Scoliosis Screening for Students From Primary and Junior Schools Using Electronic Devices

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Abstract
Study Design.: An exploratory study. Objective.: The purpose of this study is to investigate the prevalence of scoliosis in Linxia Prefecture, Gansu Province, China, and to explore the characteristics of electronic devices in scoliosis school screening (SSS). Background.: Forward bend test and scoliometer are common methods for SSS. The advantages of three-dimensional (3D) ultrasound system in SSS have been reported before. While there is a paucity of evidence to compare manual scoliometer (M-scoliometer) with electronic scoliometer (E-scoliometer), and the correlation between angle of trunk rotation (ATR) and ultrasound Cobb angle (UCA) is uncertain. Materials and Methods.: More than 27000 students in Linxia Prefecture, Gansu Province, China, were screened using M-scoliometer and E-scoliometer. Specifically, some students were screened before and after spinal motion test. Besides, one out of every 3 positive examinees would have their UCA measured. Their basic information and measurement results were recorded and analyzed. Results.: A total of 27532 students were included, whose informed consent forms were signed by their parents. The overall positive rate of primary screening was 2.27% (girls, 2.64%; boys, 1.91%; P < 0.001). There were no significant differences in positive rate between M-scoliometer and E-scoliometer ( P = 0.657). The screening speed of M-scoliometer was slower than that of E-scoliometer (36.53 vs . 19.19 s, P = 0.002). One-third of the positive students became negative after spinal motion test. Compared with the E-scoliometer group, the proportion of scoliosis in the M-scoliometer group was higher in degree I ( P = 0.046) and lower in degree II and III ( P = 0.01, P = 0.278). Moderate correlations were found between ATR and UCA (R 2 = 0.245). Conclusions.: The overall positive rate of primary screening in this study is basically consistent with previous studies. We found that electronic scoliometer is as accurate as M-scoliometer, yet faster and more convenient. Besides, a moderate correlation exists between ATR and UCA. We believe that the introduction of electronic devices will make scoliosis screening radiation-free, more convenient, and efficient.

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