Acute - a brief episode of pain, or a problem that comes on suddenly and resolves quickly. A headache lasting for an hour or two is an example of an acute event.
Adam’s Test - also called Adam’s Forward Bending Test, this is the standard screening test for scoliosis, the one most people might remember from school. It is not always 100% accurate, but it can be quickly and easily performed by nurses and other healthcare professionals. It is more effective when used in conjunction with a scoliometer. It is performed by having the patient bend forward at the waist 90 degrees with the back exposed, while an examiner searches for signs of postural asymmetries of the ribs or muscles along the spine, or a shoulder blade sticking out more on one side than the other.
Adjustment - a term used by chiropractors to describe a treatment, applied either with the hands or with the aid of a device, to assist in re-aligning the muscles, bones, and joints of the human body. Also sometimes referred to as manual therapy or chiropractic manipulative therapy (CMT).
ADL - activities of daily living. ADL is a term used to describe all of the normal routines that a person goes through in the course of a typical day, such as sitting, lifting, studying, working, playing sports, and so forth.
Adolescent - a term used to describe an individual between 10 and 17 years of age.
Alar - the alar ligament is a very important ligament that attaches to the skull and the upper bones in the neck. It is responsible for preventing excessive rotation and sideways bending (lateral flexion) of the skull on the neck. If this ligament isn’t working properly, it can create an unstable connection between the head and the rest of the spine.
Algometer - an algometer is a device that measures force or pressure. It is sometimes installed in a brace to evaluate how often the brace is truly being worn by the patient. Thermal sensors can be used for this purpose as well.
Antalgic scoliosis - sometimes called a “false” or pseudo-scoliosis, this is a temporary scoliosis that the body adapts due to the presence of pain. Once the source of the pain is resolved, the scoliosis will go away on its own.
Anterior - the front part, or in front of a part, of the body.
Anteroposterior (A-P) - starting from the front, going towards the back. For example, an AP x-ray is taken while the patient is facing the x-ray machine, so the x-ray beam goes from the front to the back.
Apex/Apical - the apex of a scoliosis curve is the center bone (vertebra) in the curve, which is usually the one farthest away from the middle of the body. Apical is the word to describe the apex of the curve.
Apophysis - often used in conjunction with Risser sign, the apophysis is a bright line along the edge of a bone seen on an x-ray. It usually indicates when the bones are finished growing.
Apparent Head Weight (AHW) – the term used to describe the relative increase in the weight of the head as it shifts forward relative to the body (see Forward Head Posture). For every inch the head moves forward, it feels like it weighs an additional ten pounds. Even though the actual weight of the head remains the same, the muscles of the neck, shoulders, and back are placed under greater strain due to the increased apparent head weight.
Arthrodesis - the medical term for the bony fusion of two or more segments of the spine.
ArthroStim – the proprietary name for a mechanical adjusting instrument commonly used by CLEAR chiropractors to adjust the neck and other joints of the body.
ATR - angle of trunk rotation; sometimes referred to as ATI, angle of trunk inclination. This is the difference in prominence between one side of the back compared to the other, as measured by a scoliometer when the patient is bending forward.
Atlas (C1) - the first bone in your spinal column, located just under your skull.
Axial - one of the three dimensions, the other two being frontal (coronal) and sagittal. The axial plane is synonymous with the transverse or horizontal plane. It refers to looking at the body from the top-down. Rotation is measured in the axial plane.
Axis (C2) - the second bone in your spinal column. The atlas (C1) sits on top of the axis (C2).
Block vertebra - another word for a hemivertebra, where two or more bones in the spine have fused to become one. This condition is present during birth.
Bone age - not every patient’s bones develop at the same rate. Two people might be the same age, but one might have more growing left to do in their skeleton than the other. For this reason, various methods of assessing bone age are used with scoliosis patients, to aid in determining when the scoliosis is at the greatest and the least risk for progression. See also chronological age, skeletal maturity.
Boston brace - the most commonly-used brace in the United States, developed in the 1970’s.
Brace – the common term for a corset-like device that is prescribed by orthopedists to prevent a moderate case of scoliosis from progressing to severe levels. There is a large variety of braces used around the world. In general, they can be rigid, semi-flexible, or elastic. Some braces are pre-fabricated, and then modified to fit the individual patient. Others are custom-fitted and created specifically for one individual. Many types of new braces use CAD/CAM, which stands for computer-assisted design and computer-assisted manufacture. See also orthosis.
BrAIST – an acronym for Bracing in Adolescents with Idiopathic Scoliosis Trial, published in the New England Journal of Medicine in October of 2013, which was the largest and most well-funded study on scoliosis bracing ever conducted in the United States. Originally designed as a randomized controlled trial (RCT), too few parents were willing to waive their right to select their preferred treatment option for their child, and so a preference cohort was added in 2009. The study evaluated the Boston TLSO specifically (no other scoliosis braces were included). The results of the study support bracing for scoliosis as an effective method for decreasing the likelihood of the Cobb angle worsening to the level where surgery is typically recommended, provided the brace is worn for a suitable number of hours each day.
Butterfly vertebra - a type of a malformation of a bone in the spine where the center of the bone does not fully develop, leading to a “butterfly”-like appearance. This can be the cause of a scoliosis, and is present at birth.
C7 plumbline - a measurement used to assess sagittal (front-to-back) alignment of the spine. When viewed from the side, a line drawn down the seventh bone in the spine should intersect with the top of the tailbone. If the C7 plumbline is shifted forward, this results in Forward Head Posture. Studies have shown that adults with scoliosis who have a forward-shifted posture have greater chances of reduced quality of life and long-term disability.
CA - chiropractic assistant. Their role is similar to a PA (physician’s assistant), in that this individual usually assists the chiropractor with patient therapies and other office tasks.
CAD/CAM - computer-assisted design/computer-assisted manufacture. This term is used to refer to how a scoliosis brace is designed and created.
Cantilever – a cantilever is a special type of lever that is anchored at one end. CLEAR chiropractors use custom-designed cantilevers as part of balance re-training and sensorimotor re-integration therapy. See also SLA.
Cavitation - the professional term for the sound that often accompanies a chiropractic adjustment; it sounds like cracking your knuckles.
Cerebellum – the part of the brain that is responsible for regulating motor functions of the body, such as balance, posture, and coordination.
