The Sagittal Plane of Scoliosis

Research on bracing has demonstrated the importance of addressing the sagittal plane of scoliosis during bracing (1). Flattening of the physiologic curves of the sagittal plane is thought to be an early indicator of adolescent idiopathic scoliosis (3,4). Dr. Hans-Rudolf Weiss, the developer of the Cheneau-style Gensingen brace by Dr. Weiss (GBW) incorporates this principle in scoliosis brace design.

the sagittal plane of scoliosis, gensingen brace

Physiologic® exercises are also used to address the sagittal plane and are a component of Schroth Best Practice® exercises (2). These specific exercises are relatively easy to perform, but can make a meaningful difference. They are not included in other Schroth program by practitioners not directly trained by Dr. Weiss or Dr. Moramarco. They are one of the important addendums to the original Schroth Method program.

As shown in the left image below, patients with scoliosis usually present with an atypical sagittal plane, often with a loss of thoracic kyphosis (flattening of the normal rounded curve in the upper back, or hypokyphosis) and a loss of lumbar lordosis (a straightening of the normal arch in the lower back, or hypolordosis). Sometimes, scoliosis patients can present with hyperlordosis (excessive arch of the lower back) as shown in the right image below. Physiologic® exercises specifically address the sagittal plane with the goal of establishing a normal range of lumbar lordosis and thoracic kyphosis.

sagittal plane scoliosis

Left: Scoliosis patient presenting with flattening of the thoracic spine (hypokyphosis) and flattening of the lumbar spine (hypolordosis).
Middle: Normal sagittal profile.
Right: Scoliosis patient presenting with excessive arching of the lower back (hyperlordosis).

For patients with kyphoscoliosis, kyphosis, or Scheuermann’s disease, physiologic® exercises are modified to address the associated hyperkyphosis (excessive rounding of the upper back). Here at Scoliosis 3DC, we also offer the kyphologic® brace, specifically made to address hyperkyphosis.

kyphologic brace

Kyphologic brace for hyperkyphosis of the thoracic spine.

(1) van Loon PJ, Kühbauch BA, Thunnissen FB. Forced lordosis on the thoracolumbar junction can correct coronal plane deformity in adolescents with double major curve pattern idiopathic scoliosis. Spine. 2008 Apr 1;33(7):797–801.

(2) Weiss HR, R Klein. Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs. Pediatr Rehabil 9:3.190-200 Jul/Sep 2006.

(3) Millner, PA, Dickson, RA.