Scoliosis School Screening Using Electronic Devices in Henan Province, China: An Exploratory Study

Study DesignAn Exploratory Study.ObjectivesTo estimate the prevalence of scoliosis and associated factors among adolescents, and to evaluate the clinical utility of an electronic scoliometer in school screening.MethodsThe scoliosis school screening was conducted in Xinyang City, Henan Province, in 2024. Students' study habits and daily routines were collected via questionnaires. Manual and electronic scoliometers were used for primary screening and compared using receiver operating characteristic (ROC) curves and agreement statistics. Three-dimensional ultrasound provided a provisional diagnosis. Multivariable logistic regression identified factors associated with scoliosis.ResultsA total of 1874 students were enrolled in this study. The positive screening rates using manual and electronic scoliometers were 4.97% and 2.87%, respectively. Among these cases, 102 students were referred for 3D ultrasound examination, with 74 students showing an ultrasound Cobb angle ≥10°. The prevalence of scoliosis was 4.55% in seventh-grade students and 4.04% in eighth-grade students. The prevalence of scoliosis was 2.99% in males and 5.96% in females. In the paired sample (n = 39), the electronic device had an AUC of 0.844 (95% CI 0.718-0.971) vs 0.751 (95% CI 0.596-0.907) for the manual device (ΔAUC = 0.093, P = 0.033). Agreement for continuous ATR showed moderate absolute agreement (ICC(3,1) = 0.614; 95% CI 0.373-0.777). Multinomial regression identified sitting with crossed legs and lack of sports participation as potential risk factors.ConclusionsThe prevalence of scoliosis among seventh and eighth-grade students in Xinyang City, Henan Province, was 4.33%. We recommend ATR ≥5°be triaged with 3D ultrasound before radiography; cases with UCA <20°should be rechecked at 3 months. Schools/parents should promote correct seated posture and more physical activity.