Current Success, Future Promise in Scoliosis Research

by HSS on the Move
Scoli before after 610 2

Yesterday we shared a Q-and-A on the history of scoliosis treatment at HSS with Dr. David B. Levine. Dr. Levine was chief of Scoliosis Surgery at HSS from 1967 to 1994 and is director of alumni affairs and chair of the HSS Archives Committee. Today we look ahead toward emerging research in the prevention and treatment of this debilitating condition.

Since the first Harrington rod surgery was performed at HSS in 1963, rod materials and technologies have advanced to allow patients to recover from surgery faster and without post-operative casts. While scoliosis surgeons embrace innovations that help patients resume their lives with minimal interruption, “we are cautious about new technologies and techniques until they have a track record for success,” says HSS spine surgeon and basic scientist Dr. Matthew Cunningham.

Future Surgical Trends

As technology continues to develop, advances in minimally invasive surgeries may ultimately make spinal fusions more tolerable, and surgical methods that do not require fusions at all may emerge. In addition, improved bracing and promising developments in physical therapy may prevent the need for surgery in some cases. These new surgical techniques are currently being evaluated.

The Promise of Genetics

One of the most significant recent advances in scoliosis is the development of genetic testing. There has been dramatic development in identifying gene mutations that correlate with scoliosis. Despite the fact that the exact cause of the type of scoliosis seen in 70 percent of children with scoliosis (“idiopathic scoliosis”) remains unknown, there is now a first-generation commercial genetic test that allows physicians to identify children at low, intermediate and severe risk for curve progression. This information helps physicians to provide appropriate preventive care. As these genetic tests improve, the ability to intervene with non-operative treatments early on will improve as well. Ultimately, early detection may help prevent the relentless scoliosis curve progression that makes surgery necessary. “It would be great value to have the ability to intervene early and prevent the problems that lead to the need for surgery,” says Dr. Cunningham.

Emerging Research at HSS

HSS physician-scientists are developing new technologies that may ultimately reduce the need for surgery in people with scoliosis and other spine conditions. Surgeons and scientists are using gene therapy to develop a new non-surgical spinal fusion technique that may replace spinal fusion surgery with an injection of genes to the spinal disc, causing the disc tissue to turn into bone. In certain situations this might be able to eliminate surgery altogether. Early diagnosis and treatment of scoliosis is important because severe scoliosis may lead to heart and lung failure if left untreated. Even more moderate cases can lead to physical restriction following surgical treatment, fueling the desire to prevent progression and avoid surgery. HSS physicians continue to use both surgical and non-surgical techniques to treat scoliosis.

Matthew E. Cunningham, M.D., Ph.D, is an orthopedic surgeon at the Spine Care Institute at Hospital for Special Surgery. Dr. Cunningham has clinical interest in thoracic and lumbar spine care, including spinal deformity (scoliosis, flatback, kyphosis, and spondylolisthesis) for adult and pediatric patients, and degenerative problems (stenosis, herniated discs, arthritis, instability) in adults. In consideration of each and every patient, he focuses on the discovery and refinement of less-invasive, less-painful, and less-disruptive ways to correct spinal pathology. 

Topics: Featured, Orthopedics
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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

Comments

Nancy R Nager says:

I have a 12 years daughter who has scoliosis she”s using a brace for 1 year I would like to have another opinion

HSS on the Move says:

Hi Nancy, If you would like to see a physician here at HSS, please contact our Physician Referral Service at +1.877.606.1555 or https://www.hss.edu/secure/prs-appointment-request.asp?pageid=6463.

franzen,t says:

Those of us united globally living with Klippel-Feil syndrome (KFS) NEED Dr”s to research, those knowledgeable and willing to learn and care for our rare disease. We need you. We hope Dr. Matthew Cunningham, Dr. Darren Lebl, and Dr. Oheneba Boachie-Adjei will consider and take on leading this field of research and help and care . We need understanding and a path for care from infancy through adulthood. We all are suffering. Many of us deal with scoliosis, instability, DDD, etc.

Judith Pincus says:

I am a former Dr. Cobb patient. I entered HSS in the spring of 1963. My parents had sought far and wide for a surgeon they trusted.
I was put into the body cast with the turnbuckle etc.I still have a protrusion and curve, but, have led an active, pain free life, having a son naturally at 37, I am about to turn 65.

HSS on the Move says:

Hi Judith, thank you for sharing your story! We are so glad to hear about your success!

franzen,t says:

I hope someone at HSS can answer my comments/?’s of July 24, and Sept. 28th. I see you’ve replied to someone’s Oct. 5 comment 5 days later.

Also – I cannot pull up any info. on the cervical spine syposium with Dr. Lebl and Dr. Cunninham that was held in May I believe. The Klippel-Feil Alliance and it’s world-wide audience of person’s living with KFS would be interested in the insights provided by this symposium.

PJ says:

If scoliosis surgery is recommended for your child, choose a surgeon with expertise, experience, and a medical center with a pediatric intensive care unit.

HSS on the Move says:

Hi PJ, thank you for your input!

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