Why Are Current Screenings Not Enough?

Many factors contribute to the inadequate state of scoliosis screening:

  • More than half of the states, including California, New York and Texas, require or recommend school-based screening for scoliosis
  • However, not every school has access to screening
  • Scoliosis screening currently uses a scoliometer with up to 30% false negative rate

Scoliosis affects about 2% of the population and often first appears during childhood and adolescence—which is why some states still require scoliosis screenings at schools. But how helpful are these checks, and are kids with scoliosis getting the care they need?

Scoliosis screenings

Scoliosis is an abnormal curvature or twisting of the spine. The curve may favor the left or right of the body, or it may cause the spine to curve too far forward or back. Although in many cases the specific causes of scoliosis is unknown, there is some evidence that it’s tied to genetics, particularly with the X chromosome (which explains why females are more likely to be affected than males).

Scoliosis screenings at schools are essentially a quick visual analysis. A school nurse (or sometimes a local chiropractor or orthopedic surgeon) has each student lean forward with head and arms down, while he or she checks for what’s called a “rib hump,” meaning the ribs are more prominent on one side than the other.

If this evidence of scoliosis is found, the student will undergo further analysis to determine the extent of the problem. If the abnormal curve of the spine is more than 30 degrees to the left or right, one shoulder and/or hip is likely to be higher than the other. In addition to potential issues with walking and standing, distortion of the chest cavity can cause problems with the lungs and heart. For this reason, these more extreme cases receive early treatment (sometimes including surgery to straighten the spine).

An abnormal curvature that’s less than 30 degrees is not considered a serious medical problem. For many of these students, the school just makes a note to “wait and see,” monitoring the problem from year to year to make sure it doesn’t get worse.

While these scoliosis screenings are done with good intentions and do catch major problems, for children and teens with less extreme cases these steps aren’t enough.

First of all, the visual analysis focuses mostly on rib hump, but only 20% of scoliosis patients show this. So it’s likely many cases are going undetected. Secondly, the “wait and see” approach falls short because most cases of scoliosis do get worse and cause problems down the road.

Long-term effects of scoliosis

While scoliosis only affects 2% of the general population, nearly 40% of the patients in our office have some degree of scoliosis. The abnormal curves tend to destabilize the spine and make it more susceptible to injury and pain. Usually these symptoms start appearing when the patients are in their mid- to late 20s. By that point, the crookedness of the spine has already caused problems with muscle development, and as patients tend to grow less active as they age, they are more susceptible to painful muscle cramps.

Another thing we see is increased wear on the spine. The spine of a 30-year-old with scoliosis is much more like the spine of a 50-year old. A 50-year-old’s spine tends to function more like that of a 70-year-old—and chances are the patient feels more like a 70-year-old when it comes to staying active.

So from a medical perspective, the “let’s wait and see what happens” approach can cause worse problems to develop down the road.

It’s far better to address scoliosis as soon as it’s identified to lessen the effect on the spine. Treatment for scoliosis sometimes includes spinal adjustments, but it can also take the form of daily, targeted stretching that can strengthen and stabilize the spine.

If you suspect your child may have some form of scoliosis (whether it showed up in a screening or not), book with us and we can take a proactive approach together. Let’s make sure scoliosis doesn’t slow your kid down in the years to come.