Other points in the talks that I though were interesting:
1. The genetic data largely agree with the Lonstein and Carlson (1984) empirical/observational data about the rate of progression increasing as the angle increases (linear at small angles and exponential at large angles). That is consistent with a genetic control on eventual angle achieved.
2. Some 80% of patients based on school screenings are low risk and will never progress. This means ANY treatment on low angles will appear to be at least 80% effective. Clear and others exploit this fact with unsuspecting bunnies who don't know this.
3. Of these "low risk" low Scoliscore patients, > 99% won't progress to > 40*. But as we have seen recently, some experienced surgeons are telling people that it isn't unusual that curves as low as the low to mid 30s* at maturity will progress to surgery territory even in young adults. And indeed we have seen several testimonials to that effect on the forum. So the true useful question may be how many progress to some angle below 40* wherein a large fraction of those patients will never progress to surgery territory. As it stands now, this cutoff (<40*) may be of relatively little use.
4. Non AIS people are related back at the 24th generation but AIS cases are related back to the 9th generation. This would seem to be very strong evidence for genetic control although I don't know if doing this work in Utah with a history of polygamy has completely biased the sample. I wish they did that in a state with a more rational history.
5. The data are biased at the low end (very few cases less than 20*) and biased at the high end (didn't pass along data of folks who made it to ~40* but didn't progress to surgery at that time). That will affect the conclusions.
6. Suken A. Shah is in the running for most devastatingly handsome orthopedic surgeon.
1. The genetic data largely agree with the Lonstein and Carlson (1984) empirical/observational data about the rate of progression increasing as the angle increases (linear at small angles and exponential at large angles). That is consistent with a genetic control on eventual angle achieved.
2. Some 80% of patients based on school screenings are low risk and will never progress. This means ANY treatment on low angles will appear to be at least 80% effective. Clear and others exploit this fact with unsuspecting bunnies who don't know this.
3. Of these "low risk" low Scoliscore patients, > 99% won't progress to > 40*. But as we have seen recently, some experienced surgeons are telling people that it isn't unusual that curves as low as the low to mid 30s* at maturity will progress to surgery territory even in young adults. And indeed we have seen several testimonials to that effect on the forum. So the true useful question may be how many progress to some angle below 40* wherein a large fraction of those patients will never progress to surgery territory. As it stands now, this cutoff (<40*) may be of relatively little use.
4. Non AIS people are related back at the 24th generation but AIS cases are related back to the 9th generation. This would seem to be very strong evidence for genetic control although I don't know if doing this work in Utah with a history of polygamy has completely biased the sample. I wish they did that in a state with a more rational history.
5. The data are biased at the low end (very few cases less than 20*) and biased at the high end (didn't pass along data of folks who made it to ~40* but didn't progress to surgery at that time). That will affect the conclusions.
6. Suken A. Shah is in the running for most devastatingly handsome orthopedic surgeon.
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