Advertisement
Advances in Adolescent Idiopathic Scoliosis

Advances in Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis (AIS) is a lateral and rotational deformity of the spine that afflicts roughly 2.5% of the population across most cultures. Only 10% of those diagnosed with AIS will actually need treatment, and few will require surgical management of their curves. Since no cause to date has been pinpointed, the vast majority of resources for treating AIS is based on the premise of following all patients closely until skeletal maturity. This means using periodic x-rays and office visits—usually at intervals of 4 to 6 months—to ensure that aggressive curves don’t get missed. The treatment regimen to this day has been to work reactively rather than proactively. This approach subjects patients to numerous x-rays, which can be deleterious and may increase the incidence of breast cancer over the long term. A newer, saliva-based genetic test called ScoliScore (Transgenomic, Inc.) may change the way we manage scoliosis patients. Based on the discovery of 53 genetic markers that have been linked to progressive scoliosis, this test compares the patient’s DNA against these markers. A score between 1 and 200 is generated. Those scoring 50 or below—roughly three-fourths of patients who are screened—will have less than a 1% chance of developing a curve that will require surgical management. Those who score 180 to 200—only about 1% of those who are screened—are at high risk for developing a curve that would require surgery. Patients with test scores falling between 50 and 180 are at intermediate risk of developing an aggressive curve. Shifting Focus of Care for Adolescent Idiopathic Scoliosis The true benefit of having an accurate and reliable saliva-based genetic test for...
[ HIDE/SHOW ]