Displaying items by tag: genetic testing for scoliosis
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Is Scoliscore going to be utilized as a high-tech paperweight?
I must admit, I’m a little taken back by the level of resistance I’m seeing in regards to the use of the Scoliscore AIS prognostic test and how it will (or actually won’t) effect treatment decisions for early stage scoliosis patients. I’m even left scratching my head after watching the patient testimonial video on the www.scoliscore.com website entitled “Isabelle’s story”.
http://www.scoliscore.com/patient-re...0/Default.aspx
The patient (Isabelle) is diagnosed with early stage scoliosis and isn’t immediately tested with the Scoliscore test. Instead she is placed into the age old “watch & wait” mentality. The doctor only recommends the use of the Scoliscore test AFTER she has experienced a “big curve increase” following a growth spurt! They immediately put her in a rigid brace (again, following the same old AIS treatment protocol) before determining her genetic risk for progression with the Scoliscore test.
The test results come back and she has a Scoliscore of 16 (very low genetic risk for curve progression to a surgical level), which begs the question…..So then why did she experience the “big curve increase” following the growth spurt? I mean, it’s great that she has a low genetic risk for developing a severe curvature (40+ degrees), but the “big curve increase” during the growth spurt was certainly less than optimal or desirable. She obviously has a very high environmental factors risk that is going completely unaddressed (and will continue to be unaddressed in the rigid brace they prescribed to her in the video). Incredibility enough, at the end of the video they in a large part use the genetic risk factor evaluation in the decision to discontinue ANY forum of treatment in Isabelle’s case, so she can go off to summer camp, without the brace (which probably wouldn’t have helped anyway since it doesn’t reduce or eliminate the environmental risk factors that are obviously driving her curve progression to this point), so she can engage in dance and swimming……Two known high risk activities for AIS patients! Ahhh!
This just goes to show that the most incredible technological advancements can be defeated by incompetence or an unwillingness to adapt to change.
I can’t tell you have many conversations I have with colleagues of mine (within the CLEAR Institute even!) and orthopedic scoliosis specialists who have a SERIOUS case of the “that’s the way we do things around here” syndrome in regards to adapting their treatment plans in accordance with the vast advantage the information from the Scoliscore test provides. They look at me and say, “well, it’s certainly nice information to have, but it isn’t going to change my treatment plan in anyway.” WHAT!?! I respond back to them with “so your planning on treating a AIS patient with a Scoliscore of 200 (the highest level) exactly the same as a AIS patient with a Scoliscore of 20 (very low genetic risk)?” A blank stare is the only response I have gotten from anyone to this point.
Think about it in a metaphoric sense. Would you react differently if you saw a child standing 20 feet off the rail road tracks as a train was bearing down on them, than a child standing ON THE TRACKS as the rail rolled towards them? I would certainly hope so. Neither case is ideal, but the two situations certainly warrant different responses.
The Scoliscore AIS prognostic genetic test will serve the patient about as much as a high tech paperweight if it isn’t utilized (in conjunction with evaluation of environmental risk factors…not the end result factors….Aka: Cobb angle) to fundamentally change the patient’s treatment plan and/or treatment options.
I think Helen Keller said it best: “The only thing worse than blindness is a person with no vision.”
I have (again) attached a flow chart depicting the traditional cobb angle directed treatment plan that attempts to solve the AIS problem without knowing the genetic risk or environmental risks of the patient, so every patient with similar cobb angles are treated the same reactionary way until it is too late and the curve progresses. And the alternative Scoliscore directed treatment plan in which the treatment plan and follow-up evaluations are personalized according to the patient’s individual genetic and environmental risk factors. The alternative pathway also provides 100% of high risk patients the opportunity to utilize guided bone growth type treatment strategies, if deemed necessary, (as well as environmental factor reduction strategies) to the most beneficial degree possible.
Scoliscore testing and reduction/elimination of environmental factors in the early stage of AIS can finally give us the power to alter the natural course of the condition and honestly tell AIS patients that we are working towards an actual “cure” for the first time.
Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.
Here is a recent paper Dr. James Ogilvie (past president of the SRS and chief medical advisor at Axial Bio-Tech) wrote in regards to the genetic testing and idiopathic scoliosis (IS). The article is only 3 pages without references and really is worth the 5 minutes it will take you to read it.
One day many years from now, we are going to look back and realize that genetic testing for IS was the landmark moment when the standard of care for IS started to be lifted out of the dark ages.
