12 March 2021
It was in 1921 that Katharina Schroth opened her first clinic introducing her new method of treatment for scoliosis which involved specific postural correction, corrective breathing exercises and rehabilitation exercises. Katherina suffered from moderate scoliosis herself and after undergoing treatment with a steel brace which she found heavy and cumbersome, she set about developing her own more functional approach.
Katherina’s grandson, Dr Rudolf Weiss, who is an orthopaedic surgeon, has carried on and expanded on her work developing the Schroth best practice programme and the Cheneau-Gensingen brace. This is an effective, evidence-based conservative treatment for scoliosis.
Dr Weiss will host a virtual conference on 19th and 20th March - The 100th Anniversary of Schroth Treatment – Learning from History. LOC has been working with Dr Weiss since 2017 and our team of Scoliosis specialists are all certified Schroth practitioners. One of the speakers at the conference, Dr Josette Bettany-Saltikov, is Debs Turnbull’s supervisor. Debs is our specialist Schroth physiotherapist and she is gathering evidence for a PhD in the efficacy of our non-surgical treatment.
To mark the anniversary LOC would like to share several case histories demonstrating how this non-surgical treatment can reduce Cobb angles in juveniles and adolescents with idiopathic scoliosis and reduce pain and improve posture in adults as well.
This young lady developed scoliosis during an adolescent growth spurt. Her mother noticed changes to her posture and following her research into the condition came across the scoliosis clinic at LOC. Her curve had progressed rapidly, and her progression factor was indicative of the need for bracing. She began a treatment regime that included Schroth therapy and a Cheneau-Gensingen brace. She managed very well with this regime and due to the nature of her curve, she was able to reduce to part-time bracing soon into her brace wear. Following 9 months of part-time bracing and consistent Schroth therapy, her Cobb angle has been reduced by 50%. Her curve is now minimal, she will be monitored out of brace for 3 months just to check there is no regression. She also had a leg left discrepancy which impacted her curve so this has been treated with foot orthotics which she will continue to wear. A great result and she is thrilled to have made such rapid progress.
One of our three-year-old patients with infantile idiopathic scoliosis. He first came to us with a single thoracic curve with a Cobb angle of 30°. He was fitted with a bespoke orthotic brace. After five months of full-time wear and Schroth physiotherapy, his Cobb angle had gone down to 22°. After seven months of part-time wear, his Cobb angle decreased again to 17°. He has responded to bracing treatment incredibly well. He is now 7 years of age, wears his brace for nighttime only and has a Cobb angle of 10° which will be monitored as he grows.
An introduction to scoliosis from our own Debs Turnbull
When this female juvenile scoliosis patient came to LOC at the age of six, she had a single thoracic curve with a 30° Cobb angle. She had a bespoke Cheneau- Gensingen brace fitted and after two months of full-time wear and a further four months of 18-hour-per-day wear along with a Schroth physiotherapy programme, her out of brace X-Ray showed that her Cobb angle had reduced to just 5°. She is now out of the brace but continuing with Schroth physiotherapy; her most recent review revealed that her curve was stable and had not regressed.
My results are amazing and unexpected, and I am glad that I received the brace through LOC. I am still wearing the brace 18 months later and my back feels even straighter. Thanks to LOC I realised that I wanted to help people with similar if not the same condition as me, so I am now going to Salford University in September to study Orthotics and Prosthetics so I will hopefully be able to help others with Scoliosis as much as LOC has helped me.
If you say something is going to be easy it will be easy and if you say something will be hard it will be hard. So, I'm just going to say that wearing my brace is easy. And as it turns out, it really is.
Sally and Debs have helped remove the stress from our situation. They have given us hope based on their extensive knowledge and expertise.
I had my brace fitted and I was also given a personalised exercise programme to help with my 3D rotation. Not only was I wearing this new brace but I still had my pectus brace on and the amazing orthotists managed to combine the two so they worked together. I really struggled with this at first; however, I kept going and now I’m really glad I did. My scoliosis overcorrected by 10 degrees and I was able to reduce my scoliosis brace wear to 16 hours a day within 6 weeks.
Don’t wait. It’s about the children because they are more likely to be confident in their late teens if you act quickly and support them. We have been lucky because we understand the condition well. That’s one of the main things, to be honest. It was hard work, but it pays off in the end.
