Welcome to Scoliosis & Biology!

Welcome to my blog, which explores the subject of biology with a key topic in mind: scoliosis. Scoliosis is a human spine abnormality, in which the spine is curved. It usually develops in adolescence, which is referred to as Adolescent Idiopathic Scoliosis. This disorder can be treated in several ways. The most common treatments are bracing and surgery. In bracing, a patient who is usually still growing, is given a back brace to wear for a certain number of hours each day. The brace holds the spine straight and deters it from growing more curved. The surgery for scoliosis is called spinal fusion surgery and is only used in severe cases. If the degree of curvature is so large that it interferes with heart and lung function, surgery is utilized. During the surgery, metal rods are placed around the vertebrae to force it straight and keep it from growing curved. 

My story:

When I was twelve years old I found out that I had developed moderate Adolescent Idiopathic Scoliosis. This disorder has been a challenge I have struggled with since my diagnosis. It has been a social issue, an emotional battle, and a physical discomfort for years. I underwent treatment in the form of a back brace, which was a difficult but successful process. In August 2012 I had my last (hopefully!) X-Ray for scoliosis. Now that I’m done growing, my spine isn’t as much of a problem for me and I will never require a spinal fusion surgery. 

Image

 

An X-Ray of my spine (August 2012) and the back brace I wore freshman and sophomore year of high school! 

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Scientific Articles

This post will share five scientific articles that will demonstrate the process of how science works using the scientific pathways.

Science is a process. It involves observing, questioning, hypothesizing, experimenting, and concluding. This is known as the scientific method, which allows us to prove or disprove theories by means of creating hypotheses, a tentative explanation for something, and finding ways to test them. The articles below will provide information on a particular topic or study in the field of biology and relate it to not only the process of science, but also to my project topic, scoliosis.

Image

(http://sciblogs.co.nz/code-for-life/2013/02/19/describing-science/)

Scientific Article 1: “Giant Bubbles Protect Fish From Scoliosis”

Summary:

Scoliosis, “a spine deformity of unknown cause” affects over 2% of the human population (Torres, 2013). The article examines the non-human angle of scoliosis, particularly on the zebra fish.  Michel Bagnat and colleagues at Duke University Medical Center became interested in the internal structure of the fish and just how it worked. Upon conducting a study, the scientists found that cells within the zebra fish prevent it from developing scoliosis. During the creature’s embryonic phase, a structure called the notochord is formed. The notochord, which is common to many similar species, is “a tube-like structure stretching from head to tail…that serves as a backbone.” The spine later replaces it. The cells within the notochord are where the prevention begins. These cells are chockfull with “huge fluid-filled vacuoles that press against a fibrous elastic wrapping.” These vacuoles are similar in structure, but not function, to the lysosome organelles, which break down cellular waste.

In order to find the true function of the vacuoles, scientists disrupted them, without harming the notochord, in embryonic zebra fish. As the fish grew, “they developed kinks in the spine,” much like human scoliosis, proving that the vacuoles act to cushion the spine during development, keeping it straight and elongated. These findings could lead to more discoveries on human scoliosis and why is occurs.

Topic:

This article has a connection to this week’s topic of cells. The article specifically underlines the importance of a particular cell organelle, the vacuole. The central vacuole is a vital structure in plant cells, but “animal cells can [also] have vacuoles” (Krogh, 2011, p. 83). This article demonstrates that vacuoles can serve an important purpose in animal cells. The vacuole helps to form a straight spine during zebra fish development, diminishing the chances of deformities.

Scientific Pathways:

Exploration and Discovery

Making observations:  Scientists observed unusual tube structures within the cells fish embryos.

Asking questions: Is there a function to these cell structures? What is it?

Sharing data and ideas: Michel Bagnat worked with his colleagues at the university.
Testing Ideas

Expected results and observations: The team expected that the notochord would simply disappear, as it does in humans, and eventually be replaced by the spine.

Actual results/observations: The team realized that the notochord actually serves the important purpose of scoliosis prevention in the zebra fish.

Community Analysis and Feedback

Coming up with new questions/ideas: The scientists wonder how these findings could relate to human scoliosis, its cause, and possibly prevention.

Benefits and Outcomes

Satisfy curiosity: The team was able to find out the function of the notochord, and the cells within, in zebra fish.

Build knowledge: The team now has knowledge of how scoliosis is prevented in an organism other than humans.

References 

Krogh, D. (2011). Biology: A Guide to the Natural World.  San Francisco, CA:

Benjamin Cummings.

