Yoga and Botulinum Toxin Reduce Adolescent Idiopathic Lumbar Scoliosis – A Control, Randomized Study

Abstract

Background Approximately 90 of scoliosis is adolescentidiopathic AIS From 10 14 years of age until 20 the spine is most vulnerable An effective non-surgical means of remediation is welcome Design Randomized controlled three-arm study assessing safety and efficacy of yoga with incobotulinum injections to reverse lumbar and thoracolumbar AIS Methods Private clinic setting Non-pregnant healthy 12 20-year-olds with AIS performed either a placebo yoga pose Group 1 the side plank Vasisthasana with placebo injection Group 2 or side plank with incobotulinum injections Group 3 In Group 3 33 IU of incobotulinumtoxin were injected into the concave-side lumbar paraspinals quadratus lumborum at curve s apex and psoas with needle entry at L3 4 Group 2 received equal volumes of normal saline solution at the same locations Random org provided randomization Objective Determine safety and efficacy of increasing muscular strength symmetry in AIS Results Each group had 10 patients All completed the three-month study period Mean self-reported daily side plank time 155 s The mean initial lumbar curvatures for groups 1 2 and 3 were 29 8 SD 6 6 37 8 SD 8 0 and 33 0 SD 6 31 degrees respectively Curves were reduced at 3 months by 1 8 2 4 -7 8 7 1 and -12 2 8 79 respectively with p 0 001 improvement in Group 2 vs Group 1 and Group 3 vs Group 1 Group 3 showed the greatest improvement Harms one patient in Group 2 one in Group 3 with transient shoulder pain that resolved by using the forearm in the pose Conclusion Muscle strength asymmetry appears to be relevant to AIS treatment Side planks performed with the convex side downward alone and side planks combined with incobotulinum injections on the concave side appeared more effective in reversing lumbar AIS than placebo exercises Incobotulinum injections with yoga appeared to be the most effective