We all remember the shock, horror, and complete disbelief of the tragic events that took place in the United States on September 11, 2001. Most of us simply couldn’t wrap our collective heads around the very idea or concept that people would hijack jet planes and convert them into 600 mph weapons of mass destruction. Immediately, fingers were pointed and blamed assigned to the various intelligence agencies who missed opportunity after opportunity to prevent the attacks, yet failed to do so. Years later the “9/11 report” concluded the biggest failure within the intelligence community was simply “a failure of imagination.” The intel analysts had simply become so complacent they couldn’t even imagine a “low tech” threat causing so much harm.
On a less morbid note, I believe Henry Ford said it best, “If I had asked my customers what they wanted, they would have said a faster horse.” Simply put, most of us just aren’t programmed to think outside the box in most cases, and the same holds true for the current state of scoliosis treatment. It’s time to update our thinking regarding the scoliosis condition and embrace innovation in our approach to treating scoliosis.
One of the most difficult aspects of innovation is the acceptance of new ideas. New ideas are rarely readily accepted at first, as they are seen as changes to the status quo and often threaten the comfort zones of known and accepted beliefs. Given the fact that ridged braces have been used since 1575, fusion surgery since 1865, and Schroth therapy developed in 1921, new ideas are in desperate need.
The focus of treatment needs to shift towards treating the whole scoliosis condition, not just the curve
Adolescent idiopathic scoliosis (AIS) is characterized by a failure of communication between the automatic postural control centers in the brain stem and the intrinsic spinal muscles, which control spinal alignment. (It is important to note mammals, including humans, DO NOT have conscious control over these muscles or the spinal alignment mechanism, thus attempts to train voluntary controlled muscles groups (Ex: Schroth, Yoga, Pilates, Swimming, ect) will NOT have an impact on spinal alignment.) The pathogenesis (cause) of the AIS condition remains largely undetermined, however it has become clear it involves far more than the spinal column and includes hormone production, bone density, and genetic pre-disposition. Any and all efforts to actually treat the scoliosis condition must focus on these underlying driving factors which combine to result in a spinal curvature, rather than merely trying to “keep up with the curve” after the fact.
Genetic pre-disposition and environmental factor = Adolescent Idiopathic Scoliosis
Recent advancements in genetic testing are opening up a whole new world of treatment possibilities for many “incurable” conditions including AIS. Like most conditions, idiopathic scoliosis appears to be a combination of genetic pre-disposition passed on from the parents/grandparents and environmental factors (bio-chemical, bio-mechanical, activity related, ect) which results in a curvature of the spine known as “scoliosis”. Extensive research is currently being done to determine many of the genetic pre-dispositions for idiopathic scoliosis in hopes of using it as a genetic “scoliosis screening test” of sorts. The hope is further clinical testing could be recommended based off any given patient’s personal genetic data and non-invasive, preventative measures (activity modification, specific supplementation, early stage scoliosis intervention treatment) could be implemented appropriately in the earliest stages of the scoliosis condition.
Higher expectations and standards for scoliosis treatment goals and outcomes
Historically, “successful” scoliosis treatment has been (and currently still is) merely halting further curve progression under the ever changing surgical threshold until the time the patient reaches skeletal maturity. Given that 80% of patient generally never demonstrate severe curve progression, this seems like a rather low bar for “success”. The ScoliSMART doctors feel treating scoliosis should consist of more than just an effort to “dodge the knife”. We feel patients should be given a genuine and conscious effort to not only halt progression, but also improve the spinal curvature and the scoliosis condition itself. Treatment outcomes should be measured not only in cobb angle reduction, but neurotransmitter levels, hormone function, and bone density levels. It is simply not enough to accept outcomes that save patients from the worst possible outcome, rather parents and patients should demand higher expectations and standard for treatment outcomes that actually attempt to make the patient actually better.
Over 15 years ago, the ScoliSMART doctors set out on a mission to find a better way to treat adolescent idiopathic scoliosis. Our approach centers around treating the whole scoliosis condition, not just the primary symptom of a spinal curvature. This requires development of a genetic pre-disposition screening test directed clinical testing, environmental interventions based off the targeted clinical testing, and most of all a mass movement of parents and patients to demand health care professionals strive for higher goals than simply preventing the spinal curvature from reaching current surgical threshold.