Torres, Isabel. (2013). Giant bubbles protect fish from scoliosis. Retrieved September

4, 2013, from http://scienceintheclouds.blogspot.com/2013/03/giant-bubbles-protect-fish-from_14.html

Scientific Article 2: “Cold Laser Therapy” 

Summary:

The article focuses on pain management for scoliosis and other issues (including carpal tunnel syndrome and repetitive stress injury). A new form of treatment has recently been introduced, a safe form of laser therapy. MicroLight Corporation of America, a leader in this technology, has brought this about. During the process, a laser light is focused on the skin, which increases cell metabolism by a process known as photobiosimulation. The newest laser, the ML830, does this without destroying the skin, making it the “non-thermal and non-destructive method for delivering light to deep tissue” solution that scientists were looking for. Patients experienced faster healing and a reduction in pain and inflammation after treatment.

Topic:

This article has a connection to this week’s topic of photosynthesis. In the article, the phototherapy laser process is compared to photosynthesis in plant cells. When the laser provides light to the cells in the human tissue, it is given energy and makes repair of the cells happen in a faster and easier manner. This is much like photosynthesis, “the process by which certain groups of organisms capture energy from sunlight and convert this solar energy into chemical energy,” (Krogh, 2011, p. 142). A plant cell receives energy in the form of light from the sun so that the plant can grow. According to the article, “ The positive effect of photobiostimulation on animal cells is analogous to photosynthesis in plant cells.” This treatment, which has the same core concept as natural photosynthesis, has been highly effective on patients who suffer from muscle pain caused by scoliosis or other disorders.

Scientific Pathways:

Exploration and Discovery

Making observations: Scientists noted how spinal or other deformities as well as modern everyday life can lead to muscle strain, an irritating and distracting issue affecting many people.

Finding inspiration: Scientists wanted to find a way to help these people cope with their pain.

Asking questions: Could there be a way to use lasers in a safe way without harming tissues?

Testing Ideas

Expected results/observations: Scientists expected to find a way to use photobiosimulation safely with the ML830 laser.

Actual results/observations: The therapy worked very well for patients suffering from pain.

Community Analysis and Feedback

Theory building: The theory that the phototherapy works much like photosynthesis in plants is developed.

Coming up with new questions/ideas: There will be new studies done to see if the same therapy will work for other medical issues, such as dental and stress problems.

Benefits and Outcomes

Develop technology: A safe laser technology is developed for deep tissue strain.

Solve everyday problems: Patients who undergo this process for carpal tunnel syndrome, scoliosis, and other ailments are successfully treated.

References

Krogh, D. (2011). Biology: A Guide to the Natural World.  San Francisco, CA:

Benjamin Cummings.

(n.d.). Cold laser therapy. Retrieved September 17, 2013 from

http://www.scoliosisnutty.com/cold-laser.ph

Scientific Article 3: “Gene Associated With Idiopathic Scoliosis Identified”

Summary:

This article discusses Adolescent Idiopathic Scoliosis and its development in humans. Since the disorder is idiopathic, “causes of scoliosis remain largely unknown” (RIKEN, 2013). Dr Ikuyo Kou, Dr Shiro Ikegawa and their team have proposed a genetic explanation. During studies in Japan, the scientists have discovered a link between a certain gene on chromosome 6 that increases susceptibility for scoliosis. This gene, GPR126, leads to abnormal spine growth when it is suppressed. This is the first gene to be linked to human scoliosis.

Topic:

This article has a connection to this week’s topic of evolution, which is “any genetically based phenotypic change in a population of organisms over successive generations” (Krogh, 2011, p. 303). Evolution ties in closely with genes. In the study done for the article, the scientists examined the genotypes of thousands of Japanese individuals, some of who had scoliosis and some of who did not. In evolution, the phenotype is affected by an organism’s environment and its genotype, which is its genetic makeup. In the individuals with scoliosis, their genotype contained a specific gene, GPR126, which led to the deformation of their spines. Although scoliosis doesn’t affect an entire population of organisms, it does affect about 2% of the population. With that in mind, scoliosis has in a way evolved through the human species as it does get passed down through generations.

Scientific Pathways:

Exploration and Discovery:

Making observations: Dr Ikuyo Kou, Dr Shiro Ikegawa and their team note that there is a possible genetic component to Adolescent Idiopathic Scoliosis.

Asking questions: The scientists want to know more about the cause and development of AIS.

