Aligning Alyssa's Spine: Spit Determines Scoliosis Risk

More than half a million visits are made to doctors' offices each year to evaluate and treat spine curvatures.

Most common in adolescents between 10 and 15 is scoliosis which can mean excruciating pain or death. But now, doctors have a way to figure out a patient's risk without guessing or over testing.

Alyssa smith loves staying active.

"I like doing dives and jumps and flips," says Alyssa Smith who has scoliosis.

But scoliosis could threaten that.

"She was fine last year,” explains Alyssa’s mother Andrea Smith. “And then she had a physical this year and she was at 20 degrees, 21 degrees."

It could get worse. It did for her mom, Andrea.

"When I hit my growth spurt at 13, the curve excelled, it went just over 70 degrees," says Andrea Smith.

At 13 she had surgery to fix it. Now a saliva test is being used to predict how severe Alyssa's curve will be.

"We may be able to use novel treatments or start earlier bracing to prevent her progression to surgery," explains Dr. Suken A. Shah at Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE.

It's called SCOLISCORE. Doctor Suken Shah says it's more than 98 percent accurate. The test uses DNA from saliva to determine scoliosis risk.

"It eliminates all the inefficiency in medical care that we currently have,” says Dr. Shah. “The test prevents overtreatment, over x-ray, bringing down the cost of medicine, to those patients that actually need it."

No matter what the result, Alyssa says she'll get through it.

"Just keep strong and don't worry about it," says Alyssa Smith.

Also to keep doing what kids do.

SCOLISCORE screens for 53 genetic markers to determine risk. Doctors know the test works for the genetic markers in Caucasian children. A test for Asian and African American children is being developed.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: Aligning Alyssa's Spine: Spit Determines Scoliosis Risk
REPORT: MB # 3525

BACKGROUND: Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis. (Source: Mayo Clinic)

SIGNS: Signs and symptoms of scoliosis may include uneven shoulders, one shoulder blade that appears more prominent than the other, uneven waist, one hip higher than the other. If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing. (Source: Mayo Clinic)

DIAGNOSIS: The doctor will initially take a detailed medical history and may ask questions about recent growth. During the physical exam, your doctor may have you stand and then bend forward from the waist, with arms hanging loosely, to see if one side of the rib cage is more prominent than the other. Your doctor may also perform a neurological exam to check for muscle weakness, numbness, and abnormal reflexes. Plain X-rays can confirm the diagnosis of scoliosis and reveal the severity of the spinal curvature. If a doctor suspects that an underlying condition - such as a tumor - is causing the scoliosis, he or she may recommend additional imaging tests, including magnetic resonance imaging (MRI), computerized tomography (CT), or a bone scan. (Source: Mayo Clinic)

NEW TECHNOLOGY: Until now, there was no way to predict how bad the scoliosis could get. Dr. Suken Shah at A.I. duPont Hospital for Children says there's now a quick and easy way to better predict the future of scoliosis patients. It's a saliva based DNA scoliosis test called SCOLISCORE. The SCOLISCORE Test is performed by collecting a saliva sample during a physician's office visit. The sample is then sent to a laboratory for analysis. Within two to three weeks of the laboratory receiving the sample, the SCOLISCORE Test report form will be sent to your child's physician. The SCOLISCORE Test assigns a numerical value (between 1 and 200) to the likelihood of curve progression based on your child's DNA and current Cobb angle. The physician can then use this information, combined with other clinical factors, to determine a personalized treatment plan for your child. Scores 1-50 means that there's a 99% chance of the spinal curve not progressing to a severe curve. (Source: Scoliscore.com)

FOR MORE INFORMATION, PLEASE CONTACT:

Steve Maurer
Spine and Scoliosis Center
(302) 651-5012
smaurer@nemours.org


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