Scoliosis Decompensation and CSL Displacement

 Decompensation is a term used in scoliosis to describe the spine leaning to one side so the head is no longer balanced over the pelvis. It is common in all curve patterns but particularly scoliosis curves that have a lumbar component. In treating scoliosis, decompensation can sometimes be the primary deficit and therefore the primary goal can sometimes be to get the decompensation under control.

sometimes we see a curve that appears at first glance to be primarily be a thoracic curve but has significant decompensation. In this case the decompensation is primary deficit and therefore the primary component to address in the treatment plan.

 

Example – Angie had a 28 degree lumbar curve but more of a problem was her large 5cm decompensation and therefore was very high risk for significant further progression. With her LA 3D brace her curve has corrected to 18 degrees but more importantly we have reduced her decompensation by 75%. If Angie continues to wear her brace full time, with further refinement, we should be able to fully correct her decompensation and bring her curve down to 10 degrees or less.

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CSL Displacement refers to the distance from the apex of the curve to the Central Sacral Line ( a line extending vertical from the center of the pelvis). Sometimes the CSL displacement is a bigger factor than the Decompensation and therefore becomes the primary deficit.

 

Example – Annie had a 49 degree Lumbar curve with very significant CSL Displacement. Our primary goal was therefore to attempt to reduce the CSL Displacement. Our initial efforts showed significant correction but we continued to work with Annie and was able to reduce even further. We are now confident that her 49 degree curve will end up being less than 20 degrees.