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New Test for Scoliosis (Curvature of the Spine) in Kids

Posted Aug 14 2010 6:32am

I have cared for many kids who have to either wear braces or have surgery for scoliosis. When a curvature of the spine is not diagnosed in a child it can lead to serious medical problems later on and also to an inability to stand erect. Wearing a brace can be uncomfortable and also impair normal physical activity. So it was good news to read about a new genetic test that could perdict whether a curvature would become increasingly severe. The test would only be of use I think in adolescent or early onset scoliosis. Many of the patients I cared for had scoliosis in connection with their neuromuscular disorders. Kids with spinal muscular atrophy and Duchenne dystrophy are particularly prone to scoliosis and the test would be of no value in these disorders. Kids with congenital myopathies and Friedrich's ataxia also  may develop scoliosis. These patients need to be carefully watched by an orthopedist and a specialist in neuromuscular disorders. Kids with spinal muscular atrophy respond very well to surgery for scoliosis if the orthopedic surgeon has had extensive experience  with the surgery and the disease. The most important thing after the surgery is performed is that the patient be allowed to sit up as soon as possible and physical therapy started. One of my patients had surgery by an orthopedist who technically was fine but had no knowledge of spinal atrophy. He left the little girl in bed and refused to allow her to sit up or have physical therapy. It changed the girl's life.

The new scoliosis test was devised by Axial Biotech and is being used in fifty U.S. spine centers. A sample of saliva is needed for the test which should make it easy to have done. However, as with all laboratory tests I would still want a pediatric orthopedist to follow a child with scoliosis on a regular basis. I think relying too much on a laboratory test can be risky and a progressive scoliosis is not something to be taken lightly. The test could perhaps prevent multiple X-rays of the back which would be a real plus.

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