Cerebrospinal fluid (CSF) – a colorless and clear fluid that flows around the brain and spinal cord. It helps to insulate the nervous system from shock. New research suggests that CSF also plays a large role in flushing out waste and toxins from the brain during sleep, including some waste products such as beta amyloid, that are thought to be associated with Alzheimer’s and other neurological disorders.
Cervical - this refers to the top seven bones in the spine that make up the neck.
Cervical lordosis - when viewed from the side, your spine should have three good curves; the cervical lordosis, the thoracic kyphosis, and the lumbar lordosis. A lordosis refers to a curve that points forward; a kyphosis is a curve that points backwards. When the good curves in the body are lost, the spine becomes unstable and it may develop a scoliosis.
Charleston brace – a night-time bending brace developed in 1978 for the treatment of single thoracolumbar curves. Compliance tends to be poor as it renders sleeping problematic.
Chêneau (brace) - the Chêneau brace is the most commonly-prescribed brace in Europe. Originally developed by Jacques Chêneau in the 1970’s, there are many different versions of this brace today which have been upgraded from the initial design.
Chiropractic – a healthcare science and art dealing primarily with musculoskeletal problems and their effect upon the nervous system, immune system, and general health of the body.
Chronic - a long-standing condition; the opposite of acute. Scoliosis is considered a chronic condition.
Chronological age - the actual age of the patient; the amount of time since the date of their birth. See also bone age.
CMS – an acronym for Core Muscle Stimulator, which is a device that applies percussive linear massage to the deep core postural muscles. See also tapotement.
CMT - acronym for chiropractic manipulative therapy, which is the technical term for the adjustments performed by a chiropractor, either by hand or with the aid of other devices. It can be used interchangeably with SMT (spinal manipulation therapy).
Cobb angle - the standard by which the severity of a scoliosis is measured. Cobb angle involves identifying the two most tilted vertebrae in a curve. A line is drawn along the top of the most-tilted bone at the top of the curve, and the bottom of the most-tilted bone at the bottom of the curve. Perpendicular lines are then drawn from these lines, and the intersection of the perpendicular lines is measured and expressed in degrees.
Coccyx - the lowest part of the spine; the tip of the tailbone.
COG - center of gravity. Sometimes also referred to as COP (center of pressure) or COM (center of mass).
Compensation - a spine that is “compensated” essentially has two curves of equal size that result in the head being more or less centered over the middle of the hips. See also decompensation.
Compensatory curve - sometimes referred to as a secondary curve, this is a curve that develops in response to the primary or main curve. It tends to be less rigid and more flexible. If the primary curve is corrected, the compensatory curve will usually resolve on its own.
Compliance - this refers to the actions taken by the patient when following the recommendations of their doctor. A patient who does not follow their doctor’s recommendation is said to be non-compliant.
Concave - the “underside” of a curve, or an inward curve. It is the opposite of convex, which refers to the top or outward part of the curve.
Congenital - a term meaning, “from birth.” If a bone in the spine fails to form properly in an infant, it can cause congenital scoliosis. It is possible for a young child to develop infantile scoliosis without any congenital abnormalities.
Conservative - in regards to scoliosis treatment, conservative treatment refers to any form of treatment which does not involve surgery, such as bracing or chiropractic. Conservative treatment could be considered the opposite of surgical treatment.
Convex - the convexity of the curve is the “high side of the rainbow.” It refers to the direction that a curve is pointing. For example, a right convex scoliosis in the mid-back would curve away from the heart.
Coronal - one of the three dimensions, the other two being axial (or transverse) and sagittal. Also sometimes referred to as the frontal plane, it involves looking at the body from the front or back. Cobb angle is measured in the coronal plane.
Cotrel-Dubousset - a type of scoliosis surgery, developed in the 1980’s.
Crankshaft phenomenon - a term used in the medical literature to describe when a new scoliosis arises after scoliosis surgery, above or below the fused segments, due to the transfer of forces through the instrumentation.
CTLSO - this stands for cervicothoracolumbosacral orthosis; it refers to a brace which involves the entire spine, including the neck (cervical), mid-back (thoracic), low back (lumbar), and tailbone (sacrum). One example of a CTLSO is the Milwaukee brace, which can include a component that attaches to the jaw to stabilize the neck.
CVA - coronal vertical axis; this refers to a line drawn straight down from the middle of the second bone in the spine (or the center of the skull) when looking at the body from the front.
DC - abbreviation for Doctor of Chiropractic.
DCRS - double rib contour sign. This is a measurement made on a lateral (side-to-side) x-ray to quantify the difference between the ribs on the left and right sides.
Decompensation - the opposite of compensation; this is used to refer to a spine where the head is not aligned over the center of the hips. It occurs when the secondary compensatory curve(s) are smaller than the primary curve.
Decompression - surgically, this refers to the process of removing parts of bones or other structures to reduce pressure on the spinal cord and/or nerves. In chiropractic, there is also a form of treatment called spinal decompression, which involves a table and straps that pull on the spine to lengthen it. Spinal decompression is often used by chiropractors to treat disc herniations; its value in the treatment of scoliosis is uncertain.
Degeneration - this refers to the process by which the discs in the spine gradually lose their flexibility and strength, and become more vulnerable to injury. It can occur due to misalignments in the spine, both scoliosis and loss of the normal good curves (cervical lordosis, thoracic kyphosis, and lumbar lordosis). A lack of motion often promotes disc degeneration.
Degenerative (de novo) scoliosis - de novo is a Latin term meaning, “from the new.” It is used to refer to a type of scoliosis which develops in adults (typically over the age of 40) with no prior history of scoliosis. This form of scoliosis is often called degenerative scoliosis, because it is believed to be caused by degeneration in the spinal discs. This is different from traumatic scoliosis, which arises due to an accident, injury, or operation.
De-rotation - the act of turning or rotating the spine back towards the ideal.
DEXA scan - an acronym for dual-energy x-ray absorptiometry, also known as bone densitometry or DXA. This is a type of scan used to measure bone mineral density and screen for osteopenia/osteoporosis.
Dextroscoliosis - the medical term for a scoliosis that curves towards the right side of the body.
Disc Index - a series of measurements comparing the height or thickness of the spinal discs on the convexity of the curve to the size or thickness of the discs on the concavity of the curve.
Distal - located farther from the center of the body. Distal is the opposite of proximal.
