School screening for scoliosis: the value of quantitative measurement (original) (raw)

Summary

Several studies advocate quantification of the bending test or performing surface topography to reduce the referral rate and to increase the specificity of the bending test in screening for scoliosis. Within the framework of a school screening project all children with a positive bending test were reexamined with measurement of rib hump height, angle of trunk rotation and moiré topography. In the period 1983–1986, out of three cohorts of 10 000 children of 10, 12 and 14 years of age, 3069 were reexamined, of whom 1931 again tested positive (63%). The value of the three techniques in terms of sensitivity and specificity within the reexamined group was evaluated with regard to the Cobb angle on a spinal radiograph, which was made in 671 cases. A reduction in referrals of 37% was found. No significant difference in the ability to detect scoliosis was found between the three techniques mentioned. It is concluded that measurement techniques are valuable in school screening programmes. In particular, if instead of a single cut-off value, a range within which the examination should be repeated is chosen, high sensitivity and high specificity can be combined. Angle of trunk rotation measurement seems to be the easiest method of screening.

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References

  1. Adair IV, Wijk MC van, Armstrong WD (1977) Moiré topography in scoliosis screening. Clin Orthop 129:165–171
    Google Scholar
  2. Asher M, Beringer GB, Orrick J, Halverhout N (1989) The current status of scoliosis screening in North America, 1986. Results of a survey by mailed questionnaire. Spine 14:652–662
    Google Scholar
  3. Ashworth MA, Ersil AK (1981) The measurement of rib hump inclination — a potential aid in scoliosis screening. Scol Res Soc 5:33–34
    Google Scholar
  4. Bunnell WP (1984) An objective criterion for scoliosis screening. J Bone Joint Surg [Am] 66:1381–1387
    Google Scholar
  5. Hearn M, Crowe A, Keessen W (1989) Influence of age on proprioceptive accuracy in two dimensions. Percept Mot Skills 69:811–818
    Google Scholar
  6. Laulund T, Syjbjerg JO, Hyrlyck E (1982) Moiré topography is school screening for structural scoliosis. Acta Orthop Scand 53:765–768
    Google Scholar
  7. Lonstein JE (1988) Natural history and school screening for scoliosis. Orthop Clin North Am 19:227–237
    Google Scholar
  8. Nachemson A (1989) School screening for scoliosis (letter). Acta Orthop Scand 60:124
    Google Scholar
  9. Ohtsuka Y, Yamagata M, Arai S, Kitahara H, Minami S (1988) School screening for scoliosis by the Chiba University Medical School: screening program. Results of 1.24 million students. Spine 13:1251–1257
    Google Scholar
  10. Ponte A (1982) Prognostic evaluation of vertebral rotation in small idiopathic curves. Proceedings of the Scoliosis Research Society, Denver, Colo. 20: 46–47
    Google Scholar
  11. Pruijs JEH, Keessen W, Meer R van der, Wieringen JC van, Hageman MAPE (1992) School screening for scoliosis: methodological considerations. 1. External measurements. Spine 17:431–436
    Google Scholar
  12. Pruijs JEH, Hageman MAPE, Keessen W, Meer R van der, Wieringen JC van (1994) Variation in Cobb angle measurements in scoliosis. Skeletal Radiol 23:517–520
    Google Scholar
  13. Schulthess W (1902) Über die Lehre des Zusammenhanges der physiologischen Torsion der Wirbelsäule mit lateraler Biegung und ihre Beziehungen zur Skoliose. Z Orthop 10:455–494
    Google Scholar
  14. Stokes IAF, Moreland MS (1987) Measurement of the shape of the surface of the back in patients with scoliosis. J Bone Joint Surg [Am] 69:203–211
    Google Scholar
  15. Stuurmans F (1984) Epidemiologie, theorie, methoden en toepassing. Dekker en van de Vegt, Nijmegen
    Google Scholar
  16. Swets JA, Pickett RM (1982) Evaluation of diagnostic systems: methods from signal detection theory. Academic Press, New York
    Google Scholar
  17. Thulbourne T, Gillespie R (1976) The ribhump in idiopathic scoliosis measurement, analysis and response to treatment. J Bone Joint Surg [Br] 58:64–71
    Google Scholar
  18. Vercauteren M, Beneden M van, Verplaetse R, Croene Ph, Uyttendaele D, Verdonk R (1982) Trunk asymmetries in a Belgian school population. Spine 7:555–562
    Google Scholar
  19. Vinchon B (1965) Présentation d'un appareil permettant la mesure des gibbosités coliostiques. Rev Chir Orthop 51:643–644
    Google Scholar
  20. Wijk MC van (1980) Moiré contourgraph — an accuracy analysis. J Biomech 13:605–613
    Google Scholar
  21. Williams JI (1988) Criteria for screening: are the effects predictable? Spine 13:1178–1186
    Google Scholar
  22. Willner S (1979) Moiré topography for the diagnosis and documentation of scoliosis. Acta Orthop Scand 50:295–302
    Google Scholar
  23. Willner S, Udén A (1982) A prospective prevalence study of scoliosis in southern Sweden. Acta Orthop Scand 53:233–237
    Google Scholar

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Authors and Affiliations

  1. Department of Orthopaedics, University of Utrecht, Utrecht, The Netherlands
    J. E. H. Pruijs & W. Keessen
  2. Department of School Health, Municipal Health Service, Utrecht, The Netherlands
    R. van der Meer & J. C. van Wieringen
  3. Department of Social Paediatrics, University of Utrecht, Utrecht, The Netherlands
    J. C. van Wieringen

Authors

  1. J. E. H. Pruijs
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  2. W. Keessen
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  3. R. van der Meer
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  4. J. C. van Wieringen
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Additional information

We regret to inform the reader of the death of W. Keessen on 4 December 1993.

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Pruijs, J.E.H., Keessen, W., van der Meer, R. et al. School screening for scoliosis: the value of quantitative measurement.Eur Spine J 4, 226–230 (1995). https://doi.org/10.1007/BF00303416

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