Testing Ideas:

Expected results/observations: The scientists expect to see a link between genotypes and scoliosis. They test their ideas by performing research on the genomes of Japanese individuals with and without scoliosis.

Actual results/observations: The scientists indeed discover not only a link, but also the actual gene that is affected.

Community Analysis and Feedback:

Publication: The scientists publish their study in the journal Nature Genetics.

Coming up with new questions/ideas: The scientists conclude that more research must be done to see how the gene increases human AIS susceptibility. They also wonder how this could affect the treatment of scoliosis; perhaps it could provide more treatment options?

Benefits and Outcomes

Satisfy curiosity: The scientists are able to find at least one connection between genetics and the cause and development of scoliosis.

Build knowledge: More information is now available on the cause of scoliosis, making it one step closer to not being such an “idiopathic” disease.

References 

Krogh, D. (2011). Biology: A Guide to the Natural World.  San Francisco, CA:

Benjamin Cummings.

RIKEN (2013, May 12). Gene associated with adolescent idiopathic scoliosis

identified. ScienceDaily. Retrieved October 2, 2013, from http://www.sciencedaily.com/releases/2013/05/130512140943.ht

Scientific Article 4: “Whale With Scoliosis Gets Brace From Seaworld” 

Summary:

            This article is about an event that happened in 2011, when a whale residing in SeaWorld was fitted with a custom back brace after being diagnosed with severe scoliosis. Using the whale’s X-rays and measurements, the brace was made completely customized. The article ends by mentioning that this seemingly positive story may just be a cover-up for SeaWorld to hide their mistreatment of animals. It is noted that being kept in tight quarters may have caused the whale’s scoliosis. 

Topic:

This article relates to this week’s topic of animals. The article answers the question “can animals have scoliosis, just as humans can?” And of course, the answer is yes. Of course, only “vertebrates,” such as a whale, can develop scoliosis. According to the text, the vertebral column is “a flexible column of bones extending from the anterior to posterior end of an animal,” (Krogh, 2011, p. G15). This distinguishes vertebrates from other chordates. Invertebrates, which make up 99% of all animal species, don’t have spines; therefore it wouldn’t be possible for them to develop scoliosis.

Scientific Pathways:

Exploration and Discovery

Making observations: Veterinarians observe scoliosis in a whale at SeaWorld.

Finding inspiration: Veterinarians and administrators at SeaWorld want to help the animal with her condition.

Sharing data and ideas: The veterinarians decide to customize a brace for the whale.

Testing Ideas

Gathering data: Data is collected on how to make the brace from the whale’s measurements and X-rays.

Community Analysis and Feedback

Feedback and peer review: GlobalAnimal.org criticizes SeaWorld for possibly causing the condition in the whale.

Benefits and Outcomes

Develop technology: A scoliosis brace customized for a whale is developed.

Solve everyday problems: A whale is treated for her condition.

References 

Krogh, D. (2011). Biology: A Guide to the Natural World.  San Francisco, CA:

Benjamin Cummings.

(2011). Whale with scoliosis gets brace from SeaWorld. Retrieved October 30, 2013

            from

http://theanimalrescuesite.greatergood.com/clickToGive/ars/article/Whale-with- scoliosis-gets-brace-from-SeaWorld098

 Scientific Article 5: “Endemic Scoliosis of Lambs in Astrakhan Region” 

Summary:

This article outlines a study done in 1968 on lambs in the then Soviet Union region. The study focused on marsh disease and salt sickness in the animals, which has been previously referred to as “enzootic marasmus.” According to the article, this disease causes the death of 10 to 50% of the lambs in the flock. The disease originates in the soil, when there are high levels of boron and molybdenum, and low levels of copper and cobalt. The disease is frequently accompanied by congenital (the lambs were born with it) scoliosis, muscular atrophy, and other abnormalities. The study recognizes that on one farm, a poisonous plant called Anabasis anaphylla constituted 15% of the pasture’s plants. However, it was concluded that it wasn’t the plants that caused the scoliosis and other abnormalities through testing done with the anabasis. It was determined that the cause was from mineral-deficient rations fed to the sheep.

Topic:

This article relates to this week’s topic of plants. In the study, it was proposed that the poisonous plants in the sheep’s pasture might have been the cause of the scoliosis. The anabasis plant would be considered an angiosperm because it flowers. According to the text, “angiosperms are defined by an aspect of their anatomy: their seeds are surrounded by the tissue called fruit” (Krogh, 2011, p. 448). Obviously, it was concluded that they were not in fact the cause, but it still relates the topic of plants with my topic, scoliosis.