JO_AIS_GeneticTesOglivie.pdf
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I'm sure many of you have heard about the scoliscore genetic profile test from Axial biotech. My test kits have just arrived and I've finished going through all the literature.....overall, I think it could prove to be very useful in the context of early stage scoliosis intervention/treatment.
The parameters for the test are as follows....
-Caucasian decent (They tell me other ethnic profiles will be available soon)
-Ages 9-13 (the will test up to 14 or 15 years of age if the patient hasn't reached skeletal maturity)
-Cobb angle B/W 10-25 degrees
Basically, the test compares the patients genetic markers against 53 other markers that have been identified as high risk from the profile of 1000's of patients whose curves progressed beyond 40 degrees before skeletal maturity. The more marker matches to the profile the higher the risk.
The list price of the test is a little steep ($2,900), but it is readily covered by insurance and they have financial assistance programs for those who qualify.
They claim the test is 99% accurate (seems a little too good to be true) at determining whether or not the curvature will reach surgical threshold (40-45 degrees) while the patient is skeletally immature. That is all it measures. A 15 degree curve could still progress to a 39 degree curve with a low risk on the scoliscore test.
Here is the real pay off in my mind. Patients who have a low or intermediate risk according to scoliscore don't even need to see an orthopedist for their condition. Plus, just think of the anxiety it will reduce for patients and parents alike....AND the x-ray monitoring schedule can be completely re-thought for low/intermediate risk cases vs. high risk cases.
A non-high risk scoliscore patient can be managed entirely with an active rehab program during the condition's early stages to minimize and reduce the risk and effect of the condition on body image/disfigurement.
Early stage scoliosis detection and intervention = The DEATH OF SPINAL BRACING.
Given the fact the bracing is only intended to reduce the "need" for scoliosis surgery (with studies show it has no effect on) and that the 3-D CAT scans are finding the rigid braces probably are actually worsening the rib cage rotation (increasing the body disfigurement)......It would seem the days of back bracing are severely numbered.
Only 1% (the high risk group) should even consider spinal bracing......and even that is most likely a waste of time.
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The first scoliosis brace attempts date back to as early as 400 A.D. and have been applied in every conceivable manner (without success) since then. The first metal scoliosis brace we constructed by Ambrose Pare in 1575 and again, didn’t work. Since then scoliosis brace makers have continued to innovate without success. Hard scoliosis brace, soft scoliosis brace, night time scoliosis brace, flexible scoliosis brace, rotational scoliosis brace, traction scoliosis brace; in the end each attempt has prove to be as feeble as the last (not due to lack of effort, application, or funding).
The main problem with scoliosis brace treatment isn’t application, but rather process. As it turns out, treating a condition that is primarily a neurological condition like it is primarily a skeletal spine problem doesn’t work too well (shocking….sarcasm). This very simple understanding of idiopathic scoliosis makes almost 3500 years of scoliosis brace treatment completely obsolete and practically worthless.
In fact, Axial Bio-Tech (developers of the Scoliscore genetic test) did a comparison study of brace treated and un-treated scoliosis patients and found absolutely no difference between the two groups long-term treatment outcomes, even when compared genetically. Scoliosis brace treatment has absolutely no effect on the natural course of the idiopathic scoliosis condition. Essentially scoliosis brace treatment and doing nothing have exactly the same effect….None.
So why do orthopedic doctors and some mis-guided chiropractors continue to prescribe a worthless and obsolete protocol like scoliosis brace treatment. Well the long answer is “this is the way we do things around here” syndrome and the short answer is financial gain.
Thousands of academic reputations and careers are based on the faulty logic that scoliosis brace treatment works and is effective, so to do an about face and reverse one’s position on the topic (even in the face of over-whelming evidence) would be career suicide for most.
The other motivation (financial gain) is a less complicated explanation, but probably more compelling. Scoliosis brace treatment generate hundreds of millions of dollars worldwide every year and you know what they stay about not finding the solution, when there is good money in prolonging the problem.
So how do we break out of this never-ending cycle of scoliosis brace treatment failure? Well, the good news is that we probably don’t have to; prognostic idiopathic scoliosis technology (Scoliscore genetic testing for idiopathic scoliosis, the scoliosis blood test, ect) will probably spell the death of scoliosis brace treatment all by itself.
