Abstract
This editorial article initiates the school scoliosis screening thematic series of the Scoliosis journal. The various issues on screening policies are discussed; clinical and practical recommendations of setting up school screening programs are also described.
Highlights
School scoliosis screening (SSS) aims to detect back trunk asymmetry in children at risk to develop progressive scoliosis
In USA, scoliosis screening has been a major commitment of orthopaedic surgeons since the early 1960s
In Lyon, France, at the 2013 annual meeting of the Scoliosis Research Society, Dr Stuart Weinstein reported the results of the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAiST)
Summary
School scoliosis screening (SSS) aims to detect back trunk asymmetry in children at risk to develop progressive scoliosis. The value of a screening examination for scoliosis has been debated due in part to inconclusive evidence of the success of non-operative treatment for scoliosis This is no longer true as the evidence from the BrAIST study established the effectiveness of bracing as early, non-operative care which can reduce the number of patients who progress to surgery, a potential cost saving for the health care system and of great benefit to patients. As Bunnell characteristically states, [23], 'it has become apparent from many reports that, there is a significant correlation between clinical deformity and radiographic measurement, the standard deviation is so high that it is not possible to reliably predict the degree of curvature from surface topography in any given patient by any technique' This described phenomenon is the cause of over-referrals from SSS programs generating a burden of care and adding to the ongoing controversy over the application of SSS. Author details 1Director of the Trauma and Orthopaedic Department, “Tzanio” General Hospital of Piraeus, Piraeus, Greece. 2Harvard Medical School, Attending Spinal Surgeon Boston Children Hospital, Boston, USA. 3University of Montreal, Attending Spinal Surgeon, Ste-Justine Mother and Child University Hospital, Montreal, Canada. 4University of Missouri Kansas City, Spine Section Chief, Children’s Mercy Hospital, Kansas City, USA. 5Department of Paediatric Orthopaedics, University of Medical Sciences, Poznan, Poland. 6Department of Orthopedic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Tokyo, Japan
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