Most people are surprised to learn that bone development is one of the most researched aspects of the scoliosis condition.  In fact, there are more studies and articles written on bone density and development in patients with scoliosis than all of aspects of the scoliosis condition (genetics, neurotransmitters, hormones, ect) combine. 

The data reported and collected so far is conclusive that low bone density in patients with scoliosis has a strong correlation with poor bone development and severity of cobb angle.  With this wealth of information, it is confusing why bone health and density are not considered, evaluated, or even discuss as part of the patient’s overall treatment strategy.  Only recently has a study treating the deficiencies in calcium, melatonin, and vitamin D3 commonly found in adolescents with scoliosis been published in peer reviewed literature.  The long-term effects of poor bone mineralization as an adolescent with scoliosis is far less understood, but the implications are fairly obvious in terms of early onset of osteoporosis.  

How is bone formed and developed?

The bones that make up the spine (vertebrae) start out as cartilage with “bone seeds” called ossification centers.  These slowly begin to grow together to form the framework of the bone.  The bone itself is formed by special cells called osteoblasts, which fill out the framework with minerals like calcium phosphate.  This creates bone density and gives it “hardness”.  Bone growth is very dependent on pressure from gravity. 

Symmetrical pressure creates equal bone growth on both sides, but the asymmetrical bone loading caused by the development of a spinal curvature caused abnormal bone growth.  The one on the inside part of the curve (concave) is under more pressure, so it begins to grow slower and more dense.  The bone on the outside part of the curve (convexity) is under less pressure, so the bone trends to grow faster and less dense. 

This is referred to as the Hueter-Volkmann principle and creates a slight bone wedge deformity over time.  The concept of bracing is based on guided growth.  The in brace curve improvement is intended to provide more symmetrical bone loading over time and hopefully prevent bone wedging.  

How does scoliosis affect bone development?

Low bone density and bone wedge deformities are known characteristics of the effects scoliosis has on bones, but only recently has the study of genetic variants provided significant insight into the topic.  The first and only multi-genetic variant study on scoliosis has identified several potential reasons for poor bone health and development in people with idiopathic scoliosis.  The most obvious is the VDR (vitamin D3 receptor) genetic variant. 

This relatively common genetic variant group decreases one’s ability to utilized their Vit D3 effectively.  This is important to bone health and development, because Vit D3 is critical for the absorption of calcium.  The implications are fairly obvious.  Less calcium, less bone density.  Scoliosis patients with the VDR genetic variant should supplement Vit D3 (with Vit K2 which aides in attaching the calcium to the bones) together daily.  SUNSHINE is a perfect blend of both.

Other genetic variants linked to idiopathic scoliosis may play a more indirect role as part of the digestion process, and the coordination of spinal cord to vertebrae growth (requiring bone growth) may also be linked to estrogen dominance due to the COMT genetic variant.  

How to maintain good bone health 

Building and maintaining bone development and bone health should be of paramount importance for both adolescent and adults with idiopathic scoliosis.  Early evidence suggests it may be a key aspect for preventing curve progression and adults with scoliosis are already entering menopause with lower than normal bone density levels.  Here are a few tips for better bone health.

• Stay active.  Pressure on bones cause them to absorb calcium, so weight bearing/lifting exercises are very beneficial.
• Whole body vibration at 30hz has been showed in increase bone density levels significantly in less than 1 year 
• Supplement with STRENGTH for complete bone density nutrition
• Take Vitamins D3 and K2 to increase calcium absorption and utilization  

Read Also - Why You Should Try Physical Therapy for Scoliosis