Scoliosis is a spinal condition derived from the Greek word ‘Scolio’ meaning S-shaped. Scoliosis is diagnosed when the spine has a sideways curve either ‘S’ or ‘C’ shaped that is more than 10 degrees. However. it can be argued that even the smallest sideways spinal curve is by definition scoliotic and therefore most of the population exhibit this condition.
Scoliosis can be classified as structural or functional.
Structural scoliosis means that the curve is fixed so that if the patient bends forward (Adam’s Test) or lays down there is no alteration in the curves.
Causes of Structural Scoliosis :
1) Idiopathic Scoliosis (IS) – the most common type of scoliosis (70% of cases). This type can be also classed as Primary as there is no established cause.
2) Degenerative Scoliosis – Degenerative scoliosis, also known as adult onset scoliosis, describes a side-to-side curvature of the spine caused by degeneration of the facet joints and intervertebral discs which are the moving parts of the spine. This degeneration and resulting spinal asymmetry can occur slowly over time as a person ages.
3) Neurological Scoliosis –
a) Spina Bifida
b) Cerebral Palsy
c) Muscular atrophy of spinal muscles
d) Familial Dysautonomia
e) Freedriech’s Ataxia
4) Musculoskeletal Scoliosis –
a) Ehlers-Danlos Syndrome
b) Charcot-Marie Tooth Disease
c) Prader-Willi Syndrome
d) Osteogenesis Imperfecta
e) Marfan’s Syndrome.
5) Congenital Scoliosis – due to a failure of normal vertebral development during 4th to 6th week of gestation. It is associated with hemivertebrae, block (unsegmented) vertebrae, &/or fusions of the posterior elements.
Functional scoliosis is not fixed. When the patient lays down or bends forward the curves straighten out. It is also known as non-structural. It can be corrected by treating the underlying condition.
Causes of Functional Scoliosis :
1) Leg length descrepancy – anatomical (corrected by heel lift) or functional (corrected by Atlas Zone Therapy)
2) Muscle Spasm – usually due to underlying spinal injury.
3) Inflammatory condition – eg appendicitis causing muscle spasm
4) Repetitive asymmetric exercise resulting in muscle imbalance – eg tennis
IDIOPATHIC SCOLIOSIS (IS)
As this type of scoliosis is the most common a more detailed review is necessary.
IS can be described as a three-dimensional abnormality of the spine that includes abnormal lateral curvature, angulation, and rotational deformities with no clear underlying cause. It is classified according to age of onset or when observed in the patient: infantile (0 to 3 years), juvenile (4-9) years, and adolescent (10 years to maturity). This classification was formulated to coincide with periods of increased growth velocity. The condition is equal between sex but girls appear to develop more severe curve progression. This has lead to the probability that hormones may play a part in this condition. As stated earlier the cause of IS is unknown. Recent research has high lighted the possibility of a genetic cause with possible genes identified but this is not proven. Curves appear more frequently in individuals with affected 1st-degree relatives, but transmission is not Mendelian. Although curvature is more likely to develop in the daughters of affected mothers than in other children, the magnitude of curvature in an affected individual is not related to the magnitude of curvature in relatives.
From a biomechanical standpoint, IS could theoretically occur as a critical buckling load (F) is reached during a patient’s growth spurt. Such a critical buckling load can occur as the spine lengthens during a growth spurt and is defined by Euler’s formula: F = EI π2/L2, where E and I are material and property constants, respectively, and L is the column’s length, in this case the patient’s precipitous increase in height.
ATLAS ZONE CONNECTION
At the Atlas Zone we have observed that most people can be regarded as having a Functional Scoliosis as it is accepted that 90% of people have a leg length descrepancy. We believe this is due to Atlas Zone dysfunction, most commonly caused by birth trauma, with consequential cranio-caudal deviation of the atlas with an associated unlevelling of the sacrum with torsion of the pelvis and functional leg length discrepancy.
Biomechanically this could further explain the buckling load theory as pre-existing presence of functional scoliosis gives a direction for buckling during the growth spurts. However, it does not explain the exaggerated growth progression in particular individuals with more severe curves.
We believe that correction of the Atlas Zone dysfunction using Atlas Zone Treatment may be very beneficial for IS patients to remove the functional element of this condition. In fact, all cases of scoliosis have a functional element that of course will become structural as time lapses.