Scoliosis Blog

Normally I really look forward to getting on board these flights. I look forward to the time I have to write. I sit back start typing and ramble on… This flight is a bit different. We are almost at the end of the first leg to Singapore, landing in an hour, and this is the first time I am putting some words down. It’s off to SOSORT again, this time in Wiesbaden, Germany. This will be my fourth time at SOSORT and my first time as not only an observer but will be presenting my initial data on Friday. I have spent the last few weeks working on the slides and rehearsing the talk. I would like to say that I am confident speaking in large crowds but I am realistic to say that “not yet”. There is a lot of data to get through and a short time to get it through. The first few hours of the flight have been spent revising and culling the presentation again. There is still some culling to do though… Gulp.

I enjoy listening to TED talks when I have the time and purchased a book entitled Talk like TED at the airport. I think I will have to revise the talk and presentation again to reflect some of the points recommended. The first chapter is all about “passion”. The presenter needs to have passion about the topic and relate how this toping “what makes my heart sing?”. I will have to work on answering this more closely.

I have used my trusty android tablet for the last few years, with a very clunky and slow keyboard. I took the plunge and purchased a new (refurbished) ultrabook for the next phase of my life. At least I can type now with a more trusty instrument and able to work on all the software that I need to. Whenever I attend surgical conferences, the surgeons seem to have all the latest toys to work with and play with. There really needs to be more health dollars in the non-surgical world. For research, for treatment and dare I say it for remuneration of us poor bastards who travel round the world trying to make it a better place. Or at least trying to make the people who live in it a bit more comfortable.

When walking with my kids on Saturday I came up with a new slogan. Negative split your life. I will get some t-shirts made and give them out (if I can). The runners who read this (if anyone does) will understand. When ever any endurance athlete does any race the race can be divided into two halves and the general idea is to try and complete the second half at a faster pace than the first. So maybe the same thing should be done for life. Ahhh, I hear you say. But you don’t know how long you’ll live. Exactly! So you need to live every day at faster “pace” than the day before. The pace can mean anything but it needs to be done with meaning and intensity.

Athletes spend time and money on training to be efficient and effective. Spinal balance is no different and we need to maintain an efficient system to minimise energy wastage. How do I bring in principles of energy utilisation into a 6 minute talk on adult spine deformity. I am not sure but will need to work it out.

The first afternoon will consist a visit to the Schroth clinic in Bad Sonnenhem. There are no longer any Schroth family there so I think it might be a bit empty. But should be interesting anyway. I wonder if there are any regrets. The clinic has been around for a long long time. There must have been some good cases and some bad cases. Is it all worth it. When I see an adolescent case in surgical range, what is the balance of risk and outcome. Still don’t know.. there is no answer and each case must be handled on an individualised basis.

The next few days are the conference days. I am looking forward to it but apprehensive about the presentation. And then the following few days will consist of a scientific meeting on surface topography hosted by DIERS who have supplied our formetric that I am finding highly beneficial.

Sleep, ahh sleep that elusive ghost that comes fleetingly to visit the multitudes of travellers ensconced in these long haul flights. There is lots of comment saying how important sleep is for spine deformity patients. I think I once wrote that Dr Stefano Negrini once said that sleep is the enemy of AIS in that the spine grows at night but daytime is the enemy of the adult as that’s were gravity is active. My on board baggage looks more and more interesting as I take more and more flights. The lumbar roll for the lordotic spine, the kidney shaped neck pillow for the cervical spine, the extra socks for the potentially cold feet. One day I might turn left on board ;-)

Ok, day 4, Sunday back on a plane. This time from Frankfurt to Berlin. I will be returning back to the surface topography session in Frankfurt this evening. One of the most well respected Endocrinologists in Australia suggested I visit Berlin, so here I am. He is an expert in Osteoporosis and I tried for some time to meet up with him to discuss my thoughts on spine deformity in the ageing and osteoporotic population. It didn’t work out for quite a long time and then the world decided it was time for us to meet and we did. My wife’s family is originally from Berlin and my people’s history have been impacted so profoundly from this place that it is hard to describe my thoughts regarding my expectations of being in Berlin. Ok, had very interesting time in Berlin. Will need to write about it more later on.. but Berlin was very interesting and I was able to visit the Otto Bock research facility. We use some of their braces in the clinic but the R&D facility is open to both the public and therapists. There was a VERY clever training system to balance dysfunction that should not be too hard to implement in the clinic one day.

