Outcome of spinal screening

Spinal screening using the Scoliometer was performed on one thousand high school students to determine the prevalence of spinal deformity and the appropriate degree of deformity to be used as a selection criterion. Eighty percent of students were found to have 3 degrees or more angle of trunk rotation (ATR). This new information predicts a referral rate of three percent if 7 degrees degrees ATR is used as referral criterion (12% referral if 5 degrees ATR is the criterion). A paradigm using the best available information on natural history and screening allows a comparison of the outcomes of screened versus non-screened school populations. Spinal screening appears to be effective in reducing the need for surgical treatment of scoliosis, but does not decrease the total cost of care for this problem. An appropriate referral criterion for spinal screening appears to be 7 degrees ATR at any level of the spine.