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Thread: DNA test for scoliosis

  1. #16
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    Quote Originally Posted by Ballet Mom View Post
    Mamamax,

    As far as I'm concerned, this guy needs to prove his own method scientifically for others to see. He's just trying to find any thing he can to try and validate his belief that bracing doesn't work and therefore a modified Makita jig saw, and a medieval looking scoliosis chair with vibration, obviously would do the trick instead.

    What's he going to do with the Scolioscore results, rev up the Makita and jiggle the patient for additional hours?
    Well, here's my thinking - taking the messenger out of the picture - I wanted to look at the information provided in the kit. I think that information is important when trying to determine how much weight should be given to it in making treatment choices. Couldn't find the info anywhere else.

    As for what anyone will do with the testing - I imagine (but do not know) that results will probably be fed into a database for future updating?

    As for an opinion regarding said messenger - I will say that using the word "cure" in the same sentence with any scoliosis treatment is, well - at the very least, not using one's best judgment. And I do not agree that this test can in any way negate the value of bracing.

    The information in the kit however - really is valuable to us all - because, it shows, in general, that it is limited in scope.
    Last edited by mamamax; 11-14-2009 at 09:13 PM.

  2. #17
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    Quote Originally Posted by Ballet Mom View Post
    Mamamax,

    As far as I'm concerned, this guy needs to prove his own method scientifically for others to see. He's just trying to find any thing he can to try and validate his belief that bracing doesn't work and therefore a modified Makita jig saw, and a medieval looking scoliosis chair with vibration, obviously would do the trick instead.

    What's he going to do with the Scolioscore results, rev up the Makita and jiggle the patient for additional hours?
    Post of the month nomination.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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    "We are all African."

  3. #18
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    Quote Originally Posted by concerned dad View Post
    Wouldnt identical twins be expected to have identical scolioscores?
    Well as we discussed before, identical twins can differ within some small boundaries for various reasons. They can differ quite a lot in the case of different X genes dominating (Lyonization) to the point where one has a dread genetic disease and the other doesn't although they are identical. But for the most part, yes.

    Since we know (or think we know.... let's say we have evidence to suggest) that the incidence of progressive scoliosis in both identical twins is not common (at least, not a given), well, wouldnt that sort of take away from the validity of the scolioscore test?
    The concordance of scoliosis in identical twins is up over 90% when you throw out single, non-reproducible GIGO Danish studies as far as I know. That can not be used to discount Scoliscore but rather supports it. Still you wouldn't expect it to be so high necessarily... I did bounce of the reasoning about not being able to use identical twins in studying midline disorders off our surgeon and he agreed. So that is more evidence that the Danish twins study didn't get adequate peer review and probably shouldn't have been published to go on a confuse little bunnies out there.

    There are reasons that most published results are false... we are seeing some of those reasons now.

    Also, I dont think this takes away from the "germ" theory. I think Dingo posited that the "germ" is likely common and that genetic make-up may make some folks more susceptable (to the commonplace "germ").
    Where is the evidence for that postulate though?

    What I find interesting, is how they (Scolioscore folks) plotted from their data two curves. Seperating the braced and unbraced kids. If bracing "worked" (lets say, "changed the natural course of progression") we would have expected to see a difference in the curves. In fact, we saw the braced cohort higher on the curve (rather than lower). (This is a SOSORT paper I linked in the Axial Biotech thread). That always baffled me and originally I dismissed it as thought these scolioscore guys were on the wrong track. Since my thinking on this has evolved.... I wonder just what it all means. I think they came up with evidence (NOT proof) that bracing does not alter the natural history. Is it valid (or am I even interpreting it correctly), I dont know. But it is a small bit of data addressing the question from a totally different angle.
    I have come across the suggestion that bracing can be worse than nothing presumably due to loss of muscle tone. This graph would be consistent with that suggestion though there is no real evidence to support the claim.

