Scoliosis has been traditionally defined as a lateral curvature of the spine greater than 10° using the Cobb methods of analysis. Scoliosis plagues not only children but the adult population as well. According to authors such as Weinstein et al, adolescent idiopathic scoliosis (AIS) affects 1-3 percent of children in the at-risk population of those aged 10-16 years.2 Concerning adult scoliosis, Schwab et al.1, concluded a prevalence rate of up to 68% in the population with an average age of 70.5 years. The National Scoliosis Foundation website estimates that in the United States, scoliosis affects 2-3% of the population or approximately 6 million people. In a recent publication, Wong et al.3 state, “Early detection by comprehensive screening programs enables early institution of conservative treatment, with the aim of reducing the number of patients with curves reaching a magnitude that requires surgical treatment.” While it is not the purpose of this article to detail the natural history or the various types of scoliosis, it is our purpose to call attention to the fact that doctors often do not adequately measure, monitor, and possibly treat such deformities when indicated. We believe that the only valid measure for doctors to detect early onset of scoliosis is not external, but rather with x-rays. As such, chiropractors should take their rightful place in being part of the solution for conservative treatment and management of scoliosis cases when surgery is not indicated.Traditional marking of x-rays by hand is very time consuming for the busy clinician. Fortunately, you now have an easy tool to use which not only measures these displacements, but at the same time educates and monitors scoliosis patients: PostureRay®. Since measuring a scoliosis is different from traditional Chiropractic Biophysics® line analysis due to excess vertebral rotation, the Risser-Ferguson analysis has been incorporated as PostureRay’s primary method. In addition, we also incorporated the traditional 4-line Cobb method of analysis. While the Cobb method is less valid, as it only measures the end points of the curve, most health care providers including orthopedists, rely on this method by default as a method for gauging the magnitude for a scoliotic deformity. In fact, this method is almost exclusively used in reporting research data. Because of this, we had PostureRay® programmed to digitize both systems of analysis in order to better aid chiropractors in documenting their patient’s scoliosis and communicate findings to other health care providers such as orthopedic spine surgeons.
As with any patient care, scoliosis is no different. You must first educate the patient on the magnitude of their problem. Below in figure 1 is an example of the patient report for the AP thoracic view. On this report, you will find very friendly patient oriented text descriptions of their findings, and again, like in the other x-ray views, there is room for you to make custom notes to your patient.
In figure 2, the Impression report can be seen. In this view, you will see that PostureRay superimposes the actual line drawing method on the x-ray itself. Furthermore, PostureRay® can quantify and qualify the patient regardless if they have one or two curves in their thoracic region.
As chiropractors, we now have the tools to more easily measure, track and create evidence-based treatment plans for patients. Using tools such as PostureRay® saves time and creates unlimited marketing potential with referring medical doctors, particularly opening doors with orthopedic spine surgeons.
If you are interested in learning more about PostureRay® and how it can help you better document and treat your patients, please go to www.postureco.com or email sales@postureco.com.
Reference List
1. Schwab F, Dubey A, Gamez L et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine 2005;30:1082-5.
2. Weinstein SL, Dolan LA, Cheng JC et al. Adolescent idiopathic scoliosis. Lancet 2008;371:1527-37.
3. Wong HK, Hui JH, Rajan U et al. Idiopathic scoliosis in Singapore schoolchildren: a prevalence study 15 years into the screening program. Spine 2005;30:1188-96.
Joseph R. Ferrantelli, D.C. graduated with honors from Florida State University in 1995 with a B.S. in Biological Sciences and earned his Doctor of Chiropractic (D.C.) degree from Life University School of Chiropractic, graduating Magna Cum Laude in March 1999. Dr. Ferrantelli is a distinguished Fellow of Clinical Biomechanics of Posture and a Certified Instructor for CBP® Seminars. Dr. Ferrantelli was named the “CBP® Chiropractor of the Year” by CBP®Seminars in 2002. Additionally, he has co-authored manuscripts published in top journals such as Spine, European Spine Journal, and JMPT. Dr. Ferrantelli is the webmaster for CBP® OnLine, www.idealspine. com and currently is in private practice in New Port Richey, FL.
Dr. Denise Perron has a Bachelors Degree in Biology and received her DC degree from Palmer Chiropractic College in the middle 1980s. She ran a high volume practice in Montreal, Quebec, Canada from 1986 to 2001. Her interest is in posture digitizers, and she has been working in that field since 2001. She is currently a consultant for business organizations and Chiropractors in Canada, USA, and Japan.
