This case is an example of a significant low ‘C’ curve responding to preventive and proactive treatment strategies. The first X-ray was taken prior to starting care and revealed an increase of 17 degrees (in 11 months) to a 71 degree Cobb angle. The second X-ray was taken 2 weeks after the initial consultation and when the first recommendation was given. That is before any intensive treatment began. The third X-ray was taken at the conclusion of two weeks treatment.
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Background:
A year 10 student presented with a single C shaped lumbar (71° Cobb angle). The curve had progressed 6 degrees in the two weeks preceding treatment to a total of a 17 degree increase within the last 11 months. She reported little discomfort, although her appearance indicated constant leaning towards the left. Given her scoliosis’s potential to grow at her age, the severity of her Scoliosis, and the spinal curve being significantly off centre, progression with surgery looking increasingly likely. Interventions were urgently required to stabilize the curve and to achieve reduction where possible.
Method
Scoliosis care commenced and the family’s concerns were articulated, and the client’s medical history, lifestyle, and Scoliosis were extensively assessed. Practical preventative and proactive strategies to manage Scoliosis were then formulated, which empowered the client and created relief for her family with the knowledge that something could now be done to manage her the curve, instead of ‘watching and waiting’.
Two weeks after the initial consultation, this year 10 student decided to commence a 2 week daily intensive programme (4 hours a day). Specific exercises were introduced in the first few days to discover the appropriate approach to address the curve. Based on her spine’s responsiveness to the exercises, the most effective exercises were then tailored to her specific curve and maintained through the intensive period.
Results
- The cobb angle reduced from 71° to 65° – Update: Great News! The client has further improved her Scoliosis in the time with us. Her curve has now been reduced to 58 degrees.
- The spine’s maximum point away from centre consecutively de-translated (moved to centre) from 80 mm to 68 mm to 60 mm from midline.
- T7 is now aligned with the centre of the spine.
- The angle of the bottom vertebra changed from 43 degrees to 34 degrees.
Discussion
The client responded well to preventive strategies and active treatment. As seen from the images and reported results, the client demonstrated movement of her spine towards the middle of the body, and consecutive reductions in Cobb angle were observed.
The potential of preventative strategies to improve or stabilize Scoliosis can be observed in this particular case.
The first x-ray is the client’s spine prior to the implementation of preventative strategies discussed in the initial consultation. The second x-ray was taken before intensive treatment, and demonstrates an improvement in the spines positioning towards the midline.
With active treatment, the client was able to further translate her spine closer to midline, resulting in a drop from 80 mm to 60 mm by the end of her 2 weeks. Her Cobb angle was also able to reduce to 65 degrees. The bottom vertebra that was tilted the most changed in its angle of inclination as well. Initially at 43 degrees from horizontal, the angle changed to 41 then 34 degrees. The movement to midline is largely affected by what happened at this level.
The client is expected to continue to improve with the implementation of preventive strategies (e.g. behaviour modification) and exercise on a regular basis for the following months (twice weekly sessions in the clinic for 1-2 hours after school, along with regular exercise at home). With continued de-translation and de-rotation of the spine, she is expected to significantly reduce her Cobb angles, further translate her spine to the centre, and thus stabilize her spine in the coming months.
Please note that severe curves as seen in this case require urgent intervention. As previously described on our Scoliosis page, high Cobb angled curves have a significant chance to proceed over time, and this will subsequently further increase concern and urgency. The chances of the spine to twist even further and for instrumentation (surgery) become more urgent.
The more ‘off-line’ the spine, the more danger there is in the spine sinking and twisting (rotating). This case demonstrate that a spine can be brought back to mid-iline and also shows a decreasing Cobb angle. Further work is required to de-rotate the spine once it has hit midline. Midline was achieved in this case in a rapid time frame. De-rotation (unwinding) exercises and strategies are advocated.
All results on this site have been achieved without bracing, machines, surgery or medications.
Disclaimer: These results are not indicative that this can be achieved in every case.
See Also:
- Scoliosis Case Study 1
- Scoliosis Case Study 2
- Scoliosis Case Study 3
- Scoliosis Case Study 4
- Scoliosis Case Study 5