What does a thorough Scoliosis exam look like? While most chiropractors are certainly able to identify a curve and execute Adams forward bending test, how many could perform a complete exam that identifies all of the pertinent structural and functional components?
With the direction of our advisors, ChiroUp has compiled a simple new form that you can use to help guide your next scoliosis exam. This evaluation allows you to quickly identify the significant structural and functional components and helps direct your subsequent clinical decision-making.
Here are 10 more clinical pearls from the ChiroUp Scoliosis condition reference.
1. When using the widely accepted definition for scoliosis of a Cobb angle greater than 10 degrees, the disease prevalence ranges between 1 and 3%- making it the most common spinal deformity requiring orthopedic management. (27-29)
2. A genetic component is suspected since scoliosis tends to run in families. (15-18) Like other genetic disorders, scoliosis is more common in children born to older mothers. (19)
3. Approximately ¼ of all adolescent idiopathic scoliosis curves will progress. (38)The chance of progression increases in relation to the magnitude of the curve and decreases in proportion to skeletal maturity. (38,39) Small curves in skeletally mature patients have a low risk of progression (2%), while large curves in immature patients progress much more frequently. (70%) (39)
4. Curve progression is more common in females. (42,43) And patients with double or multiple curves are more likely to progress than those with a single curve. (78)
5. “Early onset scoliosis” (6-12 y/o) is considered by some to be a malignant subtype of adolescent idiopathic scoliosis (13-18 y/o) due to its high degree of progression (95%) with the majority of patients (64%) requiring spinal fusion. (34-35)
6. Approximately one fourth of scoliosis patients have back pain at the time of presentation. (45) However, the presence of the disease more than triples one’s risk for developing spine pain as an adult. (46)
7. Incorporation of chiropractic care, including spinal manipulation, has been shown to lead to a reduction in Cobb angles in case studies of scoliosis patients. (1,2)
8. A systematic review of 20 studies has shown that exercise is an effective treatment for scoliosis. (65)
9. Brace treatments are typically reserved for curves between 30 and 40 degrees in patients who are still growing with a chance for progression. (39)
10. Less than 0.3% of all scoliosis cases require surgical correction. (41) Consideration for surgical intervention is generally reserved for curves that exceed 40 degrees. (39)
First and foremost, ChiroUp is a knowledge transfer tool that allows chiropractors to review and share continually evolving “best practices”. Sometimes we share new ideas about familiar topics like last week’s “Expert Advice” video demonstrating how our top rated provider treats hip flexor tendinopathy. Other times we may touch on topics that not all of us are so confident about- like Scoliosis. By working together, we can share knowledge that increases our confidence and ultimately makes our profession the undeniable best choice for patients and payors alike.
ChiroUp would not be able to share knowledge without continued input from our users and advisors. We are particularly grateful to the experts who helped create these tools including David Flatt DABCO, James Lehman FACO, Jeffrey Tucker DACRB, Robert Kuhn DACBR, Tom Hyde DACBSP, Howard Chapel DABCO, Scott Bautch DACBOH, Jess Brower DACRB, and Glenn Bub DCBCN.
- Chen KC, Chiu EH. Adolescent idiopathic scoliosis treated by spinal manipulation: a case study. J Altern Complement Med. 2008 Jul;14(6):749-51.
- Mark W Morningstar, Dennis Woggon, Gary Lawrence. Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series. BMC Musculoskelet Disord. 2004; 5: 32.
All additional references are available in the complete ChiroUp Scoliosis Condition Report. To review this or any of the 90 other evidence-based chiropractic clinical guidelines, visit ChiroUp.com.
About the Author
Dr. Tim Bertelsman
DC, CCSP, DACO
Dr. Tim Bertelsman graduated with honors from Logan College of Chiropractic and has been practicing in Belleville, IL since 1992. He has lectured nationally on various clinical and business topics and has been published extensively. He has served in several leadership positions within the Illinois Chiropractic Society and currently serves as President of the executive board.
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