Diversified - a term used to describe the general type of manual therapy and adjustments used in most chiropractic offices; often done primarily by hand with the goal of mobilizing areas of the spine that are “stuck” and not moving properly.
DoboMed - a method of conservative scoliosis treatment developed by Professor Dobosiewicz in Katowice, Poland, which focuses upon the restoration of the thoracic kyphosis as well as three-dimensional auto-correction and symmetrical positioning of the pelvis and shoulders, combined with breathing and active resistance exercises.
Dorsal - the back of a person’s torso. It is sometimes used to refer specifically to the mid-back. In other contexts, it is the opposite of ventral, which refers to the front of the torso.
Double curve - often also referred to as an “S”-curve, this involves two curvatures in the spine of roughly equal size. If the term “double major” is used, the curvatures are also of similar rigidity (they are both structural curves, or relatively inflexible).
Drop-piece/drop-adjusting - some chiropractors utilize a special modification to their chiropractic tables, which elevates about one inch, then lowers or “drops” when sufficient pressure is applied. This technique helps to reduce the amount of force required to achieve a correction.
Dura mater - Latin for “tough mother,” the dura mater is the tough protective sheath that wraps around the spinal cord.
Dynamic De-rotation Brace (DDB) - developed in Greece in the 1980’s as a modified version of the Boston brace. The main addition is a metal pad designed to enhance de-rotation.
En face - a term coined by French surgeons to describe a special x-ray view that takes into account the rotation of the spine, to capture a true picture of the spine’s position relative to the apical vertebra.
Equilibrium - a state of balance and symmetry of the body and how it regulates posture & balance. Achieving equilibrium is one of the goals of conservative scoliosis treatment.
End Vertebra - also referred to as a terminal vertebra, this refers to one of the two most-tilted vertebrae, which are selected at both the top and bottom of a curve. The end vertebrae are used to measure Cobb angle. The end vertebra at the bottom of the curve is called the inferior terminal vertebra, and the one at the top of the curve is called the superior terminal vertebra.
Ergonomics - the science and art of ensuring proper body alignment and good postural habits during activities of daily living (ADL’s), such as working, using a computer, playing, watching television , washing dishes, and other day-to-day routines.
Extrinsic - factors pertaining to something outside of the individual. It is the opposite of intrinsic, which describes aspects that are inherently part of the individual. Wearing a brace is an example of an extrinsic correction, because the force comes from elsewhere other than the patient’s own attributes. Performing scoliosis-specific exercise therapies is an example of an intrinsic correction, because it uses the patient’s own muscles and abilities.
Ferguson angle - less well-known than the Cobb method, the Ferguson angle is another way to measure the severity of a scoliosis. It involves marking the center of the top, middle, and bottom vertebral bodies and comparing the angle made by the intersection of the two lines connecting the top to the middle, and the bottom to the middle. It cannot be used interchangeably with Cobb angle, and measurements made with one system cannot easily be related to the other. Ferguson’s angle can also be used to refer to the tilt of the sacrum (tailbone) when viewed from the side; see also sacral slope (SS).
FITS - an acronym for Functional Independent Treatment of Scoliosis, developed in the 1990’s in Poland. It involves a combination of scoliosis-specific exercises, postural awareness, myofascial release, joint mobilization, foot loading, stretching/strengthening, corrective breathing, and balance exercises performed both seated and standing.
Flat-Back Syndrome - a term used to describe loss of the normal thoracic kyphosis, which is commonly found in cases of idiopathic scoliosis. It can also occur after some types of surgical fusions. In Flat-Back Syndrome, the shoulder blades stick out in the back, and the little “bumps” (spinous processes) in between the shoulder blades are very small and difficult to detect. On an x-ray of the spine taken from the side, the spine in the area of the ribs will be straight, with very little backwards-pointing curve (kyphosis).
Flexion-distraction - a type of chiropractic therapy that involves the use of a table. The patient lies down flat and holds on to a T-bar at the top of the table, while the lower half of the table slowly bends down and returns to a horizontal position, over and over. This relaxes (flexes) and stretches (distracts) the spine, and is often used as a treatment for low back pain and herniated discs. The CLEAR Institute has developed a specialized form of flexion-distraction therapy specifically for working with scoliosis patients.
Force platform - a device that measures center of gravity (COG) and sway patterns. The patient stands on the platform with their eyes open or closed, and sensors below the plate detect subtle variations in the shifting of your weight and the directions you lean in.
Forward head posture (FHP) – sometimes also called Head Forward Posture, this refers to a common problem where the head is carried farther in front of the body. When viewed from the side, the middle of the head should line up with the shoulders, hips, and feet. If the head is shifted too far forward, it places additional strain upon the muscles of the neck, shoulders, and back. FHP is commonly observed in scoliosis patients.
Functional scoliosis - this term is used to describe the flexibility of the scoliosis curve. A functional curve automatically corrects when the patient bends from side to side. A functional scoliosis is the opposite of a structural scoliosis. With a structural scoliosis, the curve is rigid and will not disappear when the patient bends to one side.
Gensingen brace - a derivative of the Chêneau brace, developed in 2009 by Dr. HR Weiss. It is also used in Dr. Marc Moramarco’s clinic in Massachusetts, USA.
Greulich and Pyle Atlas - a large collection of x-ray images that can be compared to a patient’s individual x-rays (usually of the hand) to assist in estimating their bone age and how much growing their spine has left to do.
Guarding - when discussing the body, guarding is the body’s natural reaction to protect an injured structure, such as a ligament. Typically the muscles become very tight and sore, and develop trigger points over time. Muscle guarding is a normal response, but can lead to pain and other negative effects upon health.
Halo Posture - the brand name of a type of headweight used by many CLEAR chiropractors to aid in restoring the ideal cervical lordosis and reducing forward head posture.
Harrington Factor - a number used to express the “steepness” or “shallowness” of a scoliosis curve. It is obtained by dividing the Cobb angle by the number of vertebrae in the curve. For example, a Cobb angle of 24 degrees that involves eight vertebrae will only have a Harrington Factor of 3, meaning it is a very gentle and small curve that extends over a large area of the spine. This is compared to a Cobb angle of 40 degrees that involves only five vertebrae; with a higher Harrington Factor of 8, this curve would be steeper. Curves with higher Harrington Factors tend to be more likely to get worse over time.
