The effect of school screening on surgery for adolescent idiopathic scoliosis

The objective of the study was to examine the effect of screening programmes for adolescent idiopathic scoliosis on population rates for adolescent idiopathic scoliosis surgery. A case-control study with data from The National Hospital Discharge Register, youth health care (YHC) departments in The Netherlands and a relevant census was used. The cases were 182 subjects aged 12-19 years, admitted to hospital in The Netherlands for surgical treatment of adolescent idiopathic scoliosis between 1990 and 1993. The total population of 12 or 13 year olds in the consecutive years of 1987-1992 in the regions of the participating YHC departments served as controls. Of the 182 patients that had surgery for adolescent idiopathic scoliosis in The Netherlands in the years 1990-1993, 37.9% had at one time had a screening for spinal deformities at the age of 12 or 13 years as compared to 37.9% of the control subjects. The odds ratio for cases that had surgery was 1.00 (95% confidence interval: 0.74-1.35). This study does not support the view that screening for adolescent idiopathic scoliosis reduces the population rates for scoliosis surgery. As the primary aim of screening for adolescent idiopathic scoliosis is to prevent surgical intervention, this practice should be reconsidered.