    Here is a link to the scolioscore paper
    To "spell out" what I am talking about here. Look at their figure 1 (zoom in on it).
    If someone had a Scolioscore of 100, the graph suggests that they have a HIGHER liklihood of progressing if they are braced. Wierd, no?
    That graph needs error bars. With error bars, you would probably conclude the two lines were not different and that if they did another cohort, you might not see the braced line above the unbraced. That is the error bars likely completely overlap. Mere chance that it fell out that way is my guess.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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    "We are all African."

  4. #19
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    Imagine that... FixScoliosis using the Scoliscore test. How can insurance companies justify reimbursing him for the test, when there's no proof that he can do anything with the results?

    It's really pissing me off that reknowned surgeons are routinely having reimbursement for scoliosis surgeries denied (and then approved when challenged), but chiropractors can get a Scolioscore test reimbursed. Ridiculous. It shouldn't surprise us that spine centers around the country have to have more insurance billers on staff than surgeons.

    --Linda

  5. #20
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    Quote Originally Posted by hdugger View Post
    I suspect that insurance companies pay for the test because it decreases the number of children they have to pay to brace (since, presumably, a child with a low score will chose not to be braced.)
    Maybe. Or, maybe, they'll use the test to justify bracing kids with 10 degree curves.

  6. #21
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    Scoliscore

    Pooka1

    Because body type is under complete genetic control (and not germ control), wouldn't that observed result... a good correlation between body type and scoliosis almost completely undermine the germ theory of scoliosis?
    Scoliosis appears to be caused by a neurological dysfunction. Whether it's caused by heredity or environment is not relevant to what might protect a child from curve progression. It seems likely that muscular body types protect a child from curve progression for purely mechanical reasons.

    As for the Scoliscore it wouldn't surprise me if some of the genes it's designed to detect relate to body type.

  7. #22
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    identical scores

    Concerned Dad

    Wouldnt identical twins be expected to have identical scolioscores?
    Bingo! These genes are only risk factors for curve progression.

    2007 Adolescent idiopathic scoliosis in twins: a population-based survey.

    Pairwise, the concordance rate was 0.13 for monozygotic and zero for dizygotic twin pairs; proband-wise concordance was 0.25 for monozygotic and zero for dizygotic pairs. The concordance of monozygotic and dizygotic pairs was significantly different (P < 0.05). CONCLUSION: We have found evidence for a genetic etiology in AIS, but the risk of developing scoliosis in 1 twin whose other twin has scoliosis is smaller than believed up until now.
    BTW if anyone knows of a larger study with a similarly random sample please post it. For that matter please post a link to any twin study if you've got one. My guess is that any study showing a 90% concordance rate is going to be significantly smaller and less random than this one.

    If someone had a Scolioscore of 100, the graph suggests that they have a HIGHER liklihood of progressing if they are braced.
    That may be a very relevant discovery once scientists understand why. There might be 1,000 good explanations. Maybe one is that children who have a high risk of progression tend to have the least muscle mass. Bracing might lead to muscle atrophy which in these children only makes the problem worse.
    Last edited by Dingo; 11-14-2009 at 11:04 PM.

  8. #23
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    Quote Originally Posted by Dingo View Post
    It seems likely that muscular body types protect a child from curve progression for purely mechanical reasons.
    If that was true then why is there zero long term evidence that exercise can permanently stop progression or permanently reduce a curve (after stopping the exercise)?

    I mean even Betty 14 never claimed that for exercise and that is saying something.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  9. #24
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    Quote Originally Posted by Dingo View Post
    BTW if anyone knows of a larger study with a similarly random sample please post it. For that matter please post a link to any twin study if you've got one. My guess is that any study showing a 90% concordance rate is going to be significantly smaller and less random than this one.
    Any study withOUT self identification of zygosity and scoliosis is BY DEFINITION better than the Danish study.

    And there is good reason not to use monozygous twins to study scoliosis (or any midline disorder) in the first place. This is clearly a case of inadequate peer review for many reasons.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  10. #25
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    Trt

    Pooka1

    If that was true then why is there zero long term evidence that exercise can permanently stop progression or permanently reduce a curve (after stopping the exercise)?
    Torso Rotation strength training is a new discovery. In 20 years I'm sure there will be dozens of papers on it.

