Developments in Scoliosis Treatments: Surgical & Non-Surgical

Scoliosis is a condition that has, historically, been difficult to treat effectively without spinal fusion surgery. As the condition is progressive, people diagnosed with scoliosis are often just waiting for the curve to get bad enough to need this invasive, motion-limiting surgery.

But modern medicine is changing all that. With new developments in medical technology, surgical techniques and physical therapies, many scoliosis patients can avoid fusion surgery and even reverse their spinal curvature.

What is scoliosis?

Scoliosis, simply put, is when the spine develops a spiral curve. Spines are naturally curved – once at the shoulders and once at the sacrum. But those curves are front to back. When the spine curves in a spiral; that’s when we get problems.

Scoliosis may be one curve or a compound curve, often referred to as an s curve. It is called an S curve because in a 2-dimensional x-ray the deformity looks like an S. Since the curve is really three dimensional, it is really a spiral and not an S. Doctors measure the progress of the curve via x-rays. Using the x-rays, they then determine the degree of the curve. As the condition is often diagnosed in early adolescence, if the curve can be managed until the bones are finished forming, this can minimize the need for later therapies and surgeries. There is often a congenital, trauma or illness-based cause for adolescent scoliosis.

Most often, the cause of scoliosis in adults is either degenerative musculoskeletal conditions, previous chest or back surgeries, or otherwise poor physical health that has allowed the muscles and fascia stabilizing the spine to kink, seize and weaken. If your muscles aren’t supporting your spine, it’s more likely to form these sideways curves.

There are several visible signs someone has developed scoliosis:

• Crooked rib cage
• One hip is higher than the other
• Uneven shoulders/shoulder blades
• Uneven waist
• Unnatural hump in the spine

Mild curves likely won’t cause any pain or discomfort, so they aren’t always caught. Scoliosis does not necessarily cause pain. Moderate scoliosis results in limited range of motion, and those visible signs we just mentioned. Scoliosis is considered severe when the curve is 50 degrees or more. When the curve is more severe, breathing and lung space are compromised.

New Surgical Interventions for Scoliosis

Until recently, the only proven surgical intervention for adverse spinal curves was spinal fusion. And while it today it still has a place in severe cases, it soon may not. Spinal fusion is used in a variety of degenerative spinal conditions. It’s an invasive surgery that’s extremely traumatic to the body, as the curve is corrected at once via rods and screws. Boney material is placed in the spaces between the vertebrae, where they eventually grow together, or fuse. Recovery is often painful and takes up to a year. Range of motion in the back is permanently limited.

Vertebral body tethering (VBT) is a new, much less invasive surgical treatment for scoliosis. Via small incisions, screws are placed on each side of each affected vertebrae. A cord is threaded through the screws, and the curve is progressively pulled straight over time. This surgery is less traumatic to the body in both procedure and recovery.

Vertebral body stapling is a variation on VBT. Staples are inserted endoscopically on each vertebrae on one side of the spine. A cord is then threaded through, and the spine is straightened much in the way braces straighten crooked teeth. As it’s done endoscopically, the trauma and invasiveness is minimal.

ApiFix (posterior dynamic correction) is another minimally-invasive scoliosis surgery that is essentially an internal brace for the spine. The curve is corrected during the surgery, but the device is able to be adjusted over time, if needed. ApiFix has less hospital stay time than VBT and fusion, and the healing time is the shortest of the surgical options.

Wedge osteotomies are another alternative to spinal fusion, but are only performed on patients who are already at the surgery stage – 45 to 50 degrees. It’s a very technical surgery, but when successful, offers curvature correction while sparing range of motion. In this procedure, vertebrae are surgically severed and realigned.

Regardless of how “minimally” invasive these scoliosis treatments are, they’re still surgery, and surgeries come with an array of risks and possible complications. Luckily, regenerative medicine and osteopathic manipulation methods may offer an alternative to these back surgeries.

Holistic Therapies for Scoliosis

Scoliosis is caused by fascia that does not lengthen or pathologically contracts, thereby preventing vertical growth during childhood. When the spine cannot grow vertically, it grows in what is called “the path of least resistance” which in this case is a spiral.

In adults, collapsed vertebral bone is often a major contributor to the spine curving. Bones collapse due to injury and fracture and by osteoporosis or cancer.

Chiropractic manipulation and deep-tissue massage can release seized muscles and relieve tension in the back, which allows a wellness doctor to set the spine on the correct course. A long-term regiment of massage and physical therapy can then help manage or reverse the curve in the spine. As well, it often relieves patients’ pain.

Electrical stimulation of the muscles around the spine can also serve to release that damaging tension in your muscles and fascia, which over the long-term can help the spine move away from that curved position it was stuck in by your misbehaving muscles.

Dr. Blatman uses injection techniques to release the tight fascia that binds the child (or adult that can still feel the pulling), and we can watch the spine unwind and spring up, sometimes showing a ¾” increase in height. With this technique Dr. Blatman has reversed the scoliosis and reduced the curve in several children.

Holistic nutrition counseling can identify and remove toxic foods from your diet, set you on a good stretching and exercise routine, utilize any relevant natural supplements, and design a treatment plan for therapies like physical and massage.

Your doctor may also recommend medical marijuana for managing pain symptoms, improving sleep, and reducing muscle tension throughout your course of treatment.

Complementary Treatments for Spinal Curvatures

A great addition to any holistic healing plan, when faced with soft and hard tissue injuries, is regenerative therapy. Injections of platelet-rich-plasma or stem cell solutions in the deformed muscles surrounding the spine can boost the healing process that manipulation-based methods spur and guide.

In addition, regenerative IV treatments may aid a treatment plan for scoliosis, especially if the patient is in poor health and/or has a degenerative musculoskeletal condition. IV therapies like Myers’ cocktail and lactated Ringer’s can boost all your body’s systems, and have been used for other conditions that cause chronic pain, such as fibromyalgia.

If you’re dealing with mild to moderate scoliosis, surgeons often won’t perform any corrective surgery until it’s severe, as spinal surgeries are extremely invasive, tricky, and have a long, often painful healing period. But, as we’ve seen, you have alternatives to surgery that can serve to manage or even improve your spinal curvature so surgery doesn’t have to be an imminent reality.

Consult with a wellness center that specializes in holistic, regenerative and integrative medicine to create a comprehensive plan to treat your scoliosis.