Harrington rods - the first type of instrumentation, developed for scoliosis surgery in the 1960’s by Dr. Paul Harrington. Although this type of surgery is no longer being performed in the world today, all scoliosis surgeries (except those specifically referred to as fusion-less, such as vertebral body stapling) involve the use of rods and instrumentation to assist in the fusion of the spine.
Headweight - a specialized, therapeutic headband with weights sewn into the front. The body reacts to these weights by reducing the forward head posture and restoring the cervical lordosis. There are many other different types of weights that CLEAR chiropractors use to improve posture, including shoulder, chest, and hip weights.
Hemivertebra - when one bone of the spine fails to develop fully, it creates a triangle-shape instead of a rectangle. This de-stabilizes the spine and can lead to scoliosis. It is present from birth (congenital). Hemivertebrae do not occur only in one dimension, but can also cause problems with rotation and front-to-back deformities, such as kyphosis.
Heuter-Volkmann Law) - this principle states that, when increased compressive pressure is applied to the tops and bottoms of the bones in the spine (the vertebral endplates), this inhibits and slows growth. In turn, growth is accelerated when pressure on the vertebral endplates is reduced.
Hyperkyphosis/Hyperlordosis - hyper refers to “more than,” or greater than normal. An individual with a hyperkyphosis has too much of a backward-pointing curve in their middle back; this can also be called Scheuermann’s Disease. Hyperlordosis usually suggests that there is too much of a forward-pointing curve in the low back.
Hypokyphosis/Hypolordosis - hypo refers to “less than,” or decreased from normal. Hypokyphosis of the thoracic spine (loss of the normal backward-pointing curve) is a common finding in idiopathic scoliosis. Hypolordosis of the cervical spine (forward head posture and loss of the good forwards-pointing curve in the neck) can contribute to many spinal problems, including scoliosis.
Hypotonic/Hypertonic - this refers to the state of tone in a muscle; a hypotonic muscle is generally weak, while a hypertonic muscle is overworked and tense. Both conditions are abnormal.
Hysterical scoliosis - a term used to describe a case of scoliosis with an emotional or psychological cause.
HVLA - high velocity, low amplitude. This acronym refers to the type of manual therapy or adjustments delivered by most chiropractors that deliver small amounts of force very quickly into the body to correct misalignments of the spinal joints.
Idiopathic - without a known cause. In latin, literally, “one’s own.” Scoliosis is often termed idiopathic because there is no one single, easily identifiable cause. However, this does not mean that the scoliosis does not have a cause. In most cases, idiopathic scoliosis is caused by a number of factors.
Ilia, Ilium, Iliac crest - the ilia are the hip bones; ilium is singular. The iliac crest is the top of the hip bone.
Inclinometer - another term for a scoliometer, which is a device used to screen for scoliosis and to measure the angle of trunk rotation (ATR)
Infantile scoliosis - a case of scoliosis that arises in a child under three years of age. It may be caused by a bone in the spine that did not grow properly (congenital hemivertebra), it might be the result of a disease or genetic disorder (neuromuscular), or it can have no known cause (idiopathic).
Intervertebral disc - between each bone of your spine there is a small, gelatinous substance contained inside of a tough flexible outer covering. This is what allows your spine to bend and move. The discs of the spine are alive, and require nutrients and water to thrive. They normally receive what they need through motion; when motion to the discs is restricted, it accelerates the process of degeneration and decay because the disc is not being properly nourished and hydrated, and waste materials are not being flushed out.
Instrument Adjusting - not all chiropractic adjustments are done purely by hand. Sometimes a chiropractor may use an instrument to assist in correcting the spine. There are different types of chiropractic adjusting instruments; the most commonly used is a spring-loaded device called the Activator™. CLEAR chiropractors use a mechanical adjusting instrument to precisely and gently adjust the bones of the neck.
Intrinsic - a property of an object that is inherent to that object, and cannot be separated from it; the opposite of extrinsic. Intrinsic motivations are motivations that come from within, as opposed to external rewards or punishments from other sources. Intrinsic therapies are therapies that use the patient’s own muscles and postural systems to achieve correction, as opposed to an external force such as a brace or a rod.
ISICO - an acronym for the Italian Scientific Spine Institute in Milan, Italy.
Isometric - exercises performed without motion, against resistance. These types of exercises are more effective in strengthening the core postural muscles of the body.
Isotonic - exercises performed with motion, such as weightlifting. Isotonic exercises do not have as great as an effect upon posture compared to isometric exercises.
Juvenile scoliosis - a term used to refer to a case of scoliosis diagnosed between 3 and 9 years of age.
Kyphoscoliosis - unlike most cases of idiopathic scoliosis, which are associated with a loss of the normal curve in the mid-back, cases of kyphoscoliosis have a larger-than-average backwards-pointing curve in the middle of the back, when viewed from the side. Also known as Scheuermann’s Disease.
Kyphosis - the opposite of lordosis, a kyphosis is a curve in the spine that points backwards when viewed from the side. A normal spine should have a cervical lordosis, a thoracic kyphosis, and a lumbar lordosis.
LA brace - one of the newer braces to emerge in the US, based around the design of the Chêneau brace. It is a CAD/CAM brace typically prescribed in conjunction with Schroth exercises.
Lateral - on the sides of the body. A lateral x-ray is taken from the side, with the patient rotated 90 degrees away from the x-ray machine.
Lateral olisthesis - sometimes also called a lateral listhesis, this is a sideways slippage of the apical vertebra that is commonly seen in cases of degenerative scoliosis. It can be responsible for a great deal of pain, discomfort, and disability due to the stresses it places upon the muscles, nerves, and discs.
Leg Length Inequality (LLI) - sometimes also referred to as leg length discrepancy (LLD), these terms refer to an apparent difference between the length of the legs that could contribute to uneven hips and postural scoliosis. It is unlikely that a leg length inequality could be the cause of a structural scoliosis unless it has persisted for a very long time. Leg length inequalities are usually functional in nature; true anatomical leg length inequalities are rare, and found in perhaps 5% of cases.
Levoscoliosis - the medical term for a scoliosis that curves to the left side of the body.
Longitudinal - in a lengthwise direction. The longitudinal axis of the body runs from the bottom center between the feet to the top center of the head.
Lordoscoliosis - the most common form of scoliosis, where the middle (thoracic) kyphosis has been lost or diminished. It is the opposite of kyphoscoliosis, and is often used interchangeably with the term scoliosis.
