The law of conservation tells us that matter cannot be created, nor destroyed. It's a law. No exceptions and, honestly, I don't think anyone is in dispute about it. So why, then, isn't being applied to the concept of idiopathic scoliosis treatment which is a 3 dimensional (front to back....Aka: sagital dimension, side to side....Aka: coronal dimension, head to toe....Aka: vertical height) spinal deformity? Think about it. The spine is straight on day and crooked the next. The bones haven't changed, the discs haven't changed, the ligaments and muscles don't change that quickly. In fact, there isn't anything wrong with the idiopathic scoliosis patient's spine, except for the fact that is crooked.
Everyone knows the shortest distance between 2 points is a straight line and that is exactly what the non-scoliotic spine does when it connects the head to the pelvis. However, the scoliosis spine twists and curves a crooked path when connecting the head and hips, which requires more spinal matter to travel the longer distance demanded by taking the crooked path. This begs the question, "where does the extra spine to travel the longer distance demanded by taking the crooked path come from?" It is almost as if the patient has "gained" more spine in the front to back dimension that it can hold and it is buckling off to the sides.
Most people assume that it comes from the vertical dimension (height), but we don't see any correlation between adolescent idiopathic scoliosis patient's curve progression and a loss of height. Some people think it is just a matter of rapid, uneven bone growth, but the time frame in which the curve progression advances is much too fast to be attributed to rapid, uneven bone growth and even then we don't see a large amount of vertebral body wedging during the early stages of rapid idiopathic scoliosis progression.
So where does this "extra" scoliosis spine in the side to side dimension come from? Well, it appears that it's being "lost" from the front to back dimension. The normal side view (called the "sagital" dimension) of the human spine should have forward curves in the neck and lower back, with a backwards curve in the mid back. This normal side view profile is distorted and diminished in 100% of all idiopathic scoliosis patients. This critical piece of information dramatically affects how one goes about treating the scoliosis spine, because its self-evident that one must create space in the normal side view of the spine BEFORE attempting to push the crooked spine out of the side to side crooked dimension. Essentially, all scoliosis treatment including alternative scoliosis treatment needs to focus on re-storing the sagital spine back to normal, before it can start transferring the spinal gains out of the coronal dimension.
Otherwise, it would be like (metaphorically) trying to fit 7 cars into a 3 car garage.....Not going to work out very well.
3-D effects of idiopathic scoliosis on the spinal cord
No other part of the human body comes under more stress due to scoliosis than the spinal cord. This is primarily, because the 3 dimensional spinal deformity caused by scoliosis stretches, pushes, pulls, and compresses the spinal cord in all 3 dimensions.
The spinal cord is really just an extension of the brain stem which houses all of the automatic postural control centers and is ultimately anchored to the pelvis at the bottom of the spine. This means the cord and brain stem are functionally linked and tied down pretty tight.
Dr. Alf Breig studied the relative lengths of spinal canal and cord CAN lead to pathologic axial tension of the spinal cord by back in 1978.
In 1981 another researcher (Roth) added to Breig's work when he speculated that idiopathic scoliosis is a disproportion of vertebral and neurological growth due to either a short spinal cord or overly rapid growth spurt of the spine.
The spring/string model. (think of a slinky with a string running though it)
Roth found that shortening of a string running though a spring model hindered elongation of the spring resulting in a scoliotic deformity.
The uncoupled neuro-osseous growth concept presented by Porter supported the notion of idiopathic scoliosis as a physical manifestation of the mal-adaption of the growing immature spine to the tether created by the short spinal cord.This evidence for this was the finding that the conus medullaris (the end of the spinal cord) position is NOT significantly different from that of a normal spine.
Everyone knows the shortest distance between 2 points is a straight line and that is exactly what the non-scoliotic spine does when it connects the head to the pelvis. However, the scoliosis spine twists and curves a crooked path when connecting the head and hips, which requires more spinal matter to travel the longer distance demanded by taking the crooked path. This begs the question, "where does the extra spine to travel the longer distance demanded by taking the crooked path come from?" It is almost as if the patient has "gained" more spine in the front to back dimension that it can hold and it is buckling off to the sides.
Most people assume that it comes from the vertical dimension (height), but we don't see any correlation between adolescent idiopathic scoliosis patient's curve progression and a loss of height. Some people think it is just a matter of rapid, uneven bone growth, but the time frame in which the curve progression advances is much too fast to be attributed to rapid, uneven bone growth and even then we don't see a large amount of vertebral body wedging during the early stages of rapid idiopathic scoliosis progression.
So where does this "extra" scoliosis spine in the side to side dimension come from? Well, it appears that it's being "lost" from the front to back dimension. The normal side view (called the "sagital" dimension) of the human spine should have forward curves in the neck and lower back, with a backwards curve in the mid back. This normal side view profile is distorted and diminished in 100% of all idiopathic scoliosis patients. This critical piece of information dramatically affects how one goes about treating the scoliosis spine, because its self-evident that one must create space in the normal side view of the spine BEFORE attempting to push the crooked spine out of the side to side crooked dimension. Essentially, all scoliosis treatment including alternative scoliosis treatment needs to focus on re-storing the sagital spine back to normal, before it can start transferring the spinal gains out of the coronal dimension.
Otherwise, it would be like (metaphorically) trying to fit 7 cars into a 3 car garage.....Not going to work out very well.
3-D effects of idiopathic scoliosis on the spinal cord
No other part of the human body comes under more stress due to scoliosis than the spinal cord. This is primarily, because the 3 dimensional spinal deformity caused by scoliosis stretches, pushes, pulls, and compresses the spinal cord in all 3 dimensions.
The spinal cord is really just an extension of the brain stem which houses all of the automatic postural control centers and is ultimately anchored to the pelvis at the bottom of the spine. This means the cord and brain stem are functionally linked and tied down pretty tight.
Dr. Alf Breig studied the relative lengths of spinal canal and cord CAN lead to pathologic axial tension of the spinal cord by back in 1978.
In 1981 another researcher (Roth) added to Breig's work when he speculated that idiopathic scoliosis is a disproportion of vertebral and neurological growth due to either a short spinal cord or overly rapid growth spurt of the spine.
The spring/string model. (think of a slinky with a string running though it)
Roth found that shortening of a string running though a spring model hindered elongation of the spring resulting in a scoliotic deformity.
The uncoupled neuro-osseous growth concept presented by Porter supported the notion of idiopathic scoliosis as a physical manifestation of the mal-adaption of the growing immature spine to the tether created by the short spinal cord.This evidence for this was the finding that the conus medullaris (the end of the spinal cord) position is NOT significantly different from that of a normal spine.
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