Q: Some years ago I watched a television special regarding electrical stimulation of muscles to treat scoliosis. The stimulation causes muscle contraction with resulting strengthening, much like traditional physical effort does. By carefully balancing how the back muscles were stimulated, the increased contraction could be made to straighten out the spine. Although the report I saw was dated 2005, it might be worthwhile for scoliosis sufferers to investigate this type of treatment as it is non-surgical and avoids mechanical braces.
A:Scoliosis is curvature of the spine that most frequently occurs during the growth spurt prior to puberty. Most cases are mild; however, they can become more severe as a person ages. Those that are severe can reduce the amount of space within the chest cavity, making it very difficult for the lungs to function efficiently. If the curve worsens, the spine will twist as well as curve sideways. Symptoms may include one hip sitting higher than the other, uneven shoulders, and one shoulder blade that will protrude more than the other.
It appears scoliosis may be hereditary but also may be caused by infection or spinal injury, from a birth defect, or because of a neuromuscular condition such as muscular dystrophy or cerebral palsy.
Diagnosis may be made in a physician’s office through visual examination but may be confirmed through X-ray. MRI is used for very specific cases.
Some individuals, particularly young children, may not require treatment or surgery but may be monitored through X-rays on a timely basis to determine any advances in the curvature. Children still in the growing phase may opt to wear a brace that may have to be worn 23 hours each day for several years. While the brace will not cure the condition, it may prevent any advancement. Once a child stops growing, the brace will be discontinued. The most common spinal fusion is for adolescent scoliosis that involves fusion and bone grafting; however, instrumentation for older individuals has progressed to segmental metal sections to support the bone and bone grafting.
Enter alternative approaches such as chiropractic manipulation, biofeedback and electrical stimulation. Some eight years ago Aetna Insurance Company was funding electrical stimulation because of its proven benefits, so this approach isn’t new. Electrical stimulation is a non-invasive method of control, whereby muscles on one side of the spine are stimulated electrically to contract and pull the vertebrae into a more normal position. The stimulation at that time was generally applied for anywhere between 8 and 10 hours during sleep and continued until the patient reached skeletal stability. The advantage is and was that no brace need be worn, the therapy is part-time, and there is an improvement of self-image in the affected adolescents who may have a difficult time coping. One study was performed in 1984 and others have followed since that time. The 1984 study found spinal fusion with instrumentation was effective in halting the progression of the curve in severe cases. In 1985 another study found if treatment begins early enough and the progression is not too severe, the curve can be reversed. As one might expect, over the last 20 years the success of this form of correction has been heavily debated. The treatment is still considered investigational because peer-reviewed literature apparently does not support it as effective as brace treatment. Additional well-designed randomized, controlled trials are needed to compare the use of this treatment over other alternatives such as braces.
As with many cases, we hurry up and wait. Research is truly remarkable in discovering new ways to deal with old problems. It will be very interesting to see what another eight years will bring. Thank you for your input.
Readers who would like related information can log on to nsf@scoliosis.org or write to the National Scoliosis Foundation at 5 Cabot Place, Stoughton, MA 02072.