Genetic Profile as a Predictor of Decompensation and Spontaneous Correction in Patients Treated with Spine Fusion for Adolescent Idiopathic Scoliosis
Matthew Cunningham, MD
Benjamin Bjerke-Kroll, MD
The use of the genetic screening is a new tool for the treatment of adolescent idiopathic scoliosis. This has so far been useful in predicting which patients with mild to moderate scoliosis will progress to require surgical treatment. The utility of genetics-based testing has not been used to predict post-operative progression. As such, we have been unable to find evidence of genetics-based testing to predict risk of post-operative progression. A genetics-based test should be constant over the course of a patient’s lifetime. Therefore, we will be able to study risk of post-operative progression more accurately and efficiently in a retrospective fashion, in particular by identifying those patients who progress to further deformity despite definitive treatment. Genetic testing has only been studied with respect to its relationship to overall magnitude of progression. There has been, to date, no discussion of its association with curve type or its relationship to further progression after fusion. For example, vertebra level selection in posterior spine fusion is a controversial topic, which will likely elicit differing opinions as long as the procedure is performed. Often the lumbar curve will not be touched during a spinal fusion, but the current algorithms used to fuse or not fuse (a so-called “selective thoracic fusion”) involve only classic clinical criteria. The student will perform genetic testing on pediatric patients who have already undergone spinal fusion as part of a historical database. The student will also enroll patients for further study in using the genetic test as part of future surgical decision-making. The student will have the opportunity to present his/her research to the pediatric orthopedic surgery department, as well as scrub in the operating room during spine surgery.
This position has been filled.