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| Scoliosis and back pain in children:
physical activity is the best prevention In the world’s richest countries, low back pain is so common that it has become one of the leading causes of disability and healthcare expenditure.
Back pain in children should be taken seriously as it can further reduce the amount of physical exercise they get, result in absences from school, and limit them in their everyday activities.
These brief opening remarks prompt a series of questions that our physiotherapist, Martina Poggio, here tries to answer in the light of the latest published data regarding a possible link with adolescent scoliosis, a risk that can be prevented with regular physical activity... |
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Scoliosis is caused by... People attribute scoliosis to all sorts of different things, and what they say is usually wrong! Whenever you hear or read the opinions of people claiming to know what causes scoliosis, it is best to be sceptical.
Because, let’s not forget, the vast majority of scoliosis cases are idiopathic, meaning there is no known cause. In fact, the condition is probably caused by a multitude of factors. |
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SEAS 2023: first appointment in Texas
Stars and Stripes welcomed the new year and our SEAS courses. The first course, at the beginning of January was in fact in Texas, in the United States, where our physiotherapist Alessandra Negrini gave her lessons, both theoretical and practical, to 25 participants, enthusiastic about this learning experience.
At the same time, the city of São Paulo gave the starting shot for the SEAS courses in Brazil for 20 participants, as usual, organized and carried out on-site by Isis Navarro, the Brazilian certified SEAS therapist who started her collaboration with Isico right one year ago in January 2021. Alongside the theoretical lessons held online by Michele Romano, she took care of the on-site demonstration of the practical parts of the exercises and supervised the correct execution by the participants. Step by step during the courses held throughout the past year, her autonomy has grown more and more so that currently our director physiotherapist Michele Romano attends the courses almost only as a spectator intervening if there is a need for advice or particular notions.
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| 8th edition of the World Master course just opened! January saw the kick-off for the 8th edition of our World Online Master course.
Since 2016 we can count more than 315 professionals taking part in the Chinese, English and Spanish editions of our course, coming from 58 countries. This year's edition sees represented the Czech Republic, Latvija, United Kingdom, Egypt, United Arab Emirates, Costa Rica, USA, Malaysia, India, Turkey, and Australia.
Our course will last until November 2023 with new modules and a Live session every two weeks. Even if the course already started, few places are left and it is still possible to enrol. Mid of February we will definitively close registration.
For more, please visit the dedicated website at www.scoliosismaster.org |
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Dr Fabio Zaina: new member on the 2023 ISSLS Nominating Committee Isico's expert physiatrist Dr Fabio Zaina has been selected to join the ISSLS 2023 Nominating Committee.
This committee is in charge of selecting a slot of candidates for the Officers position of the ISSLS. The International Society for the Study of the Lumbar Spine has contributed more than any other organization since its founding in 1974 to the advancement of research on low back pain and disability.
The ISSLS has more than 400 members, and Dr Zaina has frequently given reports and presented posters at yearly conferences, most recently in Boston in May.
"A significant recognition, not only for me personally, but also for the work we do as a team at Isico," Dr Zaina says, "certainly the rehabilitation treatment is at the centre of attention of those who deal with vertebral pathologies more and more in these years due to the excellent results achieved." |
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| Alberto Ponte, one of the most important experts on the spine, has passed away
Prof. Alberto Ponte, one of the leading Italian experts on the spine, often remembered for his humanity and professionalism, as well as by patients on our blog, www.scoliosi.org, passed away a few weeks ago.
Prof. Ponte has devised the "Ponte osteotomy," a technique for the surgical treatment of kyphosis but also for scoliosis, used all over the world.
We want to remember him in the words of our Scientific Director, Prof. Stefano Negrini: "It is a sad moment for those who take care of spinal pathologies in Italy and around the world. He was also an early supporter of exercise-based treatment.
He referred many patients from all over Italy to what at the time was just the "Negrini Scoliosis Center," directed by my parents, now the Vigevano Isico Center. And he has never spoken badly of conservative treatment, provided it is done by expert hands. I have very pleasant memories of him, like all those who knew him." |
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Lavinia, the most beautiful in Italy wore a brace for five years Lavinia Abate, an Isico patient for several years, was elected in December as the most beautiful in Italy.
We want to remember that also another Isico patient, Cecilia Alma Levita, participated in the same national competition.
