Scoliosis Blog

At least this is not being written in an airplane!! In May this year I discussed the work I do with the Medtronic training manager at the Spine Society meeting.  I explained that I need to work closer with the surgeons and need to better understand what they do from the surgical side of treatment.  So, thanks to Medtronic I spent one and a half days with a group of surgeons in Sydney. The surgeons were from Denmark, Australia, Korea, Japan and America.  The seminar was run by the Medtronic "faculty"  and consisted of a general session and then either a paediatric or degenerative stream.  I wish I could have attended all the streams but landed up at the one session of adult degenerative and one session of paediatric deformity.

They seemed open to my being a physiotherapist with a special interest in spinal deformity (more on this below) and I sat with interest through the cases presented.  I especially wanted to attend the talk on conservative management of scoliosis. It was presented by a surgeon from Queensland who reiterated that there is no evidence that exercises can be of benefit in adolescent scoliotic deformities and exhibited a slide with a few terms that he called "catchy names" including Schroth, SEAS, MED-X etc. I felt that his talk was derogatory in nature and quite dismissive of what we do but more from a lack of knowledge than from intent.  He stated that some of the exercises programs seemed to force the kids to wear a brace, OF COURSE conservative management requires a brace, and there are very detailed guidelines on the SOSORT website.  I wanted to jump on the table and shout it out but sat through the talk quietly until the end. I could not keep completely quiet and did announce to the surgeons that I was a physiotherapist who had certified in Schroth and SEAS and that I felt that some of my patients do need surgery and are reluctant to do so. I asked if any of the surgeons felt that bracing makes their surgical correction more difficult and they responded in the negative.  They then had a show of hands of which of them "honestly" does recommend a trial of conservative management and it seems as if the majority of them do. Some of them appear unsure of whether kids actually do wear their braces and there was interesting debate about the SpineCore brace.

So...  I took a peek into the void of knowledge between the two groups.  I think it will still take a few years before there is any real knowledge transfer between the groups because we have not yet "done our time" and have not yet arranged ourselves to present our data in a way that can be openly reviewed and criticized.  If not in a reputable journal then at least in a conference attended by our surgical colleagues.  The Spinal Research Society (SRS) is the lead global scoliosis surgical treatment society and it takes 5 years for their own members to be accepted into the society so I don't think that this is any different.  There were quite a few junior spinal surgeons who had not yet completed their training and they were telling me about the "difficult" journey they have to travel with large investments in time, finances and stress so I don't think my journey should be any different.

I spent the week with a very special lady from Melbourne, she is young in heart and older in body. She came up to Sydney with her husband and son and was a classic example of a decompensated posture. Her trunk was falling off her pelvis and her GP had advised her that nothing could be done.  We spent the week going through some Schroth exercises and I hope that she will find it beneficial (or at least continue to do so). I also recommended that she see a spinal surgeon in Melbourne as she will need additional support to stabilise her postural schema. However I leave you with an email I received from her daughter....

Hi Larry,

Thank you VERY VERY much for treating my mum. It's a pity I can't be there with her and to meet you in person, but I'm so glad that you are able to help her in so many ways.

As soon as I booked her in to see you the other day, she told everyone "At last I'm seeing someone who knows what to do with my condition." I spoke to her on the phone every night when she was in Sydney and she told me "Larry is a very nice person and very easy to talk to."

When she got home this evening, I was actually in tears (happy tears) to see her noticeably straighter. And when she forgot to hold herself up, and when I reminded her, she knew exactly what to do to straighten herself up, She regained the confident to do a lot of things from what I understood, like got onto the floor on her own, got onto the cat & dog position, etc.

Larry, you have lifted up her spirit too. She is so much happier now. Mum did fill me in about the spine specialist.

Anyway, I just want to say a BIG thank you to you for helping my mum

and that is why the journey is worth it!!