Policy Statement - Detection of scoliosis in schoolgirls

PREAMBLE. The rationale for screening adolescent schoolgirls for scoliosis (sideways curvature of the spine) is based on the established criteria that early detection and treatment where indicated result in better long-term outcomes. Most important in this regard is that in the early stages of curve development there are no symptoms to alert a girl or her parents. Hence the way to detect a curve is to look for it. Scoliosis is not a rare condition and approximately 2.5 percent of girls in the age range of 11-13 years (during the growth spurt) are at risk of developing a significant scoliosis.

Until recently screening was performed to a variable extent in government and non-government schools in Australia but because of financial restraints these programs have largely been abandoned. School screening, when properly performed, is an efficient method of detection. It should be a two-tiered process with the presence of a curve being confirmed by a medical practitioner before the parents are notified. Unnecessary notification and subsequent specialist referral are to be avoided.

The above-described changes in the health care system in Australia indicated that a new detection strategy was needed. This need led to the development of a National Self-Detection Program by the Spine Society of Australia. The aims of this new program are to increase public awareness of the condition, to encourage girls aged 11 and 13 to self-assess for the condition and to have family doctors assume care of minor curvatures. Now the ready access to the internet has enabled a more practical approach to the question of detection.

Each year in July/August all government and non-government girls’ schools will be asked via established communication channels in the school systems, and by a direct approach to school principals, to download the self-detection brochure from www.scoliosis-australia.org and distribute it to girls in Years 7 and 9 (11 and 13 years of age in most states and territories). This is the age range when scoliosis first appears.

The policy is:

• The National Self-Detection Program for Scoliosis (NSDP) is recommended for girls in Years 7 and 9 (11 and 13 years of age) by the Spine Society of Australia and the Royal Australian College of General Practitioners as a sound, preventative health measure. The program is endorsed by the Paediatrics and Child Health Division of the Royal Australasian College of Physicians.
• The NSDP is more important for girls in Year 7 than in Year 9.
• There is no case for screening adolescent boys for scoliosis.
• No case exists for the screening of adolescent boys and girls for any other spinal disorders apart from scoliosis in girls.
• The conduct of two-tiered school screening is supported where such programs still exist.