A nine year old male presented in our office with a chief complaint of juvenile idiopathic scoliosis and intermittent back pain. The patient had fractured his clavicle one month previous to his initial visit and he complained of intermittent "growing pains" in his right foot. The case history also revealed the he had been involved in a motor vehicle accident two years previously.
Postural Analysis: A supine leg check indicated a functional left leg length inequality of 3/8". Visual observation, aided by the use of a grid lined posture analysis board, revealed a center of gravity deviation of the upper torso to the left and left head rotation.
Static Palpation: Paraspinal muscle tenderness was noted at the following areas: C2 on right, T1-T3 bilaterally, L1, L2, L5 bilaterally, L3 on right, L4 on left, sacral base, and posterior superior iliac spine bilaterally. Surface EMG: Full spine surface EMG showed marked asymmetries in the paraspinal muscle activity.
X-ray analysis following the Grostic Procedure showed that the atlas was misaligned. Manual line drawing analysis of the AP 14x17 X-ray, utilizing the Cobb method, measure a right rotatory thoracic scoliosis of 17.0 degrees and a left lumbar rotatory scoliosis of 12.5 degrees.
The patient was managed with upper cervical care utilizing the Grostic Procedure of adjusting by hand. Over the five months and ten days of care teh patient was checked on 13 visits and required an upper cervical adjustment on five of these visits. The leg length inequality, and the posture and palpatory findings balanced (cleared) immediately after the first upper cervical adjustment. Post adjustment paraspinal surface EMG showed that the paraspinal muscle activity was more balanced. Post treatment X-ray taken on the 13th visit revealed the thoracic curve to be reduced to 0º and the lumbar curve was measured at 3.0º which represents an 88% overall reduction in the scoliosis after the five months of chiropractic care.
The potential for a rapid increase in scoliosis makes it critical for patients with juvenile or adolescent idiopathic scoliosis to be closely monitored. The results of this case study cannot be generalized to the entire population, but they do suggest that upper cervical care may produce good results with idiopathic scoliosis when an upper cerivcal subluxation is found.
Further research is needed to study the efficacy of chiropractic care in the correction of idiopathic scoliosis.
Author Keywords: Occipito-Atlanto-Axial Subluxation Complex, Juvenile Idiopathic Scoliosis, Grostic Procedure
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