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Open Access Highly Accessed Review

Screening for adolescent idiopathic scoliosis: an information statement by the scoliosis research society international task force

Hubert Labelle1*, Stephens B Richards23, Marinus De Kleuver4, Theodoros B Grivas5, Keith D K Luk6, Hee Kit Wong7, John Thometz8, Marie Beauséjour9, Isabelle Turgeon9 and Daniel Y T Fong10

Author Affiliations

1 Orthopedic Division, Sainte-Justine University Hospital, University of Montreal, Montreal, Canada

2 Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, USA

3 Department of Orthopaedic Surgery, University of Texas-Southwestern, Dallas, USA

4 Department of Orthopedics, VU University Medical center, Amsterdam, the Netherlands and Sint Maartenskliniek, Nijmegen, Amsterdam, the Netherlands

5 Orthopaedic and Trauma Department, Tzanio” General Hospital of Piraeus, Piraeus, Athens, Greece

6 Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, Hong-Kong, China

7 Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

8 Department of Orthopaedic Surgery, Children's Hospital of Wisconsin, Milwaukee, USA

9 Research Center, Sainte-Justine University Hospital, University of Montreal, Montreal, Canada

10 School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong SAR, Hong-Kong, China

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Scoliosis 2013, 8:17  doi:10.1186/1748-7161-8-17

Published: 31 October 2013

Abstract

Background

Routine screening of scoliosis is a controversial subject and screening efforts vary greatly around the world.

Methods

Consensus was sought among an international group of experts (seven spine surgeons and one clinical epidemiologist) using a modified Delphi approach. The consensus achieved was based on careful analysis of a recent critical review of the literature on scoliosis screening, performed using a conceptual framework of analysis focusing on five main dimensions: technical, clinical, program, cost and treatment effectiveness.

Findings

A consensus was obtained in all five dimensions of analysis, resulting in 10 statements and recommendations. In summary, there is scientific evidence to support the value of scoliosis screening with respect to technical efficacy, clinical, program and treatment effectiveness, but there insufficient evidence to make a statement with respect to cost effectiveness. Scoliosis screening should be aimed at identifying suspected cases of scoliosis that will be referred for diagnostic evaluation and confirmed, or ruled out, with a clinically significant scoliosis. The scoliometer is currently the best tool available for scoliosis screening and there is moderate evidence to recommend referral with values between 5 degrees and 7 degrees. There is moderate evidence that scoliosis screening allows for detection and referral of patients at an earlier stage of the clinical course, and there is low evidence suggesting that scoliosis patients detected by screening are less likely to need surgery than those who did not have screening. There is strong evidence to support treatment by bracing.

Interpretation

This information statement by an expert panel supports scoliosis screening in 4 of the 5 domains studied, using a framework of analysis which includes all of the World Health Organisation criteria for a valid screening procedure.