Scientific Pathways:

Exploration and Discovery

Making observations: The scientists observed the percentage of sheep that were getting sick and dying because of the marsh disease. They also observed that scoliosis correlated with the disease.

Finding inspiration: The scientists want to know the cause ad possible treatment/cure of the disease for the wellbeing of the flocks.

Asking questions: Could the poisonous plants in the pastures be the cause?

Testing Ideas

Gathering data: The scientists performed experiments involving the plants.

Expected results/observations: The scientists expected to find a link between the plants and the disease.

Actual results/observations: There was no link between the plants and the disease.

Community Analysis and Feedback

Publication: The study was published in the book Endemicheskie Bolezni Zhivotnykh.

Theory building: New theories are built on causes of scoliosis and connections between scoliosis and other diseases.

Benefits and Outcomes

            Build knowledge: Knowledge is gained on what causes, and what doesn’t cause, the marsh disease.

Solve everyday problems: Now that the origin of the disease is known, it will be easier to treat the animals affected.

References

Krogh, D. (2011). Biology: A Guide to the Natural World.  San Francisco, CA:

Benjamin Cummings.

Kolesov, A. M.Ryakhovskii, P. K.Kolesova, N. I. (1968). Endemic scoliosis of lambs

in Astrakhan region. Retrieved November 13, 2013 from http://www.cabdirect.org/abstracts/19692203027.html;jsessionid=3F2AAF4CA900943209D38DCEB9A93414

Evolution & Scoliosis

Evolution, as it pertains to biology, is a gradual modification of living things over time. This change happens through populations of organisms. Evolution is the most important concept in biology because all living things are by-products of evolution.

The process takes place through population genetics, when allele frequencies change. This can happen in numerous ways. These are known as the Four Forces of Evolution:

1. Mutations – When a new genetic variation is created in a gene pool.

2. Gene flow – When organisms move into or out of a population. Both the population they leave and the one they enter can change.

3. Genetic drift – A random change in allele frequencies that occurs in a small population.

4. Natural selection – When there are differences in fitnesses among members of a population. Some individuals will pass more genes to the next generation, which causes allele frequencies to change.

In this entry, I will be relating my project topic, Scoliosis, to the concept of evolution. I have three aspects to share as a result of my findings.

1. A Gene Associated Idiopathic Scoliosis Identified

During previous research, I came across a study by Japanese scientists that linked the cause of scoliosis with a genetic explanation. This experiment showed that a certain gene, GPR126 on chromosome 6, increases susceptibility to scoliosis when present. This is the first gene to ever be linked with scoliosis. More research is required in order to prove the connection. 

This study of genes associated with scoliosis closely ties in with evolution, since evolution is a study of genes.

For more information on scoliosis and genes, please visit my “Scientific Articles” post: https://scoliosisandbiology.wordpress.com/2013/12/08/scientific-articles/ (Article #3)

2. Evolution Of The Human Spine

Scoliosis is a disorder of the human spine. If we look more closely at the evolution of the spine itself, we can see why abnormalities and disorders are actually quite common. According to an article on Sciencemag.org, “evolution doesn’t ‘design’ anything…it works slowly on the genes and traits it has on hand, to jerry-rig animals’ and humans body plans to changing habitats and demands.” The article discusses several issues of the human body’s anatomic design that can cause problems for some people. One example of this is the structure of the spine. The human spine, which is essentially the anchor of the body, has an “S” shape. Due to this natural curvature, any weight imposed on the spine (weight of head, pressure from carrying things, or impact sports such as gymnastics or football) can lead to problems, such as general back pain or slipped discs. 

This article begs the question, could scoliosis be a by-product of poor evolutionary construction? Though the article doesn’t mention scoliosis, one theory on the cause or worsening of the abnormality is too much pressure placed on the spine (for example, young children carrying heavy backpacks), which causes a curvature.

3. Scoliosis In An Orangutan Experiment

I decided to look into further detail on the issue of scoliosis and evolution by researching if apes, who are in theory the ancestor of humans, ever develop the condition.

I came across an experiment done in the UK on scoliosis in an orangutan, a member of the great ape family. This orangutan was diagnosed with scoliosis, but in the conclusion of the study it was noted that the diagnosis was unlikely. From the background data, we can see that no case of scoliosis has ever been reported in an ape. Also the study found some factors that were atypical, including that the ape was male and the curve was short.

Although more research would be needed to confirm, we can see that scoliosis is not nearly as common in apes as it is in humans. This makes the connection to evolution that it was most likely something that occurred during the evolution of apes to human, providing more evidence to the second point made in this post.