These new technologies will provide a “heads up” to parents and patients in regards to their child’s idiopathic scoliosis condition and long before scoliosis brace treatment is indicated, so the scoliosis treatment market will naturally move towards more pro-active scoliosis treatment solutions like the Early Stage Scoliosis Intervention program we feature on this website. In fact, preliminary flowcharts and treatment models that focus on Scoliscore genetic testing for idiopathic scoliosis that completely eliminate scoliosis brace treatment and scoliosis surgery have already been developed and are being tested as you read this right now.
Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.
I'm sure many of you have heard about the scoliscore genetic profile test from Axial biotech. My test kits have just arrived and I've finished going through all the literature.....overall, I think it could prove to be very useful in the context of early stage scoliosis intervention/treatment.
The parameters for the test are as follows....
-Caucasian decent (They tell me other ethnic profiles will be available soon)
-Ages 9-13 (the will test up to 14 or 15 years of age if the patient hasn't reached skeletal maturity)
-Cobb angle B/W 10-25 degrees
Basically, the test compares the patients genetic markers against 53 other markers that have been identified as high risk from the profile of 1000's of patients whose curves progressed beyond 40 degrees before skeletal maturity. The more marker matches to the profile the higher the risk.
The list price of the test is a right in line with other genetic tests ($2,900), but it is readily covered by insurance and they have financial assistance programs for those who qualify.
They claim the test is 99% accurate at determining whether or not the curvature will reach surgical threshold (40-45 degrees) while the patient is skeletally immature. That is all it measures. A 15 degree curve could still progress to a 39 degree curve with a low risk on the scoliscore test.
Here is the real pay off in my mind. Patients who have a low or intermediate risk according to scoliscore don't even need to see an orthopedist for their condition. Plus, just think of the anxiety it will reduce for patients and parents alike....AND the x-ray monitoring schedule can be completely re-thought for low/intermediate risk cases vs. high risk cases.
A non-high risk scoliscore patient can be managed entirely with an active rehab program during the condition's early stages to minimize and reduce the risk and effect of the condition on body image/disfigurement.
Early stage scoliosis detection and intervention = The DEATH OF SCOLIOSIS BRACE TREATMENT.
Only 1% (the high risk group) should even consider spinal bracing......and even that is most likely a waste of time.
So how do we keep Scoliscore from being utilized as a high-tech paperweight?
I must admit, I’m a little taken back by the level of resistance I’m seeing from much of the orthopedic community in regards to the use of the Scoliscore AIS prognostic test and how it will (or actually won’t) effect treatment decisions for early stage scoliosis patients. I’m even left scratching my head after watching the patient testimonial video on the www.scoliscore.com website entitled “Isabelle’s story”.
http://www.scoliscore.com/patient-re...0/Default.aspx
The patient (Isabelle) is diagnosed with early stage scoliosis and isn’t immediately tested with the Scoliscore test. Instead she is placed into the age old “watch & wait” mentality. The doctor only recommends the use of the Scoliscore test AFTER she has experienced a “big curve increase” following a growth spurt! They immediately put her in a rigid brace (again, following the same old AIS treatment protocol) before determining her genetic risk for progression with the Scoliscore test.
The test results come back and she has a Scoliscore of 16 (very low genetic risk for curve progression to a surgical level), which begs the question…..So then why did she experience the “big curve increase” following the growth spurt? I mean, it’s great that she has a low genetic risk for developing a severe curvature (40+ degrees), but the “big curve increase” during the growth spurt was certainly less than optimal or desirable. She obviously has a very high environmental factors risk that is going completely unaddressed (and will continue to be unaddressed in the rigid brace they prescribed to her in the video). Incredibility enough, at the end of the video they in a large part use the genetic risk factor evaluation in the decision to discontinue ANY forum of treatment in Isabelle’s case, so she can go off to summer camp, without the brace (which probably wouldn’t have helped anyway since it doesn’t reduce or eliminate the environmental risk factors that are obviously driving her curve progression to this point), so she can engage in dance and swimming……Two known high risk activities for AIS patients! Ahhh!
This just goes to show that the most incredible technological advancements can be defeated by incompetence or an unwillingness to adapt to change.
