Direct spinal curvature digitization in scoliosis screening--a comparative study with Moiré contourgraphy

The forward bending test, widely used in scoliosis screening, is associated with high false-positive rates. We postulate that direct surface measurement of the spinal curvature by digitization of the spinous processes used in combination with the forward bending test could increase the predictive value of detecting scoliosis without sacrificing sensitivity. Sixty consecutive patients referred from a school screening program were included in this study. All had moiré contourgraphy, spinous process digitization, and erect frontal radiographs of the spine. The number of false positives from the forward bending test was 35. Moiré contourgraphy did not reduce the number of false positives significantly. A posterior spinal deformity of 10 degrees or more predicted scoliosis in all patients, with 15 false-positive readings. Direct measurement of the spinal curvature by spinous process digitization can be an effective second-stage screening tool for scoliosis in centers where all the screened positives are referred to a single center.