Idiopathic scoliosis- The importance of Classification

This article is a follow up article on the series of idiopathic scoliosis published previously. In this article, we will talk about the different types of classification and the importance of it.

One of the main differences between the traditional treatment of scoliosis and that of SpineCor system for physiotherapy and bracing is the use of curve classification in the latter system. The use of a classification system enables a more precise treatment intervention.

How are the scoliotic curves classified?

The curves are classified according to the direction of the curve, the location of the curve and the number of curves presented. The direction of the curve is either to the left or the right. The location of the curve can occur in the thorax, which is anywhere from the base of the neck to the level of the last ribcage, the lumbar, which is the lower back, or in between these two regions- the thoracolumbar region.

Why is classification important?

Scoliotic curves that occur in thorax, thoracolumbar and the lumbar region will all have different effect in the 3D presentation of how the spine will rotate, tilt and compensate inside the body, which ultimately result in a different postural presentation for each type of curve.

For example, when a right curve is present in the thoracic spine, although from the xray it looks as if the trunk should follow the direction of the scoliosis, i.e bends to the left, it does more than that. The lower trunk is also rotated to the right which causes compensation in the upper trunk to rotate left, so that the resultant effect is that the head is facing forward. However, if a scoliotic curve is present in the lumbar spine, the trunk does follow the direction of the curve.

This means that being able to diagnose the type of curve present will mean that a predictable spinal orientation can be determined. With this knowledge, exercises can be prescribed specifically to counter this movement pattern, ensuring maximum mobility and strength in the affected joint and muscles respectively.

A similar principle is used when bracing with the SpineCor system. Prior to bracing, once the curve classification is determined, the corrective movement for that specific curve is taught to the client (see fig1). Bracing is done in the corrective movement position (See fig2). This corrective movement is essentially a movement direction opposite to the orientation of the scoliotic spine. This specificity allows the collapsed side of the curve to be open and provides a real opportunity for curve reduction.