SOSORT consensus paper: school screening for scoliosis. Where are we today?

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Abstract

This report is the SOSORT Consensus Paper on School Screening for Scoliosis discussed at the 4 ^thInternational Conference on Conservative Management of Spinal Deformities, presented by SOSORT, on May 2007. The objectives were numerous, 1) the inclusion of the existing information on the issue, 2) the analysis and discussion of the responses by the meeting attendees to the twenty six questions of the questionnaire, 3) the impact of screening on frequency of surgical treatment and of its discontinuation, 4) the reasons why these programs must be continued, 5) the evolving aim of School Screening for Scoliosis and 6) recommendations for improvement of the procedure.

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Adolescent idiopathic scoliosis: natural history and long term treatment effects

Marc Asher, Douglas C Burton (2006)

Adolescent idiopathic scoliosis is a lifetime, probably systemic condition of unknown cause, resulting in a spinal curve or curves of ten degrees or more in about 2.5% of most populations. However, in only about 0.25% does the curve progress to the point that treatment is warranted. Untreated, adolescent idiopathic scoliosis does not increase mortality rate, even though on rare occasions it can progress to the >100° range and cause premature death. The rate of shortness of breath is not increased, although patients with 50° curves at maturity or 80° curves during adulthood are at increased risk of developing shortness of breath. Compared to non-scoliotic controls, most patients with untreated adolescent idiopathic scoliosis function at or near normal levels. They do have increased pain prevalence and may or may not have increased pain severity. Self-image is often decreased. Mental health is usually not affected. Social function, including marriage and childbearing may be affected, but only at the threshold of relatively larger curves. Non-operative treatment consists of bracing for curves of 25° to 35° or 40° in patients with one to two years or more of growth remaining. Curve progression of ≥ 6° is 20 to 40% more likely with observation than with bracing. Operative treatment consists of instrumentation and arthrodesis to realign and stabilize the most affected portion of the spine. Lasting curve improvement of approximately 40% is usually achieved. In the most completely studied series to date, at 20 to 28 years follow-up both braced and operated patients had similar, significant, and clinically meaningful reduced function and increased pain compared to non-scoliotic controls. However, their function and pain scores were much closer to normal than patient groups with other, more serious conditions. Risks associated with treatment include temporary decrease in self-image in braced patients. Operated patients face the usual risks of major surgery, a 6 to 29% chance of requiring re-operation, and the remote possibility of developing a pain management problem. Knowledge of adolescent idiopathic scoliosis natural history and long-term treatment effects is and will always remain somewhat incomplete. However, enough is know to provide patients and parents the information needed to make informed decisions about management options.

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Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society.

A L Nachemson, Mark Peterson (1995)

In a prospective study by the Scoliosis Research Society, 286 girls who had adolescent idiopathic scoliosis, a thoracic or thoracolumbar curve of 25 to 35 degrees, and a mean age of twelve years and seven months (range, ten to fifteen years) were followed to determine the effect of treatment with observation only (129 patients), an underarm plastic brace (111 patients), and nighttime surface electrical stimulation (forty-six patients). Thirty-nine patients were lost to follow-up, leaving 247 (86 per cent) who were followed until maturity or who were dropped from the study because of failure of the assigned treatment. The end point of failure of treatment was defined as an increase in the curve of at least 6 degrees, from the time of the first roentgenogram, on two consecutive roentgenograms. As determined with use of this end point, treatment with a brace failed in seventeen of the 111 patients; observation only, in fifty-eight of the 129 patients; and electrical stimulation, in twenty-two of the forty-six patients. According to survivorship analysis, treatment with a brace was associated with a success rate of 74 per cent (95 per cent confidence interval, 52 to 84) at four years; observation only, with a success rate of 34 per cent (95 per cent confidence interval, 16 to 49); and electrical stimulation, with a success rate of 33 per cent (95 per cent confidence interval, 12 to 60).(ABSTRACT TRUNCATED AT 250 WORDS)

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The periodic health examination. Canadian Task Force on the Periodic Health Examination.

WO Spitzer (1979)

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Journal

Journal ID (nlm-ta): Scoliosis

Title: Scoliosis

Publisher: BioMed Central

ISSN (Electronic): 1748-7161

Publication date Collection: 2007

Publication date (Electronic): 26 November 2007

Volume: 2

Page: 17

Affiliations

[1 ]Orthopaedic Department, "Thriasio" General Hospital, G. Gennimata Av. 19600, Magoula, Attica, Greece

[2 ]PT Practice, New York, USA

[3 ]ISICO (Italian Scientific Spine Institute), Milan, Italy

[4 ]President & CEO, National Scoliosis Foundation (NSF), Boston, USA

[5 ]Department of Orthopaedic Surgery, Saitama MedicalCenter, Saitama Medical University, 1981 Kamodatsujido, Kawagoe, Saitama 350-8550, Japan

[6 ]University of Arizona, Tucson AZ 85721, USA

[7 ]Instituto Èlena Salvá, Barcelona, Spain

[8 ]Asklepios Katharina Schroth Spinal Deformities Rehabilitation Centre, Bad Sobernheim, Germany

[9 ]University of Medical Sciences, Poznan, Poland

[10 ]Bpt physiotherapist specialist in treatment of spinal deformities, Moshe Dayan st. 18 Modiin, 71700, Israel

[11 ]pt physiotherapist specialist in treatment of spinal deformities, Moshe Dayan st. 18 Modiin, 71700, Israel

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Publisher ID: 1748-7161-2-17

DOI: 10.1186/1748-7161-2-17

PMC ID: 2228277

PubMed ID: 18039374

SO-VID: e165eb22-17ed-4db1-976c-6731ec1bb7b1

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

SOSORT consensus paper: school screening for scoliosis. Where are we today?

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Most cited references 332

Adolescent idiopathic scoliosis: natural history and long term treatment effects

Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society.

The periodic health examination. Canadian Task Force on the Periodic Health Examination.

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