeth
Controlling body fluids inside and outside cells
Turning the food we eat into energy

Essential Minerals
Calcium
Iron
Magnesium
Phosphorus
Potassium
Sodium
Sulphur

We also require trace elements for our bodies to work, however, these are required in smaller amounts.

Trace Elements
Meat
Fish
Cereals
Milk
Dairy Foods
Vegetables
Nuts
Boron
Cobalt
Copper
Chromium
Fluoride
Iodine
Manganese
Molybdenum
Selenium
Silicon
Zinc

Now we know how much we need vitamins and minerals, a person with Scoliosis requires these vitamins and minerals even more so than the average person and it is of vital importance that we keep our bodies in tip top condition to help support our muscles that surround the spine.

I will now talk about how I have been feeling lately because this morning I started a new course of treatment, which is linked to vitamins and minerals. I don't want to talk about the product itself yet because I want to try and test it first and then I promise to share it with you :)

In order for me to recognise if this treatment is working I need to blog about how my body is right now and the pain I am experiencing and then compare how I am feeling in a week's time.

I have had a busy summer so far so I have been more active and this could also be playing a part in why I am feeling so stiff in the lumbar area. I noticed yesterday morning that I was having that "creaking gate" feeling again, where I struggle to stand and walk because it feels like I need oiling!

My hips are extremely sore and when I push on the side of hips it feels like I am bruised, almost like I have been through a round with a professional boxer, I have noticed I am bending forward towards the end of the day once more and leaning slightly to the left side, which obviously affects many other parts of my body and then I get radiating pain in various places throughout my body.

Getting in and out in the car today was not very pleasant and to be honest I was shocked at just how painful it was, after getting into the car I had to shut my eyes and breathe slowly in and out just to focus, I managed to drive without any problems (we have an automatic Audi A6) but again getting out was painful and I was glad to get home and get into the swimming pool for some relief.

I have not had Bowen for many weeks so I am thinking that I may need to go and have another session, however, I do want to start Yoga again and I cannot do Yoga when I am having Bowen treatments, so I am hoping this new treatment will help me and I can team with that Yoga!

I have had a course of my treatment this morning and now I have to do some more, I will report again how I am feeling in a week and hopefully I can have a pain free evening.

Signing off for now and speak soon

Simone xx

Scoliosis Density Equalizing mapping & Scientometric Analysis

2009-07-29T12:39:00.002+02:00

Scoliosis Journal reports: Density-equalizing mapping and scientometric analysis

Authors: Karin Vitzthum, Stefanie Mache, David Quarcoo, Cristian Scutaru, David A Groneberg and Norman Schoffel

Published: 28 July 2009

Background
Publications related to scoliosis have increased enormously. A differentiation between publications of major and minor importance has become difficult even for experts. Scientometric data on developments and tendencies in scoliosis research has not been available to date. The aim of the current study was to evaluate the scientific efforts of scoliosis research both quantitatively and qualitatively.

Methods
Large-scale data analysis, density-equalizing algorithms and scientometric methods were used to evaluate both the quantity and quality of research achievements of scientists studying scoliosis. Density-equalizing algorithms were applied to data retrieved from ISI-Web.

Results
From 1904 to 2007, 8,186 items pertaining to scoliosis were published and included in the database. The studies were published in 76 countries: the USA, the U.K. and Canada being the most productive centers. The Washington University (St. Louis, Missouri) was identified as the most prolific institution during that period, and orthopedics represented by far the most productive medical discipline. "BRADFORD, DS" is the most productive author (146 items), and "DANSEREAU, J" is the author with the highest scientific impact (h-index of 27).

Conclusions
Our results suggest that currently established measures of research output (i.e. impact factor, h-index) should be evaluated critically because phenomena, such as self-citation and co-authorship, distort the results and limit the value of the conclusions that may be drawn from these measures. Qualitative statements are just tractable by the comparison of the parameters with respect to multiple linkages. In order to obtain more objective evaluation tools, new measurements need to be developed.

Download the PDF to read more about Scoliosis densiry equalizing & Scientometric Analysis