There has been a lot of buzz in recent years about the Minimally Invasive Spine Surgery (MISS), and in some cases minimally invasive scoliosis surgery, using small puncture incisions, XLIF’s, slipping rods under the skin, and/or going anteriorly with tethering through the chest.
But many people have not heard much about the LEAST invasive scoliosis “surgery”, which really isn’t surgery at all, which is Schroth Physiotherapeutic Scoliosis-Specific Exercises (PSSE), and 3D CADCAM bracing, also known as Rigo-Cheneau Bracing. Even I was not aware of these two techniques, that both emanated from Europe until about 3-4 years ago, which really has brought a transformation for the way we can manage scoliosis at Hey Clinic, especially in our new, much larger facility we moved into a year and a half ago on the Duke Raleigh Hospital campus at 3320 Wake Forest Road, Raleigh, NC, where we had the room to add physical therapy, and in-house brace measurement and construction, as well as put in an EOS X-Ray machine, and have a large open area for training and classes.
Yes, this has been a total “game changer” for us at Hey Clinic, and for now hundreds of our pediatric, adolescent, young adult, middle-aged adult, and older adult patients.
We had another example of a huge success in clinic this past Thursday with 14 yo Regan.
3 months ago, she got some very bad news… she had a 28.9 degree scoliosis. We recommended Schroth physiotherapy. She rolled her eyes. She was not psyched. This whole thing was a complete downer.
But she was willing to give it a shot, encouraged by one of our Schroth Therapists, Mariah, that we have seen many successes. She chose to do Schroth only for starters, and hold off on the 3D CADCAM Brace, to see what we could get. Over the last 3 months, Regan has come to Hey Clinic once a week to learn how to do the PSSE exercises, and started doing them at home for about 20-25 minutes a day, 6 days a week. She actually began to actually LIKE to do the exercises, and was faithful to do them.
Well, this past Thursday morning was the big reveal…..
Her mom and dad were there…..and the results were….29.5 degrees, down to 11.6 degrees…. 18 degree improvement in 3 months. And less pain!
With Schroth and the 3D-CADCAM braces (when needed), we are seeing 90+ % success rates thus far with conservative management. However, some curves still do progress despite our best efforts, but especially when we can inspire the compliance, the success rate is very high. When the curves do get into the range where surgery could be considered, and when it is paid for by insurance, we also are happy to discuss that option as well so that the patient as well as the family completely understand and have the freedom to make their own personal choice. About 60% of AIS scoliosis curves will progress during adulthood, so we do also always recommend lifetime follow-up.
We do see many happy patients who chose the surgical route as well, especially for curves that are in the 40-50 degree range where scoliosis surgery may be considered, and over 50 degree range where it is usually strongly considered. Curves under 40 are sometimes considered for surgery if there is ongoing pain/quality of life issues that do not respond to conservative therapy. At Hey Clinic, we take a LOT of time to help our pediatric, adolescent and adult patients to fully understand your diagnoses, as well as your CHOICES, since it is YOUR BODY, and YOUR CHOICE… which will affect you for the rest of your life, since your spine is literally the very CORE of what has to hold you up!!
So for example, on Thursday we also saw Elizabeth, who was treated at age 12 for her scoliosis with Schroth and bracing, but unfortunately her curve progressed to 56 degrees, at which point her and her parents decided to have her scoliosis addressed surgically. Bracing and Schroth compliance was a bit harder for her, which may have contributed to her curve progression. She had her surgery a year ago, and recovered quickly, back to cheerleading, and now is taking up diving, and also showed me her new dress from Christmas which she is proud of, confident in her posture going into high school and beyond.
So maybe it’s time to take a trip to Hey Clinic, and get a second opinion for bracing, Schroth, and possibly very very “minimally invasive” scoliosis care that could bring joy to your family too!
Congratulations Regan and Elizabeth!!!
