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    DNA Test Predicts Scoliosis Progression

    Genetic Markers Help Predict Low-Risk Patients, but Test Has Its Limits

    Scoliosis Progression Test: Practical Points

    The test isn't a screening test, Ward tells WebMD, but a way to predict which children who already have scoliosis are at low risk of progressing to severe curvatures.

    For those who are found to be at low risk, he says, experts would typically advise less intense follow-up, ''maybe once a year." They probably wouldn't need as many X-rays as those with a higher score, he says.

    The intermediate-risk group needs specialist care, as does the high-risk group, and more intensive follow-up, he says.

    The test can only be used in white patients, Ward says, as that is the only ethnic group with enough affected children to measure the test's accuracy, despite the researchers' efforts to recruit other ethnic groups for testing.

    If patients pay totally out of pocket, the test is expensive -- about $2,950, Ward says. But he says for patients with insurance, the out-of-pocket cost is typically $20 or less. And for indigent patients, the test can be obtained for free, he says.

    The test is regulated under the federal Clinical Laboratory Improvement Amendments and doesn't require premarketing clearance by the FDA.

    Ward says about 450 centers offer the test.

    Scoliosis Test Not Perfect

    Jeffrey Neustadt, MD, a Tampa Bay, Fla., orthopedic surgeon and affiliate associate professor of orthopedic surgery at the University of South Florida in Tampa, sees pros and cons to the new test.

    "It's really exciting work," he tells WebMD. But, he adds, "It's very expensive. Even if it's covered by insurance, it's still an expense."

    Like most tests, it's not perfect. "If you are one of those patients with a low number, you can be pretty confident that it is not going to progress, but you can't be 100% sure of that."

    Neustadt says the most difficult case to predict is an immature patient with an intermediate-degree curve. "Fortunately, there are not that many [who fit that description]," he says.

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