Lordosis - a lordosis is a curve that points forward. It is the opposite of kyphosis.
Lordotisization - the process of losing the normal thoracic kyphosis. This predisposes the spine towards developing scoliosis. Can also be used to refer to restoring the natural lordosis of the cervical or lumbar spine, which is beneficial and healthy.
Lovett sign - a term used to describe the direction of the rotation of the spine. If Lovett sign is positive, the spine has rotated towards the side of the convexity (so with a right thoracic scoliosis, the spine would be rotated clockwise when viewed from above). If Lovett is neutral, there is no rotation. If it is negative, the spine is rotating away from the side of the convexity; this is a very unusual occurrence, and usually signifies the presence of an underlying disease or pathology.
LSO - lumbosacral orthosis. A brace that covers mostly the low back.
Lumbar - a term used to describe the lower five bones in the spine, that begin after the ribs stop. These five bones are termed L1 (for the highest) through L5 (for the lowest one that sits on top of the tailbone, or sacrum). A lumbar scoliosis is a curvature that is located primarily in the low back.
Lumbodorsal (LD) angle - a measurement made on x-rays by CLEAR chiropractors to quantify the relationship between the lower lumbar spine and the upper lumbar spine.
Lumbosacral (LS) angle - in the frontal (coronal) plane, a measurement made on x-rays by CLEAR chiropractors to quantify the relationship between the top of the sacrum and the inclination of the lower lumbar spine. With a left lumbosacral angle, the bones in the low back have started to curve to the left side off of the tailbone (sacrum). In the sagittal plane (side view), another term for Ferguson’s angle or sacral slope (SS).
Lyon brace - an adjustable, symmetrical, and transparent brace that is molded after a plaster cast of the patient. Developed in the 1940’s.
Malaga brace - a type of scoliosis brace used in southern Spain that is relatively unknown outside of that region.
Manual therapy - the generic term for the types of maneuvers performed by hand by chiropractors and osteopaths to correct misalignments and restrictions in the body. It can sometimes also be used to refer to massage or any therapy that is done essentially by hand, without the aid of other devices.
Major/minor curves - major refers to the largest and least flexible scoliosis curvature in the spine. Minor curves are also called secondary or compensatory curves, and tend to be smaller and less rigid.
MDP - an acronym for Motorized Drop Piece, which is a device used as part of the CLEAR scoliosis treatment protocols to correct rotation of the pelvis and rib cage. It can also be used to help with problems with the neck, shoulders, and low back. It consists of a wedge that the patient lies down upon, which raises and lowers approximately ½ inch six times per second to apply swift but gentle corrective forces into the body.
Medial - closest to the middle of the body; the opposite of lateral.
Mehta Side-Shift - a form of scoliosis exercises developed back in the 1970’s that focuses upon shifting the alignment of the trunk relative to the hips.
Meninges - the sock-like covering that goes around the spinal cord.
Method Lyonaise - developed in 1978, this is a conservative approach to scoliosis treatment involving auto-elongation, sensorimotor re-integration, and symmetrical exercises, as well as traction, gait therapy, scoliosis-specific exercises, and bracing.
Milwaukee brace - a large brace developed in the 1940’s that extends from the jaw down to the tailbone; also called a CTLSO.
MTA - an acronym for Manual Traction Adjustment, which is a specialized type of traction that is applied by a chiropractor to address problems with the meninges and dura mater.
Nash-Moe - a system for measuring the rotation of the bones of the spine on an x-ray.
Neuromuscular Rehabilitation (NMR) - an older term, now reserved specifically for stroke rehabilitation, used to refer to exercises and therapies designed to improve the brain’s communication with the postural muscles of the body. It has been replaced by the new term, “sensorimotor re-integration” (SMR).
Neuromuscular scoliosis - a case of scoliosis that is secondary (caused by) a different disease, such as cerebral palsy or muscular dystrophy. They tend to be C-shaped rather than S-shaped, and are often decompensated.
Night-time bracing - a special type of brace that is worn only at night, and is only used for correcting C-curves; they are ineffective with S-curves (double majors). Examples of night-time braces include the Charleston and Providence braces.
Observation - also called “watch & wait” or “watchful waiting,” this is the first round of traditional orthopedic scoliosis care, recommended for curves that are considered too mild for bracing (less than 20 degrees). The rationale for observation is based around the assumption that most cases of scoliosis will not progress to surgical levels by the time the spine is done growing.
Occiput - the base of the skull, that rests upon the atlas.
Olisthesis - a slippage of a vertebra, commonly seen in cases of degenerative (de novo) scoliosis. See also lateral listhesis, spondylolisthesis, and retrolisthesis.
Orthogonal - a system for referencing three dimensional space using x for horizontal, y for vertical, and z for depth. A force that applies traction to the spine would be termed positive-y, for example, and gravity would be negative-y.
Orthosis - the technical term for a brace. The plural is orthoses.
Orthotics - orthopedically, this is the science of working with braces. It is sometimes used somewhat differently in a chiropractic context to refer to special insoles worn in the shoes.
Orthotist - the term used to refer to an individual who specializes in fitting, designing, and/or manufacturing orthoses and orthotic devices. An orthotist is not necessarily a doctor, although some are.
Osteopenia - a term used to describe a mild to moderate decrease in bone mineral density.
Osteoporosis - a term used to describe a severe decrease in bone mineral density.
Outpatient treatment - a term used to refer to exercises, therapies, and procedures that are performed outside of the clinic by the patient, usually at home or at a gym. Inpatient facilities are usually hospitals, where patients are admitted to for extended periods of time, compared to outpatient clinics, where patients come for treatment but do not stay overnight.
P-A (Postero-anterior) - starting from the back, going towards the front. For example, a P-A x-ray is taken while the patient is facing the x-ray machine, so the x-ray beam goes from the front to the back.
PASB - an acronym for progressive action short brace, developed by Dr. Lorenzo Aulisa of Rome and used primarily in Italy. It is interesting in that it rejects the three-point stabilization concept commonly used by most other braces, and focuses instead on the generation of internal forces primarily through the rib cage to induce elastic deformation, along with de-rotation. It is primarily prescribed for single lumbar curve patterns.
