2022 Volume 13 Issue 11 Pages 1171-1176
Introduction: Early detection and early brace treatment before curve progression are crucial in the treatment of adolescent idiopathic scoliosis (AIS). Therefore, school screening is considered important. However, the screening method varies from area to area in Japan because each area conducts its screenings. Some areas conduct only visual examinations as school musculoskeletal screening (SMS), while others use both visual and Moiré testing. The purpose of the present study was to examine the effectiveness of school scoliosis screening (SSS) comparing preoperative patients referred from areas with visual examination only versus visual examination and Moiré testing.
Methods: Patients who underwent surgery were divided into two groups: patients referred from areas where Moiré testing were performed in addition to visual school examinations (Group X) and patients referred from areas where only visual examinations were performed (Group Y). We investigated which areas the patients were referred from and the factors that influenced patients' decision to visit our institute. Moreover, the Cobb angle immediately before surgery were also reviewed.
Results: Group X comprised 117 patients, and Group Y consisted of 40 patients. Group X was younger than Group Y at the initial consultation. The main Cobb angle immediately before surgery of Group Y (57.7±13.7 degree) was bigger than Group X (50.0±8.6 degree) (p <0.001). In group X, 84.6% of patients were detected by SSS; in group Y, SMS was able to find scoliosis in only 42.5% of the patients.
Conclusions: We found that patients referred from area with only visual examinations had greater preoperative Cobb angles than referrals from area with both visual and Moiré testing. The percentage of patients seen as a result of SSS was lower in patients from area with only visual examination than in those with both visual examination and Moiré testing. These results suggest that a screening system with only visual examination delays the appropriate timing of referral to specialists.
