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Old 04-10-2011, 05:34 PM
Dr Scoliosis Dr Scoliosis is offline
 
Join Date: Apr 2009
Posts: 187
Default Re: Harrington Rods in for over 20 years

Robbo,

In answer to your question regarding the genetics of scoliosis, the following points can be made.
  1. Adolescent idiopathic scoliosis (AIS) has a strong genetic predisposition. For a woman with a scoliosis greater than 15 degrees, the risk of a daughter developing the condition is 25%. The risk in a son is much less. As your scoliosis developed as a much younger child, it would be classified as early onset or juvenile scoliosis. This is a much rarer condition. Whilst the genetics of this disorder are not defined, the likelihood of a parent passing it on to a child is far lower than in AIS.
  2. A number of genes have been detected that seem to play a role in the development of AIS. There are preliminary studies looking into those genes' significance. At this early stage, testing is being done on girls with scoliosis to see if carrying one or more of these genes can predict whether their curve will worsen or not with remaining growth. This can guide treatment, such as bracing.
  3. There is no test currently available that can be done either on an embryo or on a child that can determine if they will develop scoliosis. In any case, carrying certain "scoliosis genes" does not mean that someone will develop a curve. For example, in studies looking at identical twins (who are genetically identical), if one twin has a scoliosis, the chance of the other sibling developing it is between 13% and 73%. There are other factors at work that may trigger the condition. There are many theories. None give a complete explanation.
  4. Given that there is scoliosis on both your and your husband's side of the family, the chances of the condition occurring in your children are higher. As stated above, in AIS the risk to a daughter is around 25% and to a son approximately 5%. However, even if a curve develops in adolescence, the chance of needing treatment (brace or surgery) is low - between 1 in 100 to 1 in 1000. In families facing these concerns, I recommend to parents that they check their children every 6 to 12 months with the Forward Bend Test. If they see a rib prominence, then they should be seen by their local doctor. X-rays and referral to a specialist may be needed. There is an Australia-wide directory of specialists on our website.
  5. Treatment for very young children still relies on bracing and/or casting. Milwaukee braces are rarely used these days. Surgery is indicated if other treatment has not been effective. In children under 10, various telescopic rod systems have been developed that allow the spine to continue growing. In children over that age, spinal fusion, using dual rods and multiple anchors to the spine are used. These have many advantages over the Harrington system. Surgery for scoliosis remains complex but less of an ordeal than it was in previous decades.
  6. Whilst you seem to be functioning well, with minimal symptoms, I would recommend seeing a scoliosis surgeon so your current situation could be assessed. X-rays would be helpful to look at the fused section of your spine and overall alignment. The surgeon would also be able to discuss the concerns you have raised here.
Hope this has been helpful.

Dr Scoliosis