The American Chiropractor

FEATURE

tion. To complicate the issue, many of these children are told to wear bulky and uncomfortable braces for up to 23 hours a day, further limiting their physical activities and involvement with other children. Long term statistical studies show these patients are more prone to depression and alcoholism later in life. 8

The financial effects of scoliosis can be extremely difficult on the families. The average cost of the bracing procedures can run up to $10,000 or more. Once the curve develops to around 45 degrees, the cost of the scoliosis surgery can approach $140,000, not including all the pre and post surgical medical needs. Even with good insurance coverage (say, eighty percent), the patient’s portion of the expenses can easily exceed $15,000 to $20,000. In addition, many surgeries need to be repeated, especially if they are conducted before the patient and their spine have finished growing. In healthcare, there is no “Money-back Guarantee;” if the fusion fails for any reason, the patient does not get a discount on the second (or third) operation. 9, 10

While we chiropractors hold ourselves out as the spinal experts, we have historically had little to offer the scoliosis patient. This must change. We need to develop an understanding of the underlying causes of this condition so that we can develop the appropriate treatment protocols to effectively treat this condition. People living with scoliosis

deserve more options than observation, bracing and surgery.

A search of the literature reveals that there have been around 9700 articles on chiropractic; 14.7% of these are on the topic of low back pain, whereas 1.4%,of them are about scoliosis. 11 This is significant considering that there are more than ten musculoskeletal conditions that chiropractors manage besides low back pain! Currently, a case report published by three chiropractors on the chiropractic treatment of scoliosis is listed as the Most Highly Accessed Article of All-Time in its publishing journal. 12 Doctors of chiropractic working with scoliosis have been featured in numerous media outlets around the country, including CBS, ABC, NBC, & FOX News, for their groundbreaking efforts. The recent report on the burden of musculoskeletal disorders in the United States published by The Bone and Joint Decade estimates that over 2. 6 billion dollars are spent each year on hospitalization costs to treat scoliosis and scoliosis-related complaints each year. 13 The need for chiropractors to get involved with scoliosis has never been greater than it is today.

Even if a chiropractor is not interested in dedicating the necessary resources to work with severe cases of scoliosis, we all have an obligation to understand it, and to be able to educate our patients with scoliosis effectively and responsibly. The biomechanical insight gained from working with patients with