For more information on scoliosis in animals, please visit my “Scientific Articles” post: https://scoliosisandbiology.wordpress.com/2013/12/08/scientific-articles/ (Articles # 1&4)
References
Gibbons, A. (2013). Human evolution: pain came with gain. Science Now. Retrieved
December 7, 2013, from http://news.sciencemag.org/evolution/2013/02/human-evolution-gain-came-pain
Krogh, D. (2011). Biology: A Guide to the Natural World.  San Francisco, CA:
Benjamin Cummings.
Imperial College School of Medicine. (2003). Scoliosis in an orangutan. PubMed.gov.
Retrieved December 5, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/12671370
RIKEN (2013, May 12). Gene associated with adolescent idiopathic scoliosis
identified. ScienceDaily. Retrieved October 2, 2013, from http://www.sciencedaily.com/releases/2013/05/130512140943.htm

Project Lab

Title:

Patients’ Preferences for Scoliosis Brace Treatment: A Discrete Choice Experiment.

Image

(http://www.pseudohypoparathyroidism.com/battling-scoliosis/)

Introduction: Scoliosis is an abnormal curvature of the spine. This disorder, which usually originates in adolescence, generally has two treatment options: an invasive surgery known as spinal fusion, or a back brace. The back brace, which comes in many different styles/types, is designed to deter the spinal curve from further growth so that surgery isn’t necessary. This experiment was done in Rotterdam, The Netherlands by the Department of Public Health Erasmus University Medical Center.  It tested what requirements would be needed for Scoliosis patients to consider brace treatment as an alternative for surgery. It investigated which factors were most important to patients in regard to bracing and how these factors would affect their decision whether to engage in brace treatment or not.

Methods:

1. Contact 197 patients who had already undergone treatment for scoliosis. (135 gave informed consent).

2. Design a discrete choice experiment by creating a type of questionnaire simulation that makes it easy for participants to give answers easily and honestly. Consider factors that are of importance to brace-wearing patients.

3. Instruct patients to complete experiment by choosing between hypothetical brace treatment profiles that offer differing attributes. These attributes include: effectiveness (will it prevent surgery? By how much?), visibility (how noticeable will the brace be? Is it unflattering?), discomfort (will wearing the brace hurt or cause discomfort? How comfortable does the brace feel?), and treatment duration (How long will the brace be worn?)

4. Analyze results. Consider the response rate of participants as well as the range of percentages related to patient compliance.

5. Analyze subgroup data. Consider the same factors.

Results:

  • Response rate = 86% (116/153)
  • Attributes proven to be important for patients’ choice to undergo bracing treatment = All (effectiveness, visibility, discomfort, treatment duration)
  • All subgroups would undergo bracing treatment if it reduced surgery risk by an average of 53% for a three year duration of treatment. Range of 32% to 74%.

Screen Shot 2013-12-04 at 10.38.45 PM      Screen Shot 2013-12-04 at 10.55.06 PM

Discussion: Through the experiment, it was made clear that patients are only willing to undergo bracing as a treatment option if it decreases the likelihood of surgery by a sizable amount. All factors that were put into consideration (effectiveness, visibility, discomfort, and treatment duration) proved to be important to patients. This demonstrates that the issue of scoliosis bracing is a highly complex one with many facets. Through these results, the experiment has also shown that doctors must take these aspects into consideration in order to increase patient’s compliance.

Scientific Pathways:

Exploration and Discovery

Asking questions: The scientists wondered how different factors affect patient’s compliance during brace treatment.

Finding Inspiration: The scientists were inspired by the many people, especially young people, who struggle with their scoliosis and treatment, and wanted to help make things easier.

Testing Ideas

Gathering data: The discrete choice experiment was conducted on participants.

Interpreting data: The data showed that the likelihood of the treatment avoiding surgery increased patient compliance.

Community Analysis and Feedback

Publication: The study was published on PubMed.gov.

Theory Building: The theory that patient compliance is directly related to a high chance of success is built upon.

Benefits and Outcomes

Build knowledge: Knowledge is gained on patient compliance in regard to bracing as well as which factors prove to be important when considering treatment options.

Satisfy curiosity: The scientists satisfy their curiosity concerning patient’s preferences during bracing.

References

Department of Public Health, Erasmus, MC. (2010). Patients’ preferences for scoliosis brace

treatment: a discrete choice experiment. PubMed.gov. Retrieved October 29, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/20023605