Scoliosis Screening Should Make The Grade In Schools

Main Category: Bones / Orthopaedics
Article Date: 17 Jan 2008 - 4:00 PDT

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School screening may be the best tool in getting pre-teens with scoliosis early treatment. "Early screening does pick up some scoliosis in the early stages, but it is controversial because some feel it is not cost effective. That sends a message to society that it is not important to look at our children's spines. We feel it is important to catch the disease early," says Dr. Michael Vitale who co-authored an informational statement about screening for scoliosis in adolescents, published in the January, 2008 issue of the Journal of Bone and Joint Surgery. Dr. Vitale is the Director of Pediatric Spine Surgery at the Morgan Stanley Children's Hospital of New York-Presbyterian and a fellow of the American Academy of Orthopaedic Surgeons.

Scoliosis is the abnormal curvature of the spine and while it can run in families, the cause is not known. The disease usually is not physically painful, but it can be emotionally painful, striking more girls than boys during those socially awkward pre-teen years. For many people screening during middle school years seems a natural way to identify the disease early.

Screening for scoliosis is relatively easy. A trained professional does a quick back test on a student. The screener looks at a child's spine for any signs of a curvature. A normal spine looks like a straight "I". A spine with scoliosis looks more like an "S" or "C." If a curve is confirmed the student is referred to a doctor for further testing. If caught early a small curvature of the spine can be monitored and corrected with a brace. However if left too long a larger curvature may develop and require surgery.

The argument against screening in schools may be as simple as money. About half the states currently require and pay for adolescents to get screened for the disease. Some students may be misidentified during screening as possible scoliosis patients. Once a child is identified in the screening process, further costs would be necessary to confirm if they actually have scoliosis. Those costs may include:

- Primary care visit
- Orthopaedic surgeon visit
- X-ray

But the cost of surgery would be far greater.

The problem, as Dr. Vitale sees it is, "Scoliosis can develop quickly in some children. This can be missed unless we make a special effort to examine their spine."

Until now legislators have waded through information pro and con about scoliosis screening in schools to form their own conclusions. Now four major medical associations have joined forces to get the word out about the importance of screening in schools for scoliosis, giving lawmakers the information they need to make good decisions. Those groups include The American Academy of Orthopaedic Surgeons (AAOS), the Scoliosis Research Society (SRS), the Pediatric Orthopaedic Society of North America (POSNA) and the American Academy of Pediatrics (AAP). All see the value in school screening for early detection.

Dr. Vitale hopes decision makers will get the message. "We hope this statement draws more attention to the issue and gets people thinking about the potential downside to missing kids with scoliosis. It can be relatively easy to control a small curve, but the longer we wait treating a child with a more severe curve it becomes a much bigger problem."

American Academy of Orthopaedic Surgeons