Lavinia, 18, has been wearing the brace for five years, as she said: “Of all the spine centres I consulted, Isico was the only one willing to try bracing treatment, despite the severity of my curve. I have to admit that those were difficult years for me, but I never stopped doing the things I love, like dancing, singing and hanging out with my friends. Thanks to Isico and also to my own determination, I have made a considerable improvement. My curve has been reduced by almost 20°, and even though I don’t have a perfectly straight back, I have learned to love and accept my body the way it is".
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Isico Pills: a video about Cobb angle
Watch the short video about Cobb angle presented by our PT Luca Selmi. The Isico Pills format is designed for expert professionals, namely, doctors and therapists, and available with English subtitles. Share it with #isicopills on social networks! |
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Soumaya Foughali shares her experience
In each number of our Newsletter, we present the experiences on how scoliosis is treated worldwide through an interview with one of our Online Master course participants. They are fellow doctors, physiotherapists, and orthopaedic technicians coming from all over the world.
This month's interview is with the Orthotist and Prosthetist Soumaya Foughali, from Algeria, currently working in the National Office of the disabled Persons (ONAAPH) in Algeria exactly in Annaba.
"In Algeria, we have a protocol type for screening scoliosis from the 1st year in primary school, after detecting the scoliosis doctors refer the patient to our centre for scoliosis management...". |
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Should we go for the straight back goal? Paola has scoliosis: her back is twisted on itself. Therefore, she has been given a brace to wear — a nice plastic “jacket” that she is actually going to have to wear for some years to come. But why? Well, to straighten her back! This, of course, is the logical answer, but unfortunately logic and medicine don’t always go hand in hand.
Many people also think, again quite logically, that surgery can eliminate the problem of scoliosis, but the reality is that surgery simply fixes a section of the spine with screws and bolts, blocking the curve in order to stop it from worsening. And even in those instances when the surgeon manages to almost straighten the patient’s back, we have to ask ourselves whether a surgically treated scoliotic spine can ever possibly be the same as before?
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Skiing, playing a musical instrument, horse riding or even jumping in the air - is it possible when wearing a brace? Yes, it is; the hundreds of patients who participated during the past 10 years in our Concorsetto, proved it.
The videos and images of these kids are the best encouragement for those preparing to follow a demanding therapy such as that for scoliosis, and who are living the fear of not being able to practice a sport or play an instrument.
For our monthly appointment find out on our YouTube channel @ScoliosisManager how you can ice skate like Irene, 14 years old... |
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| Fabio Zaina comments on the review on the use of the brace in scoliosis with curves even over 40° Dr. Fabio Zaina, an Isico physiatrist, presents a video commentary on "Bracing interventions can help adolescents with idiopathic scoliosis with surgical indications: a systematic review."
It is commonly believed that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, expert opinions are not consistent.
The authors of this review considered randomised controlled trials, non-randomized controlled trials, prospective and retrospective observational studies, and case series: "There are some studies suggesting the use of bracing even in the case of severe curves when patients are motivated by trying to avoid surgery. More and better-quality research with coherent outcome criteria is needed".
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Can scoliosis get worse in spite of a brace-treatment
Yes, unfortunately, it can. Assuming that the patient’s brace is well constructed and has been properly checked, the most likely reason for any worsening is that it is not being worn for enough hours each day: to be effective, a brace must be worn for a number of hours commensurate with the risk of the scoliosis worsening, which is something only the treating physician can establish.
The prescribed number of dose-wearing hours should also vary over time, depending on the risk: when the risk is high, it needs to be worn all the time, and the patient should remove it only in order to take a shower. When the risk is low, they will be asked to wear it only at night.
The other possible reason for scoliosis worsening in spite of bracing therapy is, instead, much more rare: the presence of a highly aggressive form of scoliosis. A brace is worn with the aim of avoiding the need for surgery. If the brace proves unable to contain the progression and the curve exceeds 45-50°, then it will probably be necessary to consult a spine surgeon. If there is a worsening of scoliosis, but the curve nevertheless remains below this threshold, then the treatment has been effective.
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Is the Integration Problem in the Sensoriomotor System the Cause of Adolescent Idiopathic Scoliosis?
Ahmet Payas, Sabri Batin, Erdal Kurtoğlu, Mustafa Arik, Turgut Seber, İlyas Uçar, Erdoğan Unur Journal Pediatrics Orthop. 2023 Feb 1;43(2):e111-e119. doi: 10.1097/BPO.0000000000002300. Epub 2022 Nov 24. |
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