Peak growth velocity (PGV) - also sometimes called peak height velocity (PHV), this refers to the time of most rapid growth in the adolescent phase of life, when the spine could be considered to be at the greatest risk for developing a scoliosis or for an existing case of scoliosis to worsen. In females, the average age of curve acceleration is 11.7 years.
Pedicle screw - a type of specialized surgical screw that is inserted into the bones of the spine during scoliosis surgery to serve as an anchor point for hooks, wires, or rods. There is some controversy about the use of pedicle screws in spinal fusion surgery.
Perdriolle method - a system of assessing spinal rotation on x-ray using a special tool called a torsiometer.
Physiotherapy/physical therapy - an umbrella term encompassing exercises and stretching procedures that are done to treat a specific condition such as scoliosis (as opposed to general exercises, which are done to improve physical fitness and athletic performance rather than treat a specific disease).
Plumbline - typically, a rope with a weight at the bottom that is held next to the patient and compared to certain landmarks on the body to assess overall postural balance and compensation.
Polyethylene - a flexible plastic used in the making of scoliosis braces.
Polypropylene - a type of plastic that is more rigid than polyethylene that is also used in the manufacture of scoliosis braces.
Posterior - pertaining to the back of the body, or towards the back.
Posture - your posture is the natural state of the alignment of your body when you are not exerting conscious effort to change it.
Pre-fabricated - refers to a brace which is not created with a specific patient in mind, but instead may be molded or trimmed to fit a variety of patients. It is the opposite of custom-fabricated.
Primary - also known as the major curve, this refers to the largest and most rigid scoliosis curvature in the spine. Compare to compensatory, minor, or secondary.
Progression - a term used in scoliosis care to describe the worsening of a scoliosis.
Proprioception - the body’s innate ability to sense its position in the absence of other visual cues. For example, if you close your eyes, it is your body’s sense of proprioception that tells you if your arm is straight or bent, without even having to look at it. In a broader sense, it is your body’s ability to orient itself in a three-dimensional environment.
Proprioceptive neurological facilitation (PNF) - a type of advanced stretching that is designed to enhance flexibility and ranges of motion.
Prone - lying face-down.
Providence brace - a night-time brace developed in the 1990’s that focuses more upon de-rotation than sideways bending (as with the Charleston brace). It is typically used only for thoracolumbar and lumbar curves, and appears to be most effective when the apex of the curve is at T9 or below.
Proximal - closer to the center; the opposite of distal.
Pseudoarthrosis - the medical term for when two segments of the spine fail to fuse together after surgery. Literally, “false fusion.”
QOL - also sometimes referred to as HRQOL (health-related quality of life), this acronym is used to refer to a patient’s combined experiences with their overall health, and how their condition affects their ability to live without pain, disability, or depression.
Retrolisthesis - a term used to describe when one bone in the spine slips backwards on top of another. It most commonly happens at L5, the last bone of the spine that sits on the tailbone (sacrum).
Rib arch - sometimes also referred to as a rib prominence, this relates to the appearance of the ribs on the back side of the torso. When the spine rotates with scoliosis, it brings the attached ribs along. It is this rotation that is responsible for the appearance of the rib arch, more so than the Cobb angle. The term “rib hump” should be avoided, as this can be hurtful and carry negative connotations.
Rib Vertebral Angle (RVA) - a system of measurements made on an x-ray to compare the relationships between the spine and the ribs on each side. Also called the Mehta Rib Vertebral Angle after its creator, the RVA is an extremely helpful method of assessing the chance of progression in cases of infantile scoliosis.
Risser sign - the most commonly-used method of assessing skeletal maturity in scoliosis, the Risser sign is a bright line that appears on an x-ray along the tops of the hip bones. It signifies when the bones of the patient are likely to stop growing. Risser sign ranged from 0 to 5, with higher numbers indicating more advanced bone age. There are other, more accurate methods of assessing bone age which involve looking at the bones of the wrist and hand (see Tanner-Whitehouse method, Gruelich and Pyle Atlas). You can also examine the triradiate cartilage in the hip.
ROM - an acronym for range of motion. Your range of motion is the degree of mobility that you have in a specific joint before it is limited by pain or reaches the limit of how far the structures (bones, muscles, tendons, and ligaments) permit it to move without causing injury to those structures. It can be measured in degrees.
Rotoscoliosis / rotatory scoliosis - a term used to indicate lateral curvature of the spine combined with rotation; essentially a synonym for scoliosis. Almost every case of scoliosis will have some degree of rotation; if rotation is not present, it is highly likely that the scoliosis is postural, antalgic, or caused by some underlying pathology. See Lovett sign.
RSC brace - a modified version of the Chêneau brace developed by Dr. Manuel Rigo of Barcelona, Spain, intended to be applied in conjunction with a modified version of the Schroth protocols.
Sacral slope - sometimes abbreviated SS, and also known as Ferguson’s angle (not to be confused with the Ferguson method for measuring scoliosis on an x-ray), the sacral slope is a number (expressed in degrees) that measures the tilt of the tailbone (sacrum). With larger numbers, the sacrum is tilted far forward, resulting in an exaggerated forward curve (lordosis) in the low back and sometimes a spondylolisthesis of L5. With smaller numbers, the sacrum is more level to the horizon, which can result in a loss of the normal low back curve and a retrolisthesis of L5.
Sacroiliac (SI) joint - a large joint that connects the tailbone (sacrum) to the hip bones (ilia). Problems with the SI joint can cause difficulty walking, sciatica, and hip and leg pain.
Sagittal plane - one of three dimensions, used to describe the plane that splits the body down the middle into two equal parts. When you look at someone from the side, you are looking at them in the sagittal (or lateral) plane.
Scheuermann’s Disease - a term used to describe hyperkyphosis (an increased backwards curve in the middle back) caused by excessive bony growth and wedging of the bones in the thoracic spine.
Schroth - a specialized system of scoliosis-specific physiotherapeutic exercises, sometimes used in conjunction with a light brace, developed in Germany in 1921 by Katherina Schroth, who herself lived with a moderate scoliosis. It uses a combination of postural awareness (auto-correction), breathing exercises, and stretching & strengthening maneuvers, often performed in front of a mirror and assisted by a therapist. In German, it is correctly pronounced “Shröat” (rhymes with “throat”), but in the United States it is often pronounced “Shrawth” or “Shröth.” For more information, please access The Method of Katharina Schroth – history, principles and current development, by Hans-Rudolf Weiss (Katharina’s grandson), Scoliosis 2011, 6:1.
