The potential role of brain asymmetry in the development of adolescent idiopathic scoliosis: A hypothesis

Background: The size asymmetry of cerebral hemispheres may predispose to he ad tilt and asymmetric blocking of the zygapophysial joints, potentially le ading to the development of compensatory curvatures in the lower segments o f the spine. Objective: To analyze the effects of spinal manipulation, maintained by an exercise program, on the progression of idiopathic adolescent scoliosis in 2 children aged 6 and 10. Clinical Feature: The scoliosis found was 16 and 60 degrees. Intervention and Outcome: For diagnosis and monitoring of therapy, we recor ded qualitative parameters of shoulder asymmetry, axillary line asymmetry, and scapular angle position. Manual treatment consisted of the examinations of all sliding motion in zygapophysial joints and both sacroiliac joints a nd removing the limitations of the sliding motions according to the method of Karel Lewit. The treatment procedure consisted of 3 or 4 manipulations w ithin 17 months and an exercise program;The manipulation effects were maint ained by the exercise program. The exercises were done in 2 or 3 sessions w eekly for a year. In both patients we observed that scoliosis decompensatio n was successfully stopped and the effects of the correction persisted for 10 years. Conclusion: Brain and head asymmetry may be only a transient state, predisp osing to asymmetric blocking at the atlanto-occipital level. Removal of blo cking may prevent curve progression in children who had adolescent idiopath ic scoliosis. The manipulative therapy may also have a promising effect on retarding curve progression when used in skeletally immature patient.