I can’t tell you have many conversations I have with colleagues of mine (within the CLEAR Institute even!) and orthopedic scoliosis specialists who have a SERIOUS case of the “that’s the way we do things around here” syndrome in regards to adapting their treatment plans in accordance with the vast advantage the information from the Scoliscore test provides. They look at me and say, “well, it’s certainly nice information to have, but it isn’t going to change my treatment plan in anyway.” WHAT!?! I respond back to them with “so your planning on treating a AIS patient with a Scoliscore of 200 (the highest level) exactly the same as a AIS patient with a Scoliscore of 20 (very low genetic risk)?” A blank stare is the only response I have gotten from anyone to this point.
Think about it in a metaphoric sense. Would you react differently if you saw a child standing 20 feet off the rail road tracks as a train was bearing down on them, than a child standing ON THE TRACKS as the rail rolled towards them? I would certainly hope so. Neither case is ideal, but the two situations certainly warrant different responses.
The Scoliscore AIS prognostic genetic test will serve the patient about as much as a high tech paperweight if it isn’t utilized (in conjunction with evaluation of environmental risk factors…not the end result factors….Aka: Cobb angle) to fundamentally change the patient’s treatment plan and/or treatment options.
I think Helen Keller said it best: “The only thing worse than blindness is a person with no vision.”
The traditional cobb angle directed treatment plan attempts to solve the AIS problem without knowing the genetic risk or environmental risks of the patient, so every patient with similar cobb angles are treated the same reactionary way until it is too late and the curve progresses. That is why we have developed an alternative Scoliscore directed treatment plan in which the treatment plan and follow-up evaluations are personalized according to the patient’s individual genetic and environmental risk factors. The alternative pathway also provides 100% of high risk patients the opportunity to utilize guided bone growth type treatment strategies, if deemed necessary, (as well as environmental factor reduction strategies) to the most beneficial degree possible.
Scoliscore testing and reduction/elimination of environmental factors in the early stage of AIS can finally give us the power to alter the natural course of the condition and honestly tell AIS patients that we are working towards an actual “cure” for the first time.
Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT ASAP.
CLEAR's Interview with Dr. James Ogilvie (Scoliscore)
An Interview with Dr. James Ogilvie, Past President of the Scoliosis Research Society, and Founder & Chief Medical Advisor for Axial BioTech, the Creators of the ScoliScore™ Genetic Prognostic Test for Scoliosis
Dr. James Ogilvie is a board-certified orthopaedic surgeon. In addition to private practice, Dr. Ogilvie is adjunct Professor, Department of Orthopaedic Surgery, at the University of Utah in Salt Lake City and Professor Emeritus, Department of Orthopaedic Surgery, at the University of Minnesota in Minneapolis, MN. He is Staff Surgeon / Attending Staff at Shriners Hospital Intermountain Unit in Salt Lake City.
Dr. Ogilvie earned his Medical Degree at Yale Medical School in New Haven, CT and completed a surgical internship at the University of California, San Francisco. His residency education in orthopaedic surgery was performed at the University of Utah. Dr. Ogilvie advanced his skills and experience through a Spine Fellowship at Rush Presbyterian / St. Luke's Medical Center in Chicago, IL.
He is an active member of many prestigious organizations including the Academic Orthopaedic Society, American Academy of Orthopaedic Surgeons, Scoliosis Research Society, and Society of Military Orthopaedic Surgeons. Dr. Ogilvie served as a Commander in the United States Naval Reserve.
As researcher and prolific author, Dr. Ogilvie's editorship roles are recognized by journals including Spine Journal, Journal of Bone and Joint Surgery, Journal of Military Medicine, and Journal of the American Academy of Orthopaedic Surgeons.
CLEAR Institute:Today we welcome Dr. James Ogilvie, who has generously agreed to share his insight with our readers about genetic prognostic testing for scoliosis, bracing, and innovative approaches to scoliosis treatment. Dr. James, thank you very much for your time!
CI: Please tell us about the ScoliScore™ prognostic test for scoliosis. What led you to create this test, and how do you feel it will impact the way scoliosis is managed today?
James Ogilvie MD: Our initial goal was to identify the 85% of children with mild adolescent idiopathic scoliosis (AIS) who would not progress to the surgical range untreated. The current standard is to monitor everyone with multiple clinic visits and x-rays which are both expensive and present the danger of radiation exposure to growing children.
CI: Is the ScoliScore™ test expensive? Does it hurt? How accurate is it?
