Screening Sought to Spot Curved Spines

Four medical groups say schools should check preteens for scoliosis

The sideways S- and C-shaped spines that mark scoliosis occur in both girls and boys. The most common form of the problem appears after age 10.

Medical groups suggest girls be screened twice, at ages 10 and 12, and boys once, at age 13 or 14. Untreated, scoliosis in some cases can lead to physical deformity, trouble breathing and other medical problems. Scoliosis usually causes children no pain. It can run in families, but the cause is not known.

A trained professional screens children with a quick visual back test to see whether a child’s spine shows any signs of sideways curves. A normal spine should look like a straight I. A screener who sees a curve refers the child to a doctor for more tests.

Experts have been split on whether screening at school is effective from a medical and cost viewpoint. A task force of the American Academy of Orthopaedic Surgeons (AAOS), the American Academy of Pediatrics, the Scoliosis Research Society and the Pediatric Orthopaedic Society of North America recommends screening for scoliosis—ideally by a patient’s physician.

The AAOS lists these scoliosis treatments:

• Observation is appropriate when the curve is mild or the child is near skeletal maturity.
• Bracing prevents worsening of scoliosis. Doctors consider bracing when a growing child has a spinal curvature of 25 to 45 degrees.
• Surgery is an option when the curvature is more than 45 degrees and the child is still growing. Surgery may also be suggested if the patient’s skeleton has matured, but the curvature of the spine is more than 50 to 55 degrees.