Part 4 of 10 | Medical vs Conservative Treatment of Scoliosis

Dr. Walter Salubro Interviews Dr. Jeb McAviney, Scoliosis Expert, Lecturer, CEO of ScoliCare, and Founder of ScoliBrace


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Dr. Walter Salubro:
Often times before a mom or dad brings their child or teenager here for scoliosis care management, they’ve already been to the medical doctor, a pediatrician, they’ve been to the hospital for checkups and mothers. So sometimes they are put on a wait and see type approach. But what’s the traditional medical approach to scoliosis care and management versus, say, chiropractic.

Dr. Jeb McAviney:
So traditionally, the treatment is surgery, so a spinal fusion surgery. And so a lot of what happens within the medical system is geared up around that, but surgery is only reserved for the worst cases. So that’s how the wait and see approach develops within the medical system. Of course, no one wants to intervene with surgery very early on because there are, you know, it’s a big deal and there are some risks associated with it. And traditionally there hasn’t been good non-surgical treatment offered within the medical system from the chiropractic perspective. Obviously we’re not surgeons. And, you know, we’re always looking for non-surgical methods to treat scoliosis. And s, you know, research is a search. We’re also always looking to find the best methods and, you know, gradually over time scoliosis specific exercises developed, approaches like ScoliRoll, and now things like the ScoliBrace, is we’re constantly trying to see if we can help those patients avoid surgery. If surgery is required and patients who don’t have it, that we should do everything that we need to do before that point to try and stop them.

Dr. Walter Salubro:
And I think the parents and the patients appreciate that too, because that’s probably on their radar screen. They want to avoid that invasive surgery. I met a couple of patients in the last 20 years that they’ve come in already with the rods in their spine. And there’s no mobility in that area of their spine. You know, part of their, um, functional status is limited. Still living somewhat of a quality of life, but it could be a lot better if they didn’t have those rods in their back. Definitely we want to prevent that.

Dr. Jeb McAviney:
And that’s where early intervention is the key, even for adults, you know. We see in adults, scoliosis typically developing around the time of menopause, and then so women in their fifties, if they’re starting to experience more back pain or they’re seeing asymmetry in their hips, they need to be screened for scoliosis because if we start the exercise program early, perhaps they can stabilize it. We do know that it can be stabilized with bracing as well. So we need to think about it in wo ways for our adults and for adolescents.

Dr. Walter Salubro:
Yeah. Got it. So, when patients or parents are told, just wait and see, you know. Or let’s monitor that. What is the implication of that in the long run?

Dr. Jeb McAviney:
The implication of that really is, you know, if the scoliosis gets worse, it’s harder to intervene later on. So any curve that’s greater than 10 degrees when the child still has growth left, it really has the potential for scoliosis specific to be early intervention. The exercise programs are not overly invasive. They’re very low risk. So these are things that people can do as an alternative to wait and see. The other thing, people often told to wait and see when the curve is 30 degrees or so. And at this point in time, there’s a much higher risk that the curve can progress and intervening early with a brace at this point in time probably has a much better chance of stopping it progressing and, you know, exercise does at that point. So we have a little philosophy. It’s about the right treatment at the right time. You do exercise when that’s appropriate, you do bracing and that’s appropriate. Recommend surgery, if that’s appropriate. Whatever is perfect for that patient. But the key is if you wait and see and let things progress and you miss that progression, then you end up needing more and more invasive treatments along way.

Dr. Walter Salubro:
Yeah, definitely. And of course it affects their quality of life as well as it gets worse.

Dr. Jeb McAviney:

Read Related Articles:

Part 1 of 10 | What Is Scoliosis? (Dr. Walter Salubro Interviews Dr. Jeb McAviney)

Part 2 of 10 | Scoliosis 3D Deformity Explained | Dr. Walter Salubro Interviews Dr. Jeb McAviney

Part 3 of 10 | When & How To Screen For Scoliosis | Dr. Walter Salubro Interviews Dr. Jeb McAviney

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