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"I would like to thank you for helping me with my new Quickie wheelchair. It has sincerely helped me in my mobility and to have more freedom to get around my home and do my grocery shopping."
- Jacksonville, FL

Scoliosis and Adjustable Micro-Modular Seating (AMMS)

Adjustable Micro-Modular Seating (AMMS):  Thinking Outside the Box

Individuals who develop scoliosis can suffer from multiple problems depending on the severity of the scoliosis curve and other postural deformities that usually occur, including a tilted pelvis, rib hump, spinal rotation, and torticollis.

As the scoliosis worsens and the rib cage collapses into the pelvic crest, secondary problems may include respiratory and lung impairments, slowed gastrointestinal function, swallowing issues, and risk of skin breakdown due to pressure points.  In our current healthcare system, correcting severe scoliosis deformities most often includes invasive surgeries.

In the U.S., invasive surgeries are used to correct scoliosis for both children and adults.  For children, Early-Onset Scoliosis (EOS) is the curvature of the spinal column to the sides which is more than 10 degrees and starts early in child’s life, most commonly before the age of 5. Sometimes, another pathology exists which causes scoliosis (i.e. congenital vertebral anomalies, problems of the muscles and nerves or brain etc.) and sometimes, no clear underlying problem will be identified (Idiopathic EOS).

Some children with stable, non-progressive curves need only observation on the regular basis. Others with slow progressive curves will be chosen to undergo brace or cast treatment.  Currently, U.S. healthcare clinics and hospitals state surgery is the only way to interfere with the course of progressive Early-Onset Scoliosis through Growing Rod surgery or VEPTR (Vertical Expandable Prosthetic Titanium Rod) procedures.  However, this is not the methodology in other countries such as the United Kingdom.  In the U.K., invasive surgeries like this are last resort.

Growing Rod surgery is the implantation of two sets of rods on either side of the spine attached to the upper and lower spinal column vertebrae with hooks or screws (anchors) and without any fusion or instrumentation in between of those two terminal sites. The goal of the GR treatment is to correct the scoliosis at initial surgery as much as possible and then distract (lengthen) the spinal column on regular basis to induce growth of spinal column. Most of the patients will undergo a final definitive surgery when their growth plateaus and their treatments end.  In boys, growth usually stops around 16 y.o and in girls 14 y.o. at which time the growth rod treatment ends.

Approximately 6 years ago, I had the pleasure of spending 2 days with Steve Cousins, Ph.D., BASc, MASc, PEng, Founder of Matrix Seating Ltd. in the U.K., who began exploring the possibilities of using AMMS for corrective positioning in the late 1990s.  After seeing what the Matrix custom molded seating achieved for patients in the U.K., I was a believer that correction is possible.  The results were astounding!

With Matrix seating, not only can correction be possible in some cases, but other advantages include:

  • Custom molded seating that grows with the user – individually shaped and fully supportive (potentially head to toe.)
  • Easy to increase or reduce seat dimensions to accommodates a client’s weight gain or loss and/or a pediatric client’s growth.
  • Dynamic seating that moves with the user; absorbing shock and providing flexibility while maintaining proper positioning.
  • Superior flexibility and movement in areas as required, such as where spasticity is frequently present.
  • Unparalleled ventilation, promoting skin integrity.
  • Shape adjustments can be made directly while the client is seated, improving fit quality and providing instantaneous feedback during a fitting

Client with Early Onset Scoliosis:  What are the possibilities?

 

The methodology of scoliosis correction (and other postural deformities) in the U.S. is new and exciting.  In March 2015, I presented at the International Seating Symposium (ISS) to introduce the concept of AMMS and thinking outside the box…. correction.  Is FIXED really FIXED?  Even thinking ahead and preventing scoliosis in children with Early Onset Scoliosis (EOS) without invasive surgeries is not considered enough in our current healthcare industry.  The use of AMMS in both prevention of scoliosis and correction will provide patients with better long term healthcare benefits.  It will also give providers and payor sources more cost effective outcomes.

The Global Evolution of Custom Molded Seating: Options and Methodologies – See more at: https://www.rehabpub.com/2015/05/global-evolution-custom-molded-seating-options-methodologies/#sthash.KxBbU9qx.dpuf
 
To learn more, visit the website and publications at MatrixSeatingUSA.com
Publications
 
Cindi Petito, OTR/L, ATP, CAPS
Clinical Education Specialist

 

 

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