Scoliosis as a natural attitude - Idiopathic scoliosis: old and new concepts, clinical case

Edited by Dr. Giovanni Chetta

Results

Phase I: use of TIB massage and bodywork, TIB postural gymnastics and customized ergonomic insoles:

Initial situation: the important left vertebral rotation at the lumbar level (surface rotation graph) and the metameric misalignment (towards the left) always of the lumbar tract (front projection graph) are highlighted in particular.

Situation after approx. 100 days of phase I treatment : normalization of the "frontal projection" graph (metameric alignment on the frontal plane) and marked improvement of transverse vertebral rotations (surface rotation graph).

Comparison : initial situation at the top (red graphics), situation after less than 4 months at the bottom (blue graphics). In particular, there is a marked improvement in metameric alignment (frontal projection) and vertebral rotation (surface rotation). The lateral deviation (quadratic mean) has been reduced from 17 mm to 5 mm and the vertebral rotation (quadratic mean) has passed from 12.1 ° to 2.3 °.

Initial situation of the step unwinding curve : the trend of the general center of gravity of the body during the passosx (red top curve) and right (green bottom curve) is medialized in the propulsive phase (Pacini protocol, 2000).

Situation of the step unwinding curve after approx. 100 days of re-education (I phase) : the trend of the general center of gravity of the body during the passosx (red curve) and right (green curve) is lateralized in the propulsive phase (hypercorrection).

Phase II: addition of chiropractic manipulations and occlusal splint:

Situation after approx. 6 months of phase II treatment : the improvement is mainly in the sagittal plane (lateral projection graph).

Comparison : initial situation at the end of phase I above (red graphics), situation after approx. 6 months of introduction of the occlusal splint and chiropractic manipulations below (blue graphics). In particular, there is a clear improvement in the sagittal plane (lateral projection graph) with a notable reduction in lumbar lordosis (lordotic angle decreased from 56.5 ° to 42.6 °, lumbar arrow from 54.9 mm to 43.5 mm) and of functional blocks (curvature graph). The lateral deviation (mean square) reports a slight further improvement (from 5 to 4 mm), as well as the vertebral rotation (mean square) from 2.3 ° to 2 °.

Comparison between the beginning and the end of re-education: initial situation (top, red graphic) -final situation (bottom, blue graphic). There is a marked improvement in the parameters of vertebral rotation on the transverse plane (surface rotation graph) and vertebral alignment on the frontal plane (front projection graph), as well as the angle and the arrow of the lumbar lordosis on the sagittal plane (lateral projection graph). log length increased from 467 mm to 493 mm (+ 2.5 cm).

Final situation of the step unwinding curve : the trend of the general center of gravity of the body during the passosx (red curve) and right (green curve) is normalized in the propulsive phase (Pacini protocol, 2000).

Discussion of the results

The results obtained already in I phase, thanks to the use of myofascial techniques, postural gymnastics and personalized ergonomic insoles show a clear functional, structural and aesthetic improvement. The patient reported gradual improvements in general symptoms and satisfaction with the evidently more pleasant appearance. Phase II , after about six months, the contacts of the upper teeth on the bite were mostly constant and repeated. The chiropractic manipulations also allowed the elimination / reduction of functional blocks, further facilitating spinal and postural normalization in general.

Conclusions

The attitude of the spine in scoliosis represents in itself a physiological and indispensable attitude in order to obtain the goal of a specific movement of maximum effectiveness. It must be created at every step, transforming itself into the one opposite to the advancement of the contralateral lower limb. Scoliosis becomes pathological only if it "crystallizes".

Scoliosis is certainly the spinal alteration with the greatest negative aesthetic impact, as it is mainly expressed in the frontal plane. The spinal alterations that develop mainly on the sagittal plane (dorsal hypercyphosis, flat back and lumbar hyperlordosis), however, can lead to musculoskeletal problems and organic ones more relevant than scoliosis.As we have seen, the critical level, as regards human biomechanics and of the spine in particular, remains the transverse one, which must always be "dealt with" during any spinal / postural re-education program.

In the presence of pathological alteration of the spine and posture, the "interconnection and interdependence of the various parts of our body" imposes "an integrated strategy and therefore a team work capable of considering the various related critical factors. Control and functionality of the articular hinges, and in particular of occlusion, plantar support and pelvis, the critical parameters are confirmed. These parameters must always be verified (in a precise and quantifiable way, ie comparable over time) regardless of the approach used in postural re-education. In fact, considering the results obtained only in a specific body region (eg stomatognathic apparatus or breech support or rachis) without examining the effects on the entire posture, involves the risk of moving the problem to another body region.

Use specific bite and insoles and / or footwear which ergonomic systems, in synergistic combination with techniques capable of acting on the myofascial system and balance (chiropractic, bodywork, postural gymnastics), can determine important results, which can be highlighted and quantified instrumentally. bust / corrective corset it should, in my opinion, be seen (and therefore designed) as an ergonomic tool capable of acting in synergy with other ergonomic tools and various normalization techniques as well as obviously being in harmony with nature.

The importance of deepening research and experimentation in this direction is therefore evident, ie integrating various methods and tools synergistically in line with biomechanics and physiology. The study of the deformations of the rachis and of the posture in fact becomes more and more important within a society that pushes man to live in habitats and lifestyles that are not natural and therefore not very physiological. In fact, posture is increasingly implicated in many musculoskeletal and organic problems. There posturology thus it is inevitably found to be a multidisciplinary science that embraces numerous branches of medicine and technology. The professional collaboration between the various specialists, the technological evolution, the advancement of scientific research on extracellular matrix, connective tissues, neurology, biomechanics and ergonomics, represent the cornerstones of the progress of this fascinating and multifaceted science which is fundamental for the health of modern man.

Hippocrates, probably the first posturologist in history and founder of scientific medicine, stated:

"The living being is a circle ... each part is its" beginning and end " .

And again he added:

' There are only two things: science and opinion; the first generates knowledge, the second ignorance ".