Abstract
BackgroundEarly detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature.MethodsThe study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°.ResultsIn the age groups 6–9, 10–12 and 13–17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, significantly more frequent misdiagnoses (p < 0.05) were related to the lumbar and thoracolumbar (regions) sections of the spine in the groups aged 6–9 and 10–12 for ATI ≥ 7°; while no significant relationship was found at ATI ≥ 5°. For both ATI levels, the most frequent cases of mis- or undiagnosed scoliosis were observed among children with a Cobb angle of 10°-14° (p = 0.004).ConclusionA low predictive ATI value was demonstrated regarding scoliosis detection for the ATI 7° criterion in children aged 6–9 and 10–12 years, particularly for the lumbar and thoracolumbar locations. Adoption of the threshold of ATI 5° in screening tests for children aged 6–12 years, as well as for lower locations of scoliosis, may be more effective in the early detection of scoliosis.Trial registration.This study was approved by the Jan Dlugosz University in Czestochowa Ethics Committee KE-U/7/2021, and conducted under the Declaration of Helsinki.
Highlights
Detection of idiopathic scoliosis is one factor in determining treatment effectiveness
The exclusion criteria were as follows: incomplete data in medical records; previous scoliosis treatment, which may infer with the assessment of scoliosis; congenital disorders, such as shortening of one limb exceeding 2 cm; genetic conditions; neurological diseases related to the locomotor system; cardiovascular diseases; previous injuries or surgeries; neuromuscular conditions; and intellectual disability
The severity of scoliosis was measured using the Cobb angle according to the Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) guidelines [21]
Summary
Detection of idiopathic scoliosis is one factor in determining treatment effectiveness. The aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature. Diagnosis of idiopathic scoliosis (IS) is an important factor determining the effectiveness of treatment [1, 2]. The primary criterion of scoliosis detection in a clinical examination is an assessment of the angle of trunk inclination (ATI) using the Adams test [2,3,4,5]. The person’s sex, family history, biological age, individual dynamics of growth, physique, and geographical region of residence should be considered [11, 15,16,17,18]
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