Sciatica - a somewhat informal term for pain that runs from the hips down the thigh and into the knee, following the path of the sciatic nerve.
ScolioGold (Scoliosis SOS) - the proprietary name for a technique/clinic (originally in Suffolk, today in London) that incorporates elements of Schroth with trigger point therapy, proprioceptive neurological facilitation (PNF), and the FITS method, as well as other osteopathic and myofascial release techniques.
ScoliOlogic Chêneau light brace - initially called the Chêneau-Toulouse-Munster brace, this was developed by Dr. HR Weiss specifically for the Katharina Schroth clinic in Sodernheim, Germany. It is designed to be less noticeable and less restrictive than the standard Chêneau brace.
Scoliometer - also known as an inclinometer, the scoliometer is a small device that contains a bead in a fluid-filled curved tube, much like a carpenter’s level in a sense. A scoliometer is placed on an individual’s back to screen for scoliosis and to measure the amount of rotation in their spine and ribs (see ATI, angle of trunk inclination).
Scoliosis - a true scoliosis consists of three components: 1) a Cobb angle measured to be greater than 10 degrees; 2) with rotation of the vertebrae; 3) that does not disappear when the patient bends to the side (structural vs. functional). Scoliosis can be further subdivided based upon the time of diagnosis (infantile, juvenile, adolescent, and adult) and the apparent cause or lack thereof (idiopathic, congenital, neuromuscular, degenerative, traumatic, antalgic, and hysterical).
SEAS - an acronym for scientific exercise approach to scoliosis, developed by the ISICO (Italian Scientific Spine Institute) in the 1990’s, which was in turn derived from the Lyonese School of scoliosis rehabilitation in the 1960’s. It is not so much based around function as cognition and behavior, relaying heavily upon principles of auto-correction and postural awareness. Exercises are varied every 4-6 months, and often combined with a brace such as the Sforzesco or SPoRT braces.
Secondary curve - sometimes called a minor curve, it is the opposite of the primary or major curve. A secondary curve typically develops in response to the primary curve, and will resolve on its own if the primary curve is corrected.
Sensorimotor re-integration (SMR) - an advanced term used to describe the communication that occurs between the balance & coordination centers of the brain, and the postural muscles of the body. One of the theories regarding the cause of scoliosis revolves around the idea of a sensorimotor re-integration disorder; essentially, the brain and the postural muscles of the body are not communicating properly (see proprioception).
Sforzesco - a rigid scoliosis brace developed by Stefano Negrini and Gianfranco Marchini in Milan, Italy, the Sforzesco brace is based around the SPoRT principles. It is the most recently developed brace to follow these principles, with the other two being the Sibilla and Lapadula braces.
Single curve - a case of scoliosis where there is only one structural curve; sometimes called a C-curve. Compare to a double curve or S-curve pattern. Note that it is important to differentiate single curves that have a compensatory secondary curve from true double major curves.
Skeletal maturity - when the bones of the skeletal system have stopped growing. While it is typically assumed that growth is finished at age 18, this is not always the case; some people can continue growing into their mid-twenties. Risser sign is often used as an indicator of skeletal maturity, to determine how much more growth can be expected. However, it is important to note that spinal growth can continue to occur even after the Risser sign has reached stage 4 or 5. Despite many claims to the contrary, reaching skeletal maturity does not mean that the scoliosis will never get worse.
SLA - this is an acronym for Shoulder Lever Arm. It is a type of specialized therapeutic cantilever that is used by CLEAR doctors to aid in postural rehabilitation, sensorimotor re-integration and balance re-training.
Spinal canal / column / cord - the spinal canal is the tunnel that the spinal cord travels through. The spinal column (also called the vertebral column) refers specifically to the bones; the spinal cord refers specifically to the nerves.
Spinal weighting - a system of strategically placing weights on various parts of the body in order to create a reaction and re-train the centers of the brain responsible for balance, posture, and coordination. See headweight for an example.
SpineCor - the proprietary name for a dynamic, elastic brace, developed in 1998. It is less rigid and more easily-concealable than rigid braces. The SpineCor brace is typically recommended for smaller curve types, and appears most effective in treating mild, single curve patterns.
Spinous / spinous process - the part of the bones in your spine that sticks out in the back. When you run your hands down the middle of your back, the little bumps you feel are the spinous processes.
Spirometer - a spirometer is a device used to measure lung function.
Spondylolisthesis - this term is used to describe when one bone in the spine has slipped forward on top of the segment below. It is most commonly found at L5, the lowest bone in your spine that sits atop the sacrum. Often abbreviated “spondy,” they can be painful, but not always.
SPoRT – an acronym for Symmetric, Patient-oriented, Rigid, Three-dimensional. Used to describe the principles behind the Sforzesco brace and a bracing concept pioneered by the ISICO Italian Scientific Spine Institute.
SSE’s - an acronym for scoliosis-specific exercises. Used to differentiate general physical therapy programs from those designed specifically for scoliosis.
STC - an acronym for Scoliosis Traction Chair, which is a device that involves three main components: 1) straps and pads to straighten and de-rotate the spine, combined with 2) spinal traction to increase spinal flexibility, and 3) whole-body vibration to relax tight muscles, engage weak postural muscles, and enhance sensorimotor re-integration to ensure lasting changes in the posture and position of the spine.
Structural scoliosis - the structural component of a scoliosis is the part of the curve that does not straighten out when the patient bends to the side. It is the most rigid and least flexible part of the curve, and thus the most difficult to correct. If the structural curve can be corrected, though, any compensatory functional curves will then correct automatically. A structural scoliosis is the opposite of a functional scoliosis, which will correct when the patient bends to the side.
Subluxation - a term used by some chiropractors to describe a misalignment or dysfunction of the spine, nerves, and other tissues in the body. It is not used in the same way by medical doctors; the medical definition of a subluxation is a joint that has been partially dislocated.
Supine - lying on the back, face-up.
Surface topography - also sometimes called Moire topography, this is a system used for mapping the contours of an individual’s back. It is preferred over x-ray because it does not use ionizing radiation; however, it can sometimes be difficult to use as a system for measuring improvement or worsening objectively, and does not correlate perfectly with Cobb angle measurements.
