Dr Stitzel

A new way to treat scoliosis?

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by , 05-07-2009 at 04:12 PM (2835 Views)
Original article:
April 27, 2009
A new way to treat scoliosis?

The Schroth Method may throw scoliosis a new curve


A new way to treat scoliosis?

My response to the article:

Bravo on an excellent article featuring a non-bracing, non-surgical approach to scoliosis treatment. The Schroth method is a well respected system of treatment and has served as a trail blazing foundation for many physiotherapy based programs such as CLEAR Institute, FITS, and SEAS.

A couple of areas in the article make me pause with concern. The Scroth certified physical therapist, Ms. Cindy Marti, commented that she would never recommend exercise alone in place of a brace, even through the most recent research indicates that bracing has no effect on the natural progression of scoliosis and does not prevent the need for surgery. A 2007 study published in SPINE by Drs. Dolan and Weinstein concluded that observation only or bracing showed no clear advantage of either approach. Furthermore one can not recommend one approach over another to prevent surgery. They gave the recommendation for bracing a grade “D” relative to observation only because of “troublingly inconsistent or inconclusive studies on any level.”

In addition, Ms. Marti and Dr. Gupta indicated that maintaining the strength of the spinal musculature may play an important role in controlling the spinal curvature. While muscular imbalance/unilateral weakness in the scoliotic spine is most likely a compensatory response and not a cause, the aforementioned necessity of using a spinal brace instead of relying on exercise will actually cause the spinal muscles to become weaker due to the disuse of the spinal muscles (resulting from dependency on the brace). Contradiction of philosophies and lack of understand of the condition is nothing new to scoliosis patients, but subtleness of it is concerning.

Perhaps the most concerning aspect of the article is the implication that any physiotherapeutic based program needs the endorsement of Dr. Gupta, simply based on his credentials as an orthopedic surgeon. Dr. Gupta has no special training or qualifications to provide expert opinions on any scoliosis treatment options other than surgery and possibly bracing protocols. Dr. Han Weiss, director of the Schroth clinic in Germany, published a highly regarded article in a 2008 edition of Disability and Rehabilitation. The study found “no evidence has been found in terms of prospective controlled studies to support surgical intervention from the medical point of view…… Until such evidence exists, there can be no medical indication for surgery. The indications for surgery are limited for cosmetic reasons in severe cases and only if the parent and family agree with this.”

What is a scoliosis patient to do? No one really knows that this point, but early intervention with a physiotherapy based program (no bracing) seems to be the safest bet that this point.

It is not my intention to condemn the efforts of other medical professional whom are working in the good faith of their patients, however closer evaluation of this article reveals many obsolete and false assumptions/misconceptions about the disease and it’s treatment.

Clayton Stitzel DC
Co-Director, CLEAR Institute

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