    Any study withOUT self identification of zygosity and scoliosis is BY DEFINITION better than the Danish study.
    Like I said before if you've got a link to a twin study please post it.
    Last edited by Dingo; 11-14-2009 at 11:14 PM.

  11. #26
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    Quote Originally Posted by Dingo View Post
    Torso Rotation strength training[/URL] is a new discovery. In 20 years I'm sure there will be many papers on it.
    That's what Schroth was saying, 20, 40 and 60 years ago. The world is still waiting.

    And even some people who have studied it say they can't find bilateral asymmetries in muscle which is the underlying claim.

    Like I said before if you've got a link to a twin study please post it.
    You are avoiding the following issues:

    1. there are reasons monozygotic twins are not good test subjects for scoliosis etiology.

    2. there are reasons this type of study is very likely to be false.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  12. #27
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    92% concordance rate

    1997: Idiopathic scoliosis in twins

    We investigated 21 pairs of twins for zygosity and idiopathic scoliosis. DNA fingerprinting confirmed that 13 pairs were monozygotic and eight were dizygotic. There was concordance for idiopathic scoliosis in 92.3% of monozygotic and 62.5% of dizygotic twins.

    Of the 12 pairs of monozygotic twins concordant for idiopathic scoliosis, six showed discordant curve patterns but eight had differences in Cobb angle of less than 10. Seven of the ten pairs of monozygotic twins had similar back shapes.

    Our findings suggest that there is a genetic factor in the aetiology of idiopathic scoliosis; they also indicate that there is a genetic factor in both the severity of the curve and the general shape of the back.
    The sample size is very small and I don't believe it was chosen randomly. Looking through the study I can't find a mention of how the sample was chosen.

    In 2004 Moreau released a study on Melatonin Signaling Dysfunction and Scoliosis.
    Melatonin Signaling Dysfunction in Adolescent Idiopathic Scoliosis

    His sample consisted of 41 children who had severe Scoliosis that required fusion. These children were undoubtably highly, genetically susceptible to Scoliosis. Even so only about a third had a relative with any type of known spinal disorder (scroll to page 2). If Scoliosis was pure heredity that number would have approached 100% and most children would have had several 1st, 2nd or 3rd degree relatives with severe Scoliosis.
    Last edited by Dingo; 11-14-2009 at 11:45 PM.

  13. #28
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    Quote Originally Posted by Dingo View Post
    1997: [URL="http://www.jbjs.org.uk/cgi/reprint/80-B/2/212.pdf"]
    The sample size is very small and I don't believe it was chosen randomly. Looking through the study I can't find a mention of how the sample was chosen.
    Ask yourself why the Danish study, being so large as you continually point out, did NOT have the expected percentage of people with scoliosis or the expected split between mono- and di- zygotic twins (IIRC).

    That alone and all by itself casts doubt on self reported zygosity and incidence of scoliosis.

    Stephen Pinker recently mentioned the study about most research results are false. I am NOT going to make an argument from authority here.

    I am simply asking you to consider that you are missing a BOATLOAD of knowledge NECESSARY to interpret these studies. And I am further suggesting even researches are missing important variables in their analysis.

    And finally I am pointing out that you casually dismiss realities like that study showing most results are false with some offhand comment that you simply aren't interested in that little fact. Well when people like Stephen Pinker are interested in some little fact, I suggest it might be significant. No guarantees though.

    Scoliosis is worse than rocket science in terms of complexity. Far, far worse. It is proving to be a very tough nut to crack and no amount of searching the literature is necessarily going to yield the answer for at least a few reasons.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  14. #29
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    worse than rocket science

    Pooka1

    Scoliosis is worse than rocket science in terms of complexity. Far, far worse. It is proving to be a very tough nut to crack and no amount of searching the literature is necessarily going to yield the answer for at least a few reasons.
    In the meantime please post links to any twin studies you run across.

  15. #30
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    Quote Originally Posted by Dingo View Post
    Pooka1



    In the meantime please post links to any twin studies you run across.
    We are clearly not communicating.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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