title: A Genetic Test Predicts Providence Brace Success for Adolescent Idiopathic Scoliosis When Failure Is Defined as Progression to >45 Degrees.
abstract: METHODS
  Retrospective cohort.
  
  
  OBJECTIVE
  To determine whether a genetic test is associated with successful Providence bracing for adolescent idiopathic scoliosis (AIS).
  
  
  BACKGROUND
  Genetic factors have been defined that predict the risk of progression of AIS in a polygenic fashion. From these data, a commercially available genetic test, ScoliScore, was developed. It is now used in clinical practice for counseling and to guide clinical management. Bracing is a mainstay of treatment for AIS. Large efforts have been made recently to reduce potential confounding across studies of different braces; however, none of these have considered genetics as a potential confounder. In particular, ScoliScore has not been evaluated in a population undergoing bracing.
  
  
  METHODS
  We conducted a retrospective cohort study in which we identified a population of AIS patients who were initiated with Providence bracing and followed over time. Although these patients did not necessarily fit the commercial indications for ScoliScore, we contacted the patients and obtained a saliva sample from each for genetic analysis. We then tested whether ScoliScore correlated with the outcome of their bracing therapy.
  
  
  RESULTS
  We were able to contact and invite 25 eligible subjects, of whom 16 (64.0%) returned samples for laboratory analysis. Patients were followed for an average of 2.3 years (range, 1.1-4 y) after initiation of the Providence brace. Eight patients (50.0%) progressed to >45 degrees, whereas the other 8 patients (50.0%) did not. The mean ScoliScore among those who progressed to >45 degrees was higher than that among those who did not (176 vs. 112, P=0.030).
  
  
  CONCLUSIONS
  We demonstrate that a genetic test correlates with bracing outcome. It may be appropriate for future bracing studies to include analysis of genetic predisposition to limit potential confounding.
authors.affiliation: Yale School of Medicine, New Haven, CT.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Bohl
authors.forename: Connor J
authors.initials: CJ
authors.lastname: Telles
authors.forename: Ferrin K
authors.initials: FK
authors.lastname: Ruiz
authors.forename: Raghav
authors.initials: R
authors.lastname: Badrinath
authors.forename: Peter A
authors.initials: PA
authors.lastname: DeLuca
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Grauer
mesh_terms: D000293:Adolescent; D001915:Braces; D002648:Child; D018450:Disease Progression; D005260:Female; D005820:Genetic Testing; D006801:Humans; D016014:Linear Models; D008297:Male; D012600:Scoliosis / Q000628:therapy*; D017211:Treatment Failure