JO: The DNA-based test is less expensive than other comparable genetic tests and costs $2950. Our patient assistance program means that unless someone is wealthy they seldom have an out of pocket expense. It is less expensive than unnecessary years of doctor visits and x-rays. It’s a saliva-based test (no blood drawing required), and has been clinically validated to be 98% accurate. For those with a risk score of less than 50 there is less than 1% probability of progression. We have no cases of progression with scores less than 30. There is a caveat that sometimes a misdiagnosis is present and a patient's curve may progress. An MRI is then indicated and we have instances of syringomyelia or other conditions that cause progressive spine deformity.
CI: One of the reasons we at CLEAR Institute are so excited about the ScoliScore™ test is because of the potential it offers for a more efficient, personalized system of scoliosis treatment. What do you feel are some of the problems with the current system of how scoliosis is managed?
JO: The current clinical guidelines cannot identify progressive from non-progressive AIS. DNA testing allows a personalized risk of progression that is unique to each patient.
CI: You’ve published dozens of important research articles in very well-recognized journals. In one of your recent scientific articles, you utilized the potential of the ScoliScore™ test to determine which patients were at a high risk for progression, and compared two groups of patients - braced & non-braced. Your conclusion was that there is no significant difference in the natural history of scoliosis between the two groups. Could you share with us your thoughts about how this study is different than any other study which has been done on bracing in the past? Did the results of this study surprise you?
JO: Rigid bracing has been commonly practiced by spine surgeons for more than 100 years. Unfortunately those studies were unable to risk stratify the enrolled patients. Therefore they observed some that had a high risk of progression and braced some that had less than 1% risk of progression. No definitive answers have come from the current brace studies. Many surgeons have suspected this was the case, but bracing had become the “standard of care” and it was too threatening not to brace young patients.
CI: We’ve heard a great deal about the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) study that is currently being led by Stuart Weinstein, MD, at the University of Iowa, which is the largest NIH-funded clinical trial in the history of orthopaedic pediatrics, and is scheduled for completion this August. What are your thoughts about this study? Do you think patients benefit from bracing?
JO: Without a knowledge of an individual patient’s risk of progression, some patients with little risk are being braced unnecessarily and some who have a very high risk are assigned to the observation arm. In effect, there is one equation with two unknowns, treatment assignment and genetic risk of progression. A single equation with two unknowns cannot be answered.
CI: The roots of bracing as a treatment for scoliosis go back a long ways (as early as 650 AD, Paul of Aegina was bracing scoliosis patients with wooden strips & bandages). What do you see happening in the future for scoliosis braces?
JO: With an understanding of the genetic factors that influence AIS progression and identify an individual’s risk, future spine therapists can challenge the current ineffective treatment routines and innovate on new therapies.
CI: If bracing is found not to be effective, do you think school scoliosis screening programs for scoliosis should be eliminated? How do you think ScoliScore™ will affect the potential benefit of scoliosis screening programs?
JO: Current school screening is not effective. However, early screening in school or a doctor’s visit is necessary to diagnosis AIS in its early stages when non-surgical treatments are more effective.
CI: Many people believe there are barriers to integrated medicine – that is, traditional medicine working hand-in-hand with alternative treatments such as chiropractic. Your presence here today is proof that hope exists for doctors of all specialties to work together for the common good of the patient, and it is greatly appreciated! What do you recognize as the major obstacles that prevent orthopedic surgeons from referring patients with mild scoliosis to a chiropractor?
JO: Health science is not the province of only one discipline. Allopathic medicine is ideally evidence-based. Surgeons will refer appropriate patients to the chiropractic profession, much as we refer patients to orthotists, as scientific evidence is generated that validates non-surgical treatment.
CI: Last March, some of the members of CLEAR Institute, including the founder, Dr. Dennis Woggon, were invited to the headquarters of Axial BioTech in Salt Lake City, Utah, for an opportunity to learn more about the ScoliScore™ test and tour the $19-million dollar facility in person. It made a very positive impression on everyone from CLEAR, and we would like to thank you again for Axial’s warm hospitality at that meeting. It was also an occasion for you to learn more about the methods & protocols developed by CLEAR Institute. What did you think about this new system of scoliosis treatment? Did anything in particular about CLEAR Institute impress you?
JO: I was impressed with two items, first the innovative approach that CLEAR has taken to non-operative AIS treatment is needed. With a realization that bracing is at best not very successful and at worst, not useful at all, innovative physiologic treatment regimes are needed. Secondly, CLEAR has made a commitment to evaluate these new therapies in a manner that will pass scientific scrutiny.
