Scoliosis is a common condition and affects approximately 3% of the general population worldwide. Girls are affected 5 times as commonly as boys. Most people have mild curves which do not require operative intervention. However, 10% to 20% of all scoliotics, or approximately every 3 out of 1000 people have scoliosis severe enough to require surgery. In the USA, approximately 38000 children undergo surgery every year for this condition. An equal number undergo bracing (Population of USA is 305 million).
In children who have scoliosis, it is extremely important to identify the condition very early.
Early treatment, (before the curves become severe), is extremely beneficial to the child and gives a good long-term result.
Children who present with severe deformity in advanced stages of the disease need extensive surgery and suffer a much higher morbidity.
Scoliosis does not lead to cosmetic deformity alone; Scoliosis, if left untreated, results in diminished pulmonary function due to poor lung development, restrictive lung disease, decreased cardiac function and limitation of physical ability. Untreated scoliotics have a high incidence of degenerative spine disease by the 5th decade of life. Larger spinal curves (above 40 degrees) tend to progress even after cessation of growth, and become severe as the patient ages.
Early detection is imperative for successful treatment. A curve cannot be corrected except by surgery, so it is important that the curve is not allowed to progress.
Since early intervention has such huge benefits for a child suffering from scoliosis, it becomes imperative to screen all susceptible age groups for scoliosis . Thankfully, screening is a simple procedure, and the steps are as follows
A young boy with mild scoliosis
Adam’s forward bending test
This test is called the Adam’s forward bending test. A positive finding is an indication for an Xray whole spine PA standing and a referral to a scoliosis specialist.
Other findings may be evident ( See the pictures below):
Severe scoliosis with all the typical features described
Severe scoliosis revealed on forward bend test.
Always screen your patients / children who are 9 years and above. Early detection will make non-surgical treatment possible.