Syringomyelia / syrinx - a syrinx is a fluid-filled cyst; when it found in the spinal cord, it is called a syringomyelia. Cerebrospinal fluid (CSF) usually flows around the brain and spinal cord; when the flow of CSF is altered, the fluid can collect into a cavity. These are not uncommon in scoliosis patients. Sometimes, they can be harmless and cause no problems; other times, they can cause significant pain, diminished sensation, and worsening of the curve.
Tanner-Whitehouse method – a highly accurate method of assessing bone age and skeletal maturity, involving an x-ray of the hand and wrist. See also Risser sign and triradiate cartilage.
Tapotement – also called percussive massage, this is a type of massage that involves linear, straight up-and-down motions. Compared to standard orbital massage, it is much more effective in relaxing the deep core postural muscles.
Thoracic –the middle part of the spine, where the ribs connect. There are twelve bones in the thoracic spine, T1 through T12.
Thoracolumbar – involving both the thoracic (middle) and lumbar (low back) regions of the spine.
TLSO – thoracolumbosacral orthosis. A term used to describe a brace which covers most of the back and also involves the hips. The Boston brace is the most common version of a TLSO.
Traction – a force that lengthens the spine; the opposite of compression. Medical traction, such as halo traction or the Cotrel system, is often done with the aid of skull pins (called a halo), pulleys, and weights. Before surgery, sometimes a patient is anesthetized and placed under very strong traction to determine the flexibility of the spine. In chiropractic offices, traction is used very differently: significantly less force is applied, and no drugs or surgical procedures are involved. Traction can be done by the doctor to the patient, or by the patient alone with the aid of a special traction device.
TriaC brace – developed in the Netherlands, this is a flexible or “soft” brace like SpineCor. Like SpineCor, its advantages include less restriction of breathing, greater comfort, and greater concealability, and is typically recommended for curves below 25 degrees.
Triradiate cartilage – a Y-shaped band of cartilage, found in the area of the hips. It can be referred to as “open” or “closed;” this indicates whether it is fully formed. This can be used as an indicator of skeletal maturity, along with Risser sign and the Tanner-Whitehouse method. There is a greater risk for scoliosis to progress (get worse) when the triradiate cartilage is still open, and a greater chance that bracing will fail.
T-score – a component of bone density tests that compares the sample to a normal, age-matched control, and measures the number of standard deviations away from the mean. It is slightly less specific than the Z-score, as it does not consider gender, weight, or ethnicity. A T-score of -1.0 or higher is considered normal; between -1.0 and -2.5 is indicative of osteopenia, and -2.5 or less indicates that the bone density is significantly below normal (osteoporosis).
Ultrasound – also called sonography. A type of imaging that uses high-frequency sound waves to create images of inside the body. It is most commonly used to view an unborn baby. Recently, the concept of using ultrasound imaging to measure scoliosis has begun gathering interest.
VEPTR – an acronym for vertebral expandable prosthetic titanium rib. The VEPTR procedure is used as an alternative to the typical spinal fusion surgery in cases of congenital or neuromuscular scoliosis. More information about the VEPTR procedure can be found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616470/
Vertebra – One of the 24 bones of the spinal column. There are 7 cervical vertebrae (in the neck), named C1 through C7 in descending order. In the thoracic spine (mid-back), where the ribs attach, there are twelve, T1 through T12. Where the ribs stop, the lumbar spine (low back) begins, with 5 more, L1 through L5. The skull is sometimes called C0, and the sacrum can be called S1. The plural of vertebra is vertebrae.
Vertebral body stapling (VBS) – a new surgical procedure developed for mild cases of scoliosis. In essence, devices that look like staples are implanted into the spinal bones on the convex side of the curvature, and tightened. The idea is to reverse the growth forces into the bones of the spine, and prevent a larger curve from developing.
Vicious Cycle - a concept explained and developed by Martha Hawes PhD and Ian Stokes PhD, describing how the buckling of the spine causes imbalances in the muscles, which then leads to further buckling, which then causes still greater muscle imbalances.
VT – an acronym for Vibrating Traction, which is a vibration therapy device utilized in CLEAR Scoliosis Centers for rehabilitation of the tendons, spinal discs, and ligaments.
WCR brace – one of the newest braces to emerge in the United States, developed by Mr. Grant Wood based around the Chêneau brace and applied using Dr. Manuel Rigo’s system of scoliosis classification for bracing. Unlike the LA brace, exercises are not a component of treatment.
Whole-Body Vibration (WBV) therapy – a method of treatment in which the patient stands on a vibrating platform. The benefits of WBV therapy are believed to be related to the specific frequencies and amplitudes of the vibration; different systems of the body respond to different settings. CLEAR uses a specific form of WBV therapy to stimulate communication between the brain and the body, and to enhance the effectiveness of isometric exercises, in order to achieve changes in posture and improve balance. See also sensorimotor re-integration.
Wilmington brace – also known as the DuPont brace, this is a type of TLSO similar to the Boston brace. It is somewhat easier to wear and remove.
Wobble chair – the proprietary name for a chair used in chiropractic spinal rehabilitation that has a seat mounted on a 360-degree pivot point. Stretching and bending exercises are performed by the patient while seated on this chair to warm up the spine and increase ranges of motion. Sometimes referred to as an ARC, or active rehabilitation chair.
X-ray – also called a radiograph, an x-ray is a two-dimensional image generated by shooting invisible particles (x-rays) through the body onto a screen. Bones and dense materials such as metal will block the passage of x-rays. When an x-ray hits the screen, it turns the screen black. When it is blocked, the screen stays white. In this manner, an x-ray is very good for imaging scoliosis and measuring the position of the bones.
Yoga – a Hindu system of exercise and philosophy, combining spiritual meditation and physical motions, which involves controlling one’s breathing, thoughts, and posture to increase health, wellness, flexibility, and relaxation. While some yoga postures can be harmful for certain types of scoliosis, Elise Miller has developed a yoga program specifically for scoliosis that can be adapted to many different curve patterns.
Z-score – a component of bone density tests that compares the sample to a normal, age-matched control, and measures the number of standard deviations away from the mean. It is slightly more specific than the T-score, as it also considers gender, weight, and ethnicity. A Z-score of -2.0 or less indicates that the bone density is significantly below normal.
For additional terms and acronyms commonly used in the conservative management of scoliosis, please consult the SOSORT 8th Consensus Paper on Terminology.