A meta-analysis concludes that in-school scoliosis screenings are insufficient. The study’s authors explain that “the use of school scoliosis screening is controversial, and its clinical effectiveness has been diversely reported.” Consequently, they pooled data from 36 scientific inquiries on the topic.
“Studies were included if: (1) they adopted a retrospective cohort design; (2) were screened using either the forward bending test (FBT), angle of trunk rotation, or Moiré topography; (3) reported results of screening tests and radiographic assessments; (4) screened adolescents only; (5) reported the incidence of curves with a minimum Cobb angle of 10° or greater; and (6) reported the number of referrals for radiography. Reviews, comments, case studies, and editorials were excluded.”
Overall, 5% of the students were referred for radiography. And, “the pooled positive predictive values for detecting curves ≥10°, curves ≥20°, and treatment were 28.0%, 5.6%, and 2.6%, respectively.” Compared with programs using other tests, those using FBT alone were significantly more problematic.
“The use of the FBT alone in school scoliosis screening is insufficient,” conclude the study’s authors. “We need large, retrospective cohort studies with sufficient follow-up to properly assess the clinical effectiveness of school scoliosis screening.”
Spine – May 1, 2010;35:1061-71.