Curve Magnitude in Patients Referred for Evaluation of Adolescent Idiopathic Scoliosis: Five Years' Experience From a System Without School Screening

Spine Deform. 2016 Mar;4(2):120-124. doi: 10.1016/j.jspd.2015.10.001. Epub 2016 Feb 2.


Study design: Retrospective cross-sectional study.

Objectives: To analyze the referral pattern of patients with adolescent idiopathic scoliosis (AIS) in a tertiary hospital in a nationalized health care system without school screening and to compare curve magnitude on referral with results reported in the literature.

Summary of background data: In Denmark, school screening for AIS has not been in effect for more than two decades, and there is limited knowledge of curve magnitude and pattern of referral to specialized treatment in our country. Other studies, however, have assessed the effectiveness of school scoliosis screening. Our tertiary institution receives referrals for evaluation of AIS from general practitioners (GPs) and other hospitals or private specialists.

Method: A review was conducted on all patients diagnosed with AIS between 2010 and 2015. Data collection included age, gender, menarchal status, recommended treatment, and major curve Cobb angle for all patients aged 10-19 years referred for evaluation of AIS. Major curve magnitude was categorized as 10-19, 20-39, or ≥40 degrees, and the distribution of categories was compared to a screened population reported in the litterature.

Results: A total of 166 of 460 newly referred AIS patients were referred from GP. Mean age was 15 years (standard deviation = 2) and median Cobb angle was 35 degrees. Overall, 33% were initially recommended treatment with a brace. This group had a median curve size of 41 degrees, and 28% presented more than 1 year past menarche. We found a significantly larger curve magnitude at the time of referral in our GP cohort compared to a screened population (p < .001), and 22% versus 8% had a Cobb angle >40 degrees (p < .001).

Conclusion: The present study confirms that in a health care system without school screening, patients with AIS referred for evaluation by GPs have larger curve sizes compared to systems with school screening.

Level of evidence: III.

Keywords: Adolescent; General practitioner; Scoliosis; Screening.

MeSH terms

  • Adolescent
  • Braces*
  • Child
  • Cross-Sectional Studies
  • Denmark
  • Female
  • Humans
  • Menarche
  • Referral and Consultation*
  • Retrospective Studies
  • Scoliosis / therapy*
  • Young Adult