“Improved worldwide scoliosis screening and testing would help prevent scoliosis from advancing undetected. Early intervention is crucial with scoliosis, but you won't seek help for your child if you don't know there is a problem.”
Improved Scoliosis Screening is Needed
Diagnosing scoliosis in its early stages ensures the most options for treating the curvature and slowing or stopping the progression. Children's bones are not yet fully hardened, so non-surgical treatments may be used to prevent progression of the curvature.
Scoliosis, when left untreated, can get worse and may cause chronic back pain, impact heart and lung function, and take a toll on self-esteem. Screening for the condition is non-invasive, inexpensive, and takes about 30 seconds. With early detection and proper treatment, people diagnosed with scoliosis can live healthy, active lives.
Scoliosis is an abnormal curvature of the spine that affects two to three percent of the population, or an estimated 7 million people in the United States. Most are diagnosed with scoliosis between the ages of 10 and 15, but the condition also affects infants and adults. It is a condition that affects people of all races, classes, and genders. Girls are eight times more likely than boys to have a curve that will progress to a magnitude that requires treatment. Scoliosis is common in children with a variety of congenital and neuromuscular diseases, but it is most prevalent in seemingly healthy children, with no known cause (idiopathic).
Most curvatures are minor and require only that patients are monitored by their doctors. According to the American Academy of Orthopaedic Surgeons, one-quarter of children with spinal curves require medical attention. In 2004, 1.26 million patients diagnosed with scoliosis utilized health care resources. The estimated total hospital charges, excluding professional fees and non-covered charges, for all patients released from the hospital with an idiopathic scoliosis diagnosis was $2.7 billion.
Fewer than half of the states in our nation currently legislate screening for scoliosis at schools, so it is imperative that parents, teachers, coaches, healthcare professionals and children are aware of the early signs of scoliosis. Additionally, advances in science and technology mean both the diagnosis and treatment of scoliosis are improving every year. Your doctors and medical staff can help raise the awareness of all these issues through the news media and community events.
“A few seconds can possibly save a child you know years of pain later in life. It’s time to spread the word.”
Getting the Jump on Scoliosis
Who is predisposed to scoliosis?
Girls and boys age eight to 14
Girls are eight times more likely to get scoliosis
Children with a thin or lanky body shape
A child whose parent or sibling has scoliosis
What are the signs of early stage scoliosis?
The scoliosis posture has five primary hallmarks visible even in the early stages of mild idiopathic scoliosis. These include:
Tilted eye line
One shoulder hangs higher than the other
One shoulder blade sticks out more than the other
One hip appears higher or more pronounced than the other
One side of the rib cage appears higher than the other
Mid-ear not aligned with the tip of the shoulder when viewed from the side
Center of eyes not aligned horizontally with the center of hips
The body tilts to one side
One leg appears shorter than the other
Ribs stick out when a child does a full forward bend
Any one of these signs, or a combination of them, warrants a posture evaluation by a specialist. Your child can also have a prognostic test to determine the likelihood that a small scoliosis curve will progress. Neurotransmitter, bone metabolism, hormone, and genetic tests also allow us to treat the underlying deficiencies that contribute to progression.
Adam's forward bend test
The purpose of the Adam’s forward bend test is detecting structural or functional scoliosis. This test is most often used during school screening for scoliosis. It can also be used with patients who have a family history of scoliotic posture or with patients who have detectable scoliosis of uncertain etiology. The scoliosis is functional when the characteristics of scoliosis becomes more visible while the patient bends. With a structural scoliosis, the scoliotic deformity will remain the same as in the standing position. If there is an increased kyphosis when bending forward, Scheuermann’s disease or congential kyphosis is also possible.
Before you perform the Adam’s forward bend test, it is best to look for limb length discrepancy. The spine needs to be visible. The patient bends forward at the waist until the back comes in the horizontal plane, with feet together, arms hanging and knees extended. The palms are held together. The examiner looks from behind, along the horizontal plane of the column vertebrae. The examiner looks for indicators of scoliosis, such as spinal asymmetry, unlevel shoulders, scapula asymmetry, unlevel hips, the head that does not line up with the pelvis or a rib hump. An increased or decreased lordosis/kyphosis can also be a sign for scoliosis. The rotation deformity or rib hump can be measured with a scoliometer. You can also download the free SpineScreen app where you can:
Learn the signs of scoliosis and treatment options available
Perform a preliminary spine check on your child at home
Schedule calendar reminders for annual screenings
Many students are given the Adam’s Forward Bend Test in school, typically when they are in 5th or 6th grade, to determine whether or not they may have scoliosis. However, many schools today do not do these screenings, so it is advisable to make sure the screening is done as part of a child's annual physical exam with the pediatrician. This is why it is crucial that we fight together to make it mandatory that all schools are screening.
In the Adam's Forward Bend Test, the student bends forward at the waist with arms hanging downward toward the floor and knees straight, while being observed by a health care professional. This bending-forward position most clearly shows any asymmetry in the spine and/or trunk. The health care professional looks for abnormal appearance in the spine, hips, and shoulders, such as :
- Any type of hump or uneven appearance around the area of the rib cage
- Any side-to-side asymmetry in the spine
- Shoulders that appear to be different heights
- One hip that sticks out more prominently than the other