I finally found that I had arrived at the right place and something was actually being done.
My pain levels are hugely improved, my ribs were tender and now they are not. My brace was made individually for me. It’s not one size fits all and, if it is not completely perfect, LOC alters it on the spot. I was so surprised that I could wear the brace under my clothes, I did not need to go and buy anything, I just wear loose tops.
The brace is very light. Obviously, the first couple of days we were told it was going to be uncomfortable for her, I bought so many pillows! But although the first night was not very comfortable, the second night she got used to it and then she was wearing it all day long and I thought ‘that’s brilliant!’ She was only taking it off for two or three hours to go out with friends or do the exercises, but she didn’t have any problems really.
Debs and Sally are fantastic. I mean, they’ve become like family now. They are extraordinary people and do such good work with these kids, both of them, it’s fantastic. The whole experience has been very good. They make you feel welcome from the beginning, and you can ask as many questions as you want, and they answer everything. If you have a problem they give you their personal mobile so you can just call them if you have a problem and they’ll solve it straight away. I’m very pleased with the treatment, the people, with everything.
She’s wearing the brace all the time now and she’s doing very well. She’s very good at school too, the brace doesn’t get in the way of anything. It fits underneath her school uniform and you can’t see it. Sometimes I even have to ask her when she’s sitting down if she’s wearing it because I can’t see it! She says ‘of course mummy’ and I say ‘let me try!’ I have to knock through the clothes and only then can I hear she’s wearing the brace!
Obviously, the results speak for themselves. I would definitely credit LOC, but if I were to give any advice [to parents in a similar position] it would be to contact Debs and Sally. Ricarda likes it there, she loves the people like Debs and Sally and felt really comfortable, everything was really relaxed and nice. She worked really hard during training with Debs who kept saying that Ricarda was such a workhorse!
Sinead is one of our successful adult scoliosis patients who has experienced scoliosis-related back pain since her twenties. Since starting a course of Schroth based physiotherapy and wearing a bespoke Cheneau-Gensingen spinal brace, her rib cage has deteriorated from 16 to 8°, progression has been halted and she reports her pain is reduced.
Here’s another of our adult patients, Lady Venetia, describing her experience of treatment at LOC:
Whilst adolescent idiopathic scoliosis is less common in males, at LOC we do see a number of young adolescent males with scoliosis. This young man was 13 when he first attended LOC. He had a double major curve and his father had noticed asymmetry to his pelvis and shoulder blades. They were keen to act and he began wearing a Cheneau-Gensingen brace immediately. 18 months after wearing a brace, he now uses a brace for overnight wear only and has seen a significant reduction in his curve.
Ricarda was one of the first patients we treated with Schroth and Cheneau-GensIngen bracing. She had a thoracic curve of 31°. Her parents wanted to avoid surgery and had searched for alternative options. She was incredibly motivated and really embraced her treatment plan. As she is now fully matured, she has been discharged from wearing her brace and no longer has to follow her Schroth exercise programme. Her Cobb angle at the end of treatment was just 11° and her posture is symmetrical and stable. A great result!
The operation used to treat severe scoliosis curves is typically spinal fusion surgery; a major procedure that involves moving muscles and realigning the skeleton into place. The curved, deformed vertebrae are fused together into a single bone, putting metal screws and rods into the spine to help straighten it. Surgery typically lasts between 4 and 8 hours depending on the severity of the curve. Bone graft is then taken from other parts of the body and used to cover the implants.
Following the operation, it is necessary to spend around a week in intensive care before returning home and the first few days are often uncomfortable. Most adolescents can expect to return to school from 2-4 weeks following surgery, but pain medication may be required up to 6 weeks following. A full recovery from the procedure can take up to a year, as it can take that long for the spine to heal fully.
Spinal fusion surgery causes the fused portion of the back to become permanently stiff, as a result, returning to sports that require large amounts of flexibility (ballet, yoga, gymnastics, dance) or contact (rugby, football, karate, hockey) may take longer.
Risks of spinal fusion surgery are like that of any other major procedure and include infection, blood clots and anaesthesia complications. The added risks include permanent nerve damage to the spine and paralysis.