Part 1

Pruijs, J. E. H.; Keessen, W; Meer, R.B. Van Der; Wieringen, J. C. van; Hageman, M. A. P. E.

doi:10.1097/00007632-199204000-00009

Cited by 34 publications

(8 citation statements)

References 0 publications

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“…A Meta-analysis of the clinical effectiveness of school scoliosis screening citing 34 studies reported the pooled referral rate to radiography of 5% [38]. It is now widely agreed upon that referral rates should be in the range of 2% to 3% in school screening for scoliosis [20,39,41,42]. In the present screening study the referral rate was 1.5% based on a scoliometer reading of 7° which may reflect that screening was conducted on 12 -year- old children only.…”

Section: Referral Ratesmentioning

confidence: 99%

“…Objections to scoliosis screening are largely based on the low prevalence rate of clinically significant scoliosis, the inverse relationship of sensitivity and specificity in the screening process, high rates of false-positive cases, high inter-observer variations and the costs involved mainly because of over-referrals [14,15]. The challenge in scoliosis screening programmes therefore is to decrease the sensitivity to an acceptable rate of false positive results and to increase specificity in order to reduce over-referrals thereby reducing costs for the patients and society.…”

Section: Introductionmentioning

confidence: 99%

“…It has been recommended that an inclination above 7° or ATR > 1 cm is a positive screening sign and should be followed-up with an X-ray for further evaluation of the curve [19]. …”

Section: Introductionmentioning

confidence: 99%

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School screening and point prevalence of adolescent idiopathic scoliosis in 4000 Norwegian children aged 12 years

Adobor

Rimeslåtten²,

Steen

et al. 2011

Scoliosis

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BackgroundSchool screening for adolescent idiopathic scoliosis (AIS) is discussed. The aim of the present study was to describe the point prevalence of AIS and to evaluate the effectiveness of school screening in 12-year- old children.MethodsCommunity nurses and physical therapists in the Southern Health region of Norway including about 12000 school children aged 12 years were invited to participate. All participating community nurses and physical therapists fulfilled an educational course to improve their knowledge about AIS and learn the screening procedure including the Adam Forward Bending Test and measurement of gibbus using a scoliometer.ResultsSub-regions including 4000 school children participated. The prevalence of idiopathic scoliosis defined as a positive Adam Forward Bending Test, gibbus > 7° and primary major curve on radiographs > 10°, was 0.55%. Five children (0.13%) had a major curve > 20°. Bracing was not indicated in any child; all children were post menarche; four had Risser sign of 4, and one with Risser 1 did not have curve progression > 5° at later follow-up. In one of these 5 children however, the major curve progressed to 45° within 7 months after screening and the girl was operated.ConclusionThe point prevalence of AIS in 12- year old children is in agreement or slightly lower than previous studies. The screening model employed demonstrates acceptable sensitivity and specificity and low referral rates. Screening at the age of 12 years only was not effective for detecting patients with indication for brace treatment.

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Section: Referral Ratesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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School screening and point prevalence of adolescent idiopathic scoliosis in 4000 Norwegian children aged 12 years

Adobor

Rimeslåtten²,

Steen

et al. 2011

Scoliosis

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“…Adolescent idiopathic scoliosis (AIS) is the most common form and is often associated with rapid growth [4]. The prevalence rate of idiopathic scoliosis as proposed by the Scoliosis Research Society (Cobb angle >10°) [6] is reported from 0.5% to 3%, but only 5% of these patients have curve progression to >30° [7,8]. We recently performed screening in 4000 twelve years old Norwegian children and found a 0.55% point prevalence of AIS [9].…”

Section: Introductionmentioning

confidence: 99%

“…Screening for scoliosis allows for early detection and has in addition, provided valuable knowledge about prevalence, aetiology and the natural history [32,33]. However, there are objections to scoliosis screening based largely on the low specificity of the screening test and the costs involved because of over-referrals [8,34,35]. In our recently published screening program, we found a specificity of 0.99 and a positive predictive value of 0.37 [9].…”

Section: Introductionmentioning

confidence: 99%

Scoliosis detection, patient characteristics, referral patterns and treatment in the absence of a screening program in Norway

et al. 2012

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BackgroundEarly diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed.ObjectivesTo describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003–2011, when there was no screening and to compare treatment modalities to the period 1976–1988 when screening was performed.MethodsPatient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003–2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976–1988.ResultsWe registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003–2011. There were 644 (86%) girls and 108 (14%) boys. Mean age at detection was 14.6 (7–19) years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38° (10°-95°). About 40% had a major curve >40°. Seventy-one percent were detected by patients, close relatives, and friends. Orthopaedic surgeons referred 61% of the patients. The mean duration from detection to the first consultation was 20(0–27) months. The proportion of the average number of patients braced each year was 68% during the period with screening compared to 38% in the period without screening, while the proportion for those operated was 32% and 62%, respectively ( p=0.002, OR 3.5, (95%CI 1.6 to 7.5).ConclusionIn the absence of scoliosis screening, lay persons most often detect scoliosis. Many patients presented with a mean Cobb angle approaching the upper limit for brace treatment indications. The frequency of brace treatment has been reduced and surgery is increased during the recent period without screening compared with the period in the past when screening was still conducted.

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