Genetic vs Environmental factors in idiopathic scoliosis The new ScoliScore™ test is answering a WHOLE bunch of questions about the genetic origin of AIS......it really is a game changer.....But, as with any new significant leap forward in technology is does also raise some new questions. It has been long recognized the idiopathic scoliosis is a combination of genetic and environmental factors (nature vs. nurture type argument), but no one has been able to determine how much of each was playing a role in the condition itself. Basically, we have to unknown variables, so anyone with a basic understanding of algebra can tell you that you cant solve an equation with 2 unknowns. As it turns out, the genetic risk of developing scoliosis in each individual varies greatly as do the environmental factors, so the topic of this thread can not necessarily be applied to the individual, but the same cannot be said about applying it to a large population of scoliosis patients. Let explain. We know that approximately 4% of scoliosis patients (or their legal guardian) elect to have scoliosis surgery for their condition.....and many more whose curvatures do reach the phantom surgical threshold (40-45 degrees) do not chose to have the surgery, so the true number of scoliosis patients whose curvatures reach surgical threshold could be as high as 6-8%! (Educated guess?) So what am I getting at? Well, the ScoliScore only classifies 1% of people with AIS as genetically high risk for developing a severe curvature.....that means at least 3% (and an unknown % of patients on the high side if you include those whose curves progressed to 40+ degrees but refused the surgery) of the patients whom elect to have surgery for their condition can contribute their curve progression to environmental factors, not primarily genetic factors. Interesting huh? The role of environmental factors in scoliosis may be a more important contributing factor in curve progression in the 99% of non-high genetic risk patients. This means innovative active rehab therapies that actually change many of the environmental factors that contribute to curve progression (forward head posture, loss of sagittal spine curves, hip rotation, just to name a few) could have the effect of changing the natural course of this condition despite the genetic propensity of the patient.
Posted on: Sat, 07 Jun 2014 19:10:00 +0000
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