ABSTRACT: BACKGROUND: Today, acupuncture therapy is commonly used for pain control throughout the world, although the putative mechanisms are still unclear. A Pub Med search for the key words "Acupuncture" and "Scoliosis" reveals 3 papers only, not containing any results of studies designed for the treatment of scoliosis with the help of acupuncture. Because of this lack of trials especially designed for the treatment of scoliosis this pilot study has been performed. METHODS: 24 girls undergoing in-patient rehabilitation, 14 - 16 years of age (at average 15,1 years, SD 0,74) with the diagnosis of an Adolescent Idiopathic Scoliosis (AIS) have agreed to take part in this controlled single blind crossover study. Average Cobb angle was 33 degrees (SD 9,2) ranging from 16 to 49 degrees. 10 of the girls had a thoracic, one a lumbar, 7 a double major and 6 a thoracolumbar curve pattern. The patients have been scanned with the Formetric(R) surface topography measurement system before and after lying on the left side [L], before and after sham acupuncture [S] and before and after real acupuncture [R]. RESULTS: For the whole group of patients no significant changes have been found during lying, sham acupuncture or real acupuncture. There were no differences between the patient groups with different curve pattern. In the explorative subgroup analysis of Patients with curvatures from 16 to 35 degrees, however significant changes in surface rotation have been found after R intervention as well as a strong differences in lateral deviation while in the L or S intervention no real changes have been achieved. CONCLUSION: One session with real (verum) acupuncture seems to have an influence on the deformity of scoliosis patients with no more than 35 degrees. The findings during verum acupuncture clearly are different to sham acupuncture or just lying, while in the whole group of patients also including patients with curvatures of more than 35 degrees no obvious changes have been found. The results of this study justify further investigation of the effect of acupuncture in the treatment of patients with scoliosis.

ABSTRACT: BACKGROUND: Today, acupuncture therapy is commonly used for pain control throughout the world, although the putative mechanisms are still unclear. A Pub Med search for the key words "Acupuncture" and "Scoliosis" reveals 3 papers only, not containing any results of studies designed for the treatment of scoliosis with the help of acupuncture. Because of this lack of trials especially designed for the treatment of scoliosis this pilot study has been performed. METHODS: 24 girls undergoing in-patient rehabilitation, 14 - 16 years of age (at average 15,1 years, SD 0,74) with the diagnosis of an Adolescent Idiopathic Scoliosis (AIS) have agreed to take part in this controlled single blind crossover study. Average Cobb angle was 33 degrees (SD 9,2) ranging from 16 to 49 degrees. 10 of the girls had a thoracic, one a lumbar, 7 a double major and 6 a thoracolumbar curve pattern. The patients have been scanned with the Formetric(R) surface topography measurement system before and after lying on the left side [L], before and after sham acupuncture [S] and before and after real acupuncture [R]. RESULTS: For the whole group of patients no significant changes have been found during lying, sham acupuncture or real acupuncture. There were no differences between the patient groups with different curve pattern. In the explorative subgroup analysis of Patients with curvatures from 16 to 35 degrees, however significant changes in surface rotation have been found after R intervention as well as a strong differences in lateral deviation while in the L or S intervention no real changes have been achieved. CONCLUSION: One session with real (verum) acupuncture seems to have an influence on the deformity of scoliosis patients with no more than 35 degrees. The findings during verum acupuncture clearly are different to sham acupuncture or just lying, while in the whole group of patients also including patients with curvatures of more than 35 degrees no obvious changes have been found. The results of this study justify further investigation of the effect of acupuncture in the treatment of patients with scoliosis.

OBJECTIVE: This report of one case illustrates the potential effect of acupuncture on low back pain and curvature progression in adult degenerative scoliosis. CLINICAL FEATURES: A 74-year-old woman experienced low back pain and kyphoscoliosis for 2 years. She received regular rehabilitation and medications for 2 years, but the curvature of the lumbar spine and backache still progressed. The Cobb angle was 31 degrees and surgical intervention was suggested to reduce the pain. INTERVENTION AND OUTCOME: Before surgery, the patient was treated with acupuncture three times per week starting on May 29, 2008. After 6 weeks of treatment, the patient's lower backache decreased and follow-up radiographs showed that the Cobb angle decreased by 10 degrees . She underwent surgery on October 3 to have a better quality of life. CONCLUSIONS: Acupuncture was associated with a reduction in the degree of curvature in this case, after 2 years of conventional medical treatment had failed to stop the backache and curvature progression. This suggests that acupuncture not only plays an important role in pain control, but can also improve curvature progression for certain patients with degenerative scoliosis.

OBJECTIVE: This report of one case illustrates the potential effect of acupuncture on low back pain and curvature progression in adult degenerative scoliosis. CLINICAL FEATURES: A 74-year-old woman experienced low back pain and kyphoscoliosis for 2 years. She received regular rehabilitation and medications for 2 years, but the curvature of the lumbar spine and backache still progressed. The Cobb angle was 31 degrees and surgical intervention was suggested to reduce the pain. INTERVENTION AND OUTCOME: Before surgery, the patient was treated with acupuncture three times per week starting on May 29, 2008. After 6 weeks of treatment, the patient's lower backache decreased and follow-up radiographs showed that the Cobb angle decreased by 10 degrees . She underwent surgery on October 3 to have a better quality of life. CONCLUSIONS: Acupuncture was associated with a reduction in the degree of curvature in this case, after 2 years of conventional medical treatment had failed to stop the backache and curvature progression. This suggests that acupuncture not only plays an important role in pain control, but can also improve curvature progression for certain patients with degenerative scoliosis.

