Understanding Scoliosis - Part 1: A Mind Body Detective Approach


Scoliosis - A Mind Body Detective Approach
Scoliosis - A Mind Body Detective Approach

What is Scoliosis?

Scoliosis is from the ancient Greek, ‘Skoliosis’, which means “a bending”.

It is the medical diagnosis given to the curvature of the spine, usually into an “S” or a “C” shaped curvature. Medically the cause is unknown, although it is associated with other conditions, such as cerebral palsy, neurofibromatosis and muscle spasms. There is also a genetic risk factor for those with other affected family members.

In some, the curvature of the spine may be minimal, and may stabilise. In others, the degree of curvature can become more severe (measured by the two degrees of flexion measured as a deviation from the straight spinal column), and be ‘unstable’, progressively becoming worse over time.

The only allopathic treatments that are available for Scoliosis, are physical interventions - such as ‘bracing’ or surgery, with the treatment provided depending upon the severity and stability of the condition for each individual.

Bracing uses an external structure to support the spine during growth, whereas surgery is the internal application of stabilising metal rods which are drilled into the spine itself (see image below: before and after surgical intervention).


Diagnosis

Physical examination will include

  • Gait assessment: looking for signs of other abnormalities or causes associated with a spinal curvature

  • Adams forward bend test: a preliminary test often used in schools. Adopting the ‘dive’ position, provides a visual aspect of the prominent line of the spine and height of the posterior ribcage can be assessed

  • Neurological assessment

  • Skin assessment for ‘cafe au last spots’ - indicating neurofibromatosis feet assessments for cavovarus deformity abdominal reflexes & muscle tone for spacticity

  • X-Rays: to check coronal (front-back view) and lateral (side view), measuring kyphosis (excessive ‘humping’ of the back) and lordosis (excessive inward curvature in the lumbar region of the spine). Measurement of spinal deviation uses the ‘Cobb Angle’

  • MRI: for further investigation of the spinal chord

Most diagnoses occur in children & adolescents, between the ages of 10-20 years old.

As you will see as we discuss the main mind-body and emotional contributing factors (in terms of Meta Health), this is the optimal age whereby children begin to question the social constructs and inherited belief patterns that they have automatically picked up through their family or other social groups. Therefore, when we consider the age that scoliosis occurs, we can see how this correlates with issues and conflicts that are part of the social and personal development of an individual at this age range.


Measuring

The Cobb Angle is the system originally used to measure the coronal plane in x-rays for the classification of scoliosis. It was subsequently adopted to also measure the sagittal plane.

Measured from a vertebral fracture (if in relation to a traumatic spinal fracture classification), or the optimally deviated vertebra (shown in the illustration as the blue vertebra), a line is drawn parallel to the superior endplate of one vertebrate above the vertebra trauma, and intersected with a line drawn parallel to the inferior endplate of the vertebra one level below the vertebra trauma.

Scoliosis severity is measured through the Cobb Angle:

Mild: 10-30º

Moderate: 30-45º

Severe: >45º



Mind Body Detective Scoliosis Cobb Angle
Measurment of the cobb angle and an X-Ray indicate a severe spinal deviation

The onset of scoliosis is usually between 10-20 years old. 

It is more common in females than males.

It affects approximately 3% of the population.

It is