Role of screening in diagnosis of scoliosis in children; A report from Shiga prefecture

Abstract

Introduction: Screening of scoliosis has been carried out as a part of school musculoskeletal screening since 2016. In Shiga prefecture, this screening is performed based on self-assessment questionnaire and physical examination without any devices by school doctors who do not specialize in orthopedics. The objective of this study is to evaluate the contribution of screening in early diagnosis of scoliosis.

Methods: We retrospectively investigated patients who visited our hospital because of suspected spinal deformity for the first time between 2017 and 2019. Patients who were referred to our hospital based on a screening program (Group S) were compared to the others (Group N). In this study, we included screening programs performed in pre-school children as well as in school-aged children and adolescents. Patients who had already been diagnosed as a disease which is known to be a risk for scoliosis were excluded. We investigated the age and Cobb angle at the first visit, diagnosis, and whether the visit was according to the screening program or not.

Results: 137 patients were identified. 110 of them were girls. 63 patients (46%) visited our hospital according to a screening program. The diagnosis was idiopathic scoliosis in 119 patients, congenital scoliosis in 6 patients and syndromic scoliosis in 6 patients. 6 patients did not have scoliosis. The mean age and the mean Cobb angle of the patients in Group S and N were 12.6 (±3.1) and 12.9 (±3.8) years, and 25.4 (±14.4) and 29.3 (±12.5) degrees, respectively. No difference was observed between Group S and N (p=0.99 and 0.27).

Conclusions: In Shiga, screening programs involved in almost half of the diagnosis of scoliosis. Our result did not support early diagnosis of scoliosis by screening programs. Self-assessment questionnaire and physical examination alone may be insufficient for early diagnosis of scoliosis.