OBJECTIVE: To describe the use of Pilates therapy and sacro-occipital technique in the management of a 39-year-old woman with scoliosis who had undergone spinal fusion many years earlier. Clinical Features: The patient had progressive severe low back pain that had worsened over the years after her surgery and had prevented her from activities such as carrying her son or equipment necessary for her job as a photographer. Intervention and Outcome: The patient was provided a series of Pilates exercises used to overcome her chronic habituation and muscle weakness. Although this therapy went on for some time, she did begin to stabilize and increase physical activity. At present, she is no longer limited in her physical activity, although she still exhibits some symptoms from her scoliosis. CONCLUSION: The addition of Pilates therapy can be useful to care for patients with chronic low back pain and deconditioning.

A novel technique is offered for correction of postural defects and early manifestations of scoliosis in schoolchildren using methods of functional biofeedback training. The technique allowed the patient to use the biofeedback signals informing on the degree of asymmetry in bioelectric activity of paravertebral muscles in static active straightening of the vertebral column. The data revealed a steady decrease in asymmetric activity indices in muscles erecting the column. This provided a physiological basis for a high clinical efficiency of the technique.

The possibility of using learned physiological responses in control of progressive adolescent idiopathic scoliosis (AIS) was investigated. Sixteen (16) AIS patients with progressing or high-risk curves (Cobb's angle between 25 degrees and 35 degrees at start and reducible by lateral bending) were fitted with a device with tone alarm for poor posture. In the first 18 months of application, 3 patients defaulted and 4 showed curve progression>10 degrees (2 changed to rigid spinal orthoses and 2 underwent surgery). The curves for the other 9 patients were kept under control (within +/- 5 degrees of Cobb's angle) and 5 of them have reached skeletal maturity and terminated the application. The remaining 4 patients were still using the devices until skeletal maturity or curve progression. The curve control rate was 69%. A long-lasting active spinal control could be achieved through the patient's own spinal muscles. Nevertheless, before the postural training device could become a treatment modality, a long-term study for more AIS patients was necessary. This project is ongoing in the Duchess of Kent Children's Hospital, Sandy Bay, Hong Kong.

OBJECTIVES:The aim of this study was to evaluate the effect of scoliosis specific exercises (SSE) on a side-alternating whole body vibration platform (sWBV) as a home-training program in girls with adolescent idiopathic scoliosis (AIS).

METHODS:40 female AIS patients (10-17 years) wearing a brace were randomly assigned to two groups. The intervention was a six months, home-based, SSE program on a sWBV platform five times per week. Exercises included standing, sitting and kneeling. The control group received regular SSE (treatment as usual). The Cobb angle was measured at start and after six months. Onset of menarche was documented for sub-group analysis.

RESULTS:The major curve in the sWBV group decreased significantly by -2.3° (SD±3.8) (95% CI -4.1 to -0.5; P=0.014) compared to the difference in the control group of 0.3° (SD±3.7) (95% CI -1.5 to 2.2; P=0.682) (P=0.035). In the sWBV group 20% (n=4) improved, 75% (n=15) stabilized and 5% (n=1) deteriorated by ≥5°. In the control group 0% (n=0) improved, 89% (n=16)stabilized and 11% (n=2) deteriorated. The clinically largest change was observed in the 'before-menarche' sub-group.

CONCLUSIONS:Home-based SSE combined with sWBV for six months counteracts the progression of scoliosis in girls with AIS; the results were more obvious before the onset of the menarche.

OBJECTIVE:Manipulation under anesthesia (MUA) is an outpatient procedure that is performed to restore normal joint kinematics and musculoskeletal function. This article presents a case of a patient with idiopathic lumbar degenerative scoliosis who developed intractable pain as an adult and reports on the outcomes following a trial of MUA.

CLINICAL FEATURES:A 59-year-old female patient presented to a chiropractic office with primary subjective symptoms of lower back and bilateral hip pain. Numerical pain rating scores were reported at 8 of 10 for the lower back and 9 of 10 for the sacroiliac joint/gluteal region. A disability score using a functional rating index demonstrated a score of 26 of 40 (or 64% disability). Over the preceding 5 years, the patient had tried a number of conservative therapies to relieve her pain without success.

INTERVENTION AND OUTCOME:The patient was evaluated for MUA. The patient was scheduled for a serial MUA over 3 days. Numerical pain rating scores 8 weeks after the MUA were 1 of 10 for the lower back and 3 of 10 for the sacroiliac joint. Her disability rating decreased to 11 of 40 (28%). Radiological improvements were also observed. These outcomes were maintained at 6-month follow-up.

CONCLUSION:Pain, functional, and radiographic outcomes demonstrated improvements immediately following treatment for this patient.