Child Orthopedics

Frequently Asked Questions

Is it true they are no longer going to do scoliosis screening in the schools? Why not?

You heard right. The United States Preventive Health Task Force has made the recommendation to stop school screening. School screening has been done for many years to identify children at increased risk for scoliosis. But studies have not been able to prove that it is cost effective.

There is not enough evidence to show that treating early cases of mild scoliosis makes a difference. Even so, it's still possible that without early detection, diagnosis will come later and the result will be more severe spinal curves.

Without the screening process, it may be too late to keep the curves from getting worse (progression). In order to change this policy, researchers must prove that bracing is a significantly effective treatment for mild, but progressive curves.

New guidelines from the Scoliosis Research Society (SRS) may be helpful. The SRS Committee on Bracing has set up ways to collect and report data so that one study can be compared to another. The number of subjects tested can be combined making the results more significant.

The first two studies on bracing using this criteria have now been published. The children included were the same age with the same degree of spinal curvature. three different braces were used and the results compared. It remains to be seen if these children were braced soon enough to avoid surgery.

If children aren't identified early enough through school screening, then they may not have a chance to try bracing. They may have to have surgery first. And surgery gets more complex with more advanced cases of scoliosis. Until further studies are completed, debate may continue on this topic for some years to come.

Robert N. Hensinger, MD, and George H. Thompson, MD. Orthotic Management in Adolescent Idiopathic Scoliosis. Leveling the Playing Field. In Journal of Pediatric Orthopaedics. June 2007. Vol. 27. No. 4. Pp. 367.

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