Well the talk went ok. The TED book (I haven’t finished it yet) says to speak with passion, engagement, personality and use novel ideas and techniques. The YouTube tutorials say to use the slides as background and engage the audience personally. The truth is once I got on stage and went through the first slide… it was all nerves, stress, tension and terror. Or so I thought. I cannot think how many times I started the first lines – “Saggital balance describes the vertical alignment of the trunk over the pelvis”. I rehearsed and rehearsed and rehearsed. Part of my recent marathon training was going through the lines of my talk, over and over, as I ran and ran. I listened to the video playback of the talk and it didn’t sound as bad as when I was up there giving it.

So, just like postural training, if you spend long and hard enough training then I think it is possible to achieve reasonable outcomes.

Back to SOSORT, I really think we are getting there. It was good to engage with Dr Steven Glassman again and I really think he was open to what the rest of the world has to offer with regard to conservative scoliosis. I did eventually put his paper up in my presentation and I think some of the audience “got it”. I have been asked by a few people for copies of the presentation so I guess that makes it worthwhile.

The good news is that there was another Australian at the conference. Another bracing specialist for Sydney. Jeb couldn’t be there due to family commitments and I also heard that the bracing specialist I had met in Sydney last year had gone to BUPA to spend time with Dr Rigo and had even spent some time with Dr Rigo in his clinic. It seems that things are getting there with regard to non operative care of scoliosis.

i got to meet up with Christa Schroth and we had quite a few "talks". I hope I did not give her too much of a hard time.

My colleague and friend Lou-Ann Rivett won the SOSORT award for the best paper. I am glad that I got to see the study in action many years ago and it was well deserved. It confirms that the RSC brace in the right hands is a very effective tool and it confirms that the psychoemotional capacity of the child and her parents are essential in conservative management.

We had the opportunity of hearing a keynote address from the famed Dr Jurgens Harms. He is the lead editor of a famous textbook called the the Harms study group. The book, apart from being one of the most expensive items in my library. I will write more on the plane back.

When Helmut Diers came to Sydney last year he asked that I stay behind after SOSORT to attend the Diers business and science meeting. I got to see firsthand the power and research that has gone into the design and build of the formetric that we have. I was able to spend lots of time with the DIERS clinical specialists as well as to see how their specialists use surface topography and measured motion mechanics to identify and treat a multitude of clinical cases. Spine and scoliosis is only a small part of its power.  BUT and it’s a big BUT, the devices are only tools to identify and quantify issues, but the clinician needs to interpret the results otherwise its just a waste.

Cindy Marty, who is an American Schroth therapist in Minneapolis was at Sosort and has been elected onto the SOSORT board. She published on Linked In today a link to the New York Times article on scoliosis. I will insert the link. Take it with you to give it to your doctor.

Prof Patrick Knott from Chicago presented some current studies that are currently underway with some of the world’s to spine surgeons. I have asked Patrick to give me a copy of the protocols so we can begin to mimic these studies performed globally. I will then be able to see if the results we are getting with the formetric are consistent with global results.  I have often been chastised by my more business minded friends for not using social media effectively to promote what we do.  Apart from this Blog, which is a passive, long winded ramble, I do not commit much to publicity. Anyway, I mentioned Friday’s talk on LinkedIn and got some humerous replies about wearing a suite. The Diers company were exhibiting one of their higher spec’d machines at the research event. I have often seen examples of subject data but this time decided to volunteer myself to be a subject. This reminded me of physio school when we had to strip down in class for practical sessions. I have spent the last few days analysing the data from the Diers examination and am enjoying seeing the power of the tests performed.

I detoured to Johannesburg on the way back from Frankfurt and am writing this on the plane back to Sydney. I spent some time with Gary at Ergotherapy who continues to explore saggital profile in seating. I was introduced to the mother of a young girl who has recently been diagnosed with scoliosis and has gone into a brace. Her physio is Lou-Anne Rivett and bracing specialist is Rowan Berkowtiz. I was able to tell this mother that Lou-Anne won the international paper of the SOSORT conference and that her daughter was in good hands. I look forward to being able to have a similar level of confidence with our own Sydney based treatment. We have everything in place…..   I think the time is nearing that we (read I) need to get out there more and start  

click here to see NY times article