CI: The potential of the ScoliScore™ test to revolutionize research into scoliosis is amazing. For the first time in history, we have a method of identifying which patients are most likely to progress to surgical levels. In your opinion, is it possible that an individual at high risk could undergo a treatment which reduces their chance of progression? In other words, could it be possible to re-test someone after treatment and see a lower ScoliScore™ test result?
JO: It would be unlikely that the human genome will be changed by physical treatments. However, the expression of those genes can be modified.
CI: Dr. Ogilvie, thank you again for donating your time to share your knowledge & wisdom. Do you have any final words for our readers?
JO: DNA prognostic testing is only the beginning of our understanding of AIS genetics. As we learn what those causative genes do we may have even more effective interventions. Thank you for your generosity in letting me introduce genetic science into the treatment of a disorder in which we all have a great interest.
You can learn more about this revolutionary new prognostic test for scoliosis at www.scoliscore.com.
Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT ASAP.
Back Bracing for Scoliosis.
Does it work?
Spinal bracing for Adolescent Idiopathic Scoliosis has NO effect on the natural course of Adolescent Idiopathic Scoliosis (I knew it!)
The creators of the Scoliscore genetic test plotted the results of brace treatment against the expected/predicted genetic course of the condition. Guess what? The two graphs match almost perfectly (see the pic by clicking on the link below), which means spinal bracing doesn't alter the condition in any way, shape, or form. It basically proves that brace treatment is pretty much worthless and does not reduce or eliminate ANY of the environmental factors (forward head posture, loss of normal curve in the neck, hip rotation, ect) that cause AIS when combined with pre-disposing genetic factors. This is EXACTLY why the CLEAR Institute treatment program doesn't recommend invasive, expensive, and ineffective spinal bracing in its treatment programs.
http://www.scoliosisjournal.com/content/4/S2/O59
It should be recognized that this study only used data from North American braces and did not include data from the Spine Cor brace, but I seriously doubt they would perform any differently since the same basic bracing concepts still hold true in those types of braces as well.
Over-correction bracing may produce a "guided growth" type effect via the Hueter-Volkmann principle, but is only achieved through manipulation of secondary adaptations to the condition and cannot be considered working towards a cure. Approximately 1% of genetically pre-disposed AIS patients can and will potentially benefit from this type of approach, but the cost/risk/benefit must be weighted against other guided growth type treatments like vertebral body stapling (VBS). However, VBS seems to be most effective when applied to a skeletally immature spine with a cobb angle of 35 degrees or less. A skeletally immature patient (who is part of the 1% genetically high risk) with a cobb angle greater than 35 degrees probably should be the only patients for which guided growth type bracing should be considered.
Bottom line: For 99% of the non-high risk AIS patients bracing does not change any of the environmental (or genetic) factors that create AIS and therefore has no bearing on the condition's natural course. The entire premise of spinal bracing is fundamentally flawed and any attempts to develop a build off those flawed fundamentals will be flawed by default.
At what point are we going to get our heads out of the sand (or out of other places) and realize that we are doing a major disservice to 99% of scoliosis patients for whom spinal bracing is recommended. It all starts with a major PUSH for earlier & more effective screening, a mass movement towards genetic testing as many AIS kids as possible and genetic risk appropriate early stage scoliosis intervention ASAP.
Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT ASAP.
What role do environmental factors play in scoliosis?
Scoliosis is a complex condition that involves both genetic and environmental factors. The more a patient is genetically pre-disposed to developing the condition the less environmental factors they will need to incur to before developing scoliosis. Of course the opposite is true as well. A patient with a low pre-disposal for genetic factors for scoliosis, but high environmental factors galore may also have the same overall risk of developing the condition and the genetically high risk patient.
We can't change our genes (yet), so we are left with only having the ability to reduce/eliminate the environmental factors that (when combined with genetic factors) cause Adolescent Idiopathic Scoliosis (AIS).
So how much affect do environmental factors have on scoliosis? Well, let's look at it from this perspective.
Approximately 4% of all scoliosis cases chose to have the spinal fusion surgical procedure (and that doesn't include the patients who refuse the procedure) and the Scoliscore genetic test predicts that only 1% of patients should have the genetic pre-disposition to develop a curvature that would reach surgical level.
The conclusion: At least 3% of the 4% of AIS cases going to spinal fusion surgery are due to environmental factors driving the condition, not just genetic pre-disposition.
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