A Cost-Effective and Innovative Screening Approach, for Idiopathic Scoliosis in Girls, Before their Skeletal Maturity

Abstract

Background: Adolescent idiopathic scoliosis is a three dimensional deformity of the spine with no identifiable causes. Early detection of scoliosis prevents progress into severe scoliosis in a growing child before the skeletal maturity. There are two critical stages in the development of body posture during the school years. These are the age when a child goes to school and the attainment of puberty. The growing children may show accelerated or retarded periods of growth at certain stages giving rise to a rapid or slow progression curve. In girls the pre-pubertal growth spurt falls in the age range of 10-13 years. Objective: To identify high risk idiopathic scoliotic curve in pre pubertal school girls using non-invasive technique, Adams forward bending test (FBT), Scoliometer and I phone app. Method: The present descriptive cross sectional study was conducted in pre pubertal girls aged 10-13 years enrolled in both the aided and unaided schools of Dakshana Kannada (Karnataka-India). All the willing students (n=600) were screened using physical examination (Adams forward bend test), Scoliometer device and Scoliometer application. Results: A total of 24/600 of the pre pubertal girls were found to have asymmetrical back when physically examined in standing position with FBT, resulting in right thoracic level curve 30 , 50 ,70 . All 4% of the high risk identifiable participants had a reading >50 when screened using the Scoliometer device and I phone App i.e. similar results were obtained. Body mass index (BMI) was increased in some of the positive cases. Conclusion: The study found that the inclination degree of 5° or greater is more acceptable in early detection of scoliotic curve before the skeletal maturity of the spine. This predictive value was satisfactory to advocate the school screening programme in early detection of scoliosis.