Research reinforces call for early scoliosis detection, appropriate treatment

In light of new research confirming the effectiveness of early and appropriate treatment for scoliosis, a newly revised position statement strongly supports timely screening and appropriate treatment to halt or minimize further curvature of the spine.

"Screening for the Early Detection of Idiopathic Scoliosis in Adolescent," is a joint statement between the American Academy of Orthopaedic Surgeons (AAOS), the American Academy of Pediatrics (AAP), the Pediatric Orthopaedic Society of North America (POSNA) and the Scoliosis Research Society (SRS).

Scoliosis is a condition that causes the spine to curve sideways. And while there are several different types of scoliosis that affect children and adolescents, the most common is idiopathic scoliosis, which means the exact cause of the condition is not known. For years, routine scoliosis screening has been controversial with studies both supporting and discouraging efforts. However, the 2013, multi-center National Institutes of Health (NIH)-funded study, Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST), documented significant success in preventing spinal curve progression and surgery in children who were screened, diagnosed, and treated with a custom brace.

"The BrAIST study provided high quality evidence that bracing for adolescent idiopathic scoliosis can decrease the rate of progression of spinal curve to the surgical level," said M. Timothy Hresko, MD, co-author of the revised statement. "Early detection of scoliosis is essential to identifying patients who may benefit from the use of a spinal brace. The new, 2016 joint position statement—released jointly by four prominent child health organizations—reflects the importance of early scoliosis detection."

The revised statement highlights the BrAIST research and strongly recommends that:

• Screening examinations for spine deformity be part of medical home preventive care visits for girls at age 10 and age 12; for boys, once at age 13 or 14.
• Screening programs have well-trained personnel who can appropriately administer forward bending tests, and the use of a scoliometer, to correctly measure and identify abnormal spine curvature, and to refer patients for additional tests and imaging as needed.
• Any imaging tests adhere to the principles of ALARA (As Low as Reasonably Achievable) standards to minimize radiation exposure in young patients.
• Bracing is an effective non-operative intervention to reduce the risk of progression to surgical treatment.