Adolescent Idiopathic Scoliosis – Pilot Study on the Application of Extra-corporal Shockwave Therapy (ECSWT)

Scoliosis is a lateral deviation of the spine that has no known cause. Overgrowth of the vertebral column due to a lordo-scoliotic maladaptation of the spine to the subclinical (functional) tether of a relatively short spinal cord can cause the onset and progression of AIS.With the exception of spinal manipulation described by Tomaschewski and neurosurgical release of the filum terminale described by Royo-Salvador, no treatment implications have yet been obtained from the results as published so far.

External manipulation, according to Tomaschewski’s logic, can affect the ‘flatback’ contracture found in the lower thoracic region in patients with early AIS and have a beneficial effect on the 3D deformity of the spine and trunk. The hypothesis for this pilot study was that by using ECSWT, the ‘flatback’ contracture that is normal in patients with AIS in the lower thoracic region could be minimised.

Materials and Procedures: Girls aged 12 to 15 years old with a Cobb angle between 20 and 50 degrees (average 35.3 degrees, SD 9.6) were qualified for the analysis (average 14.1years SD 1.1).

(1) Surface Topography (Formetric Diers) before, (2) after 5 minutes in the treatment position without application of ECSWT, and (3) after application of ECSWT were used in the study.

After the intervention, both lateral deviation (RMS = Root Mean Square) and surface rotation (RMS) were steadily reduced. After the intervention, the sagittal parameters kyphosis angle and lordosis angle both increased consistently. The findings were consistent, but not statistically important.

Conclusions: The findings of this study support the idea of a functional tethering of the spinal cord in patients with AIS. In patients with AIS, ECSWT seems to have a positive effect on 3D deformity and the subjective sensation of a tense back. As Tomaschewski points out, manipulating the ‘flatback’ contracture, which is typical in the lower thoracic region, can be beneficial.

Author (s) Details

Hans-Rudolf Weiss
Schroth Best Practice Academy, Neu-Bamberg, Germany.

Sarah Seibel
Department of Radiology, Medizinisches Versorgungszentrum Mittelmosel, Zell-Barl, Germany.

Marc Moramarco
Scoliosis 3DC, Baldwin Green Common, Suite 204, Woburn, MA, USA.

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