Lately, the Scoliosis (and the financial) worlds have been abuzz with news about The ScoliScore AIS Prognostic Test, which is, according to the website www.scoliscore.com, “the first clinically validated and highly accurate prognostic test for AIS curve progression.” This is pretty amazing news – it can literally change the path that children and their families face when being diagnosed with Adolescent Idiopathic Scoliosis. But, is this a test that we should really put our money, hopes, and futures on? I did some digging and offer you some of my research tidbits, as well as my opinion.
I will start by saying that the ScoliScore, in its current state, will do nothing to help either of my children with their treatment plan. This test is a genetic test, performed by a simple collection of saliva, that will give a numerical value on a patient’s likelihood (based on 53 genetic markers) of having his or her curve progress into the surgical level by the time he or she reaches spinal maturity. However, in its current state, the test only works for Caucasian children between the ages of 9 and 13, who are diagnosed with Adolescent Idiopathic Scoliosis (AIS) and have mild curves (between 10 and 24 degrees Cobb Angle). Both of my children were diagnosed much younger than 9 (therefore, their diagnosis is Juvenile Idiopathic Scoliosis) AND my daughter’s curve has been above 50 degrees for a couple years, so we are already beyond the “not knowing” stage – we KNOW that her curve be bad because it already is. However, if your child does have AIS and is Caucasian (and meets the other parameters), the test might help you map a course of action for your child’s treatment plan.
As I mentioned before, the ScoliScore has been in the business press quite a bit as well, mainly because Transgenomic, Inc is acquiring the global rights to Axial Biotech’s ScoliScore for $4.4 Million. See the article in Business Wire The test itself is pretty pricey (around $2,600), but is covered by most insurances. This article also has some helpful data regarding the percentage of people who may be able to benefit from this test: “Each year, 100,000 children between the ages of 9 and 12 present to physicians with a mild AIS curve ≥10 degrees. Approximately 2-4 percent will eventually experience curve progression necessitating an instrumented fusion procedure. This means that approximately 96,000-98,000 of these newly diagnosed patients will not progress to a curve requiring instrumented fusion. As a result of the inability to predict which patients will require surgical intervention and which will not, a large majority of patients undergo medical and radiographic monitoring that, with the use of ScoliScore™, may not be required.” Unnecessary x-rays can contribute to other health conditions, like cancer, so it is important to minimize their use. However, the test is so new that many people don’t feel comfortable enough to base their health decisions on its accuracy. And, just because a curve hasn’t reached surgical level, does not mean it is not significant. 45-50 degree Cobb Angle curves still create deformity and pain in adults. So, suggesting that a patient do NOTHING is not, in my opinion, a good course of action, even if his or her ScoliScore indicates they won’t progress to surgical level.
The best benefit I see to using the ScoliScore test is to help a patient determine if they can get by with less aggressive bracing strategies and/or limit the frequency of x-ray testing. And, of course, to bring peace of mind to all involved. But, I still feel it is important to stay on top of the curve with some sort of preventative intervention, such as the Tornado Suit and ARC3D approach that Dr. Morningstar employs, the Pettibon or Clear system of therapy, or the Spinecor, etc. There are other therapies that may also be useful to a patient, but it is important that patients do not use this test as an excuse to sit idly by and allow Scoliosis to progress too far. We have enough of the “wait and see” mentality in this country when it comes to Scoliosis, so I fear this test may push patients along that same course of action. As a Mother, though, it sure would make me sleep better at night if I knew with 99% accuracy that my children’s curves would stay under surgical level. So, if you are considering this test, and your insurance will cover it, it seems like a good piece of information to have in your pocket. However, I would urge you to continue to seek proactive ways to keep the Scoliosis at bay, no matter what the score reads.