Introduction de Lignes directrices pour le dépistage de la scoliose juvénile

Various organizations have recommended routine screening for scoliosis in children and adolescents since the 1980s.More than half of U.S. states either mandate or recommend school-based screening for scoliosis.Children and adolescents are usually screened with the forward bend test, with or without scoliometer measurement.

Patients with a Cobb angle of less than 20° are observed without treatment; however, exercise may be recommended at this time. Patients with a Cobb angle greater than 30° or a Cobb angle of 20° to 30° that progresses 5° or more over 3 to 6 months are treated with bracing. Patients with a Cobb angle of 40° to 50° may be treated with bracing or surgery, while those with a Cobb angle greater than 50° typically require surgery.

This guidance applies to asymptomatic children and adolescents aged 10 to 18 years. This recommendation does not apply to children and adolescents presenting for evaluation of back pain, breathing difficulties, abnormal radiography findings or other imaging studies, or obvious deformities in spinal curvature.

If idiopathic scoliosis is suspected, radiography is used to confirm the diagnosis and to quantify the degree of curvature (i.e., the Cobb angle) and the Risser sign (the stage of ossification of the iliac apophysis).

Goal of Scoliosis Screening

The goal of scoliosis screening is to decrease or stop progression of spinal curvature during the period of adolescent growth prior to skeletal maturity. Treatment of adolescent idiopathic scoliosis is determined by the degree of spinal curvature and the potential for further growth and generally includes observation, bracing, surgery, and exercise.

Scoliosis Screening Test Method

Most screening tests for adolescent idiopathic scoliosis are noninvasive. Screening is usually done by visual inspection of the spine to look for asymmetry of the shoulders, shoulder blades, and hips. In the United States, the forward bend test is commonly used to screen for idiopathic scoliosis. First, a clinician visually inspects the spine of a patient while the patient is standing upright. Next, the patient stands with feet together and bends forward at the waist with arms hanging and palms touching. The clinician repeats the visual inspection of the spine.A scoliometer, which measures the angle of trunk rotation, may be used during the forward bend test. An angle of trunk rotation of 5° to 7° is often the threshold for referral for radiography.Other screening tests include a humpometer, the plumb line test, and Moiré topography (creating a 3-dimensional image of the surface of a patient’s back)

Scoliosis Screening Procedure

These guidelines have been prepared to assist school health personnel in the development of an effective scoliosis screening program. Several key terms are defined below.

1. Scoliosis – a lateral or side to side curvature of the spine.

2. Kyphosis – an accentuated backward rounding of the upper spine, also called Scheurmann’s disease.

3. Lordosis – an accentuated forward curvature of the lower spine, also called swayback.

4. Scoliosis Screening – means examination of the uncovered spine including the cervical, thoracic, and lumbar segments by viewing from the back, front, and sides under adequate illumination and observing the existing range of motion of the spine in all directions.

A juvenile scoliosis screening program aims to achieve two main objectives:
Identify common spinal deviations in children at an early stage.
Provide education. For the program to be successful, it necessitates a collaborative effort, involving resources from both the school and the community.

The following should be considered before scoliosis screening is initiated:

1. The quantity of students requiring screening at each grade level.
2. Designation of school staff responsible for conducting screenings, potentially involving roles such as school physician, nurse-teacher, nurse practitioner, regular nurse, physical therapist, or physical education teacher.
3. Adequate training for school personnel tasked with screening responsibilities.
4. Parent and student education to ensure the provision of precise information and alleviate concerns.
5. Essential educational materials required for parents, students, screeners, and school staff.
6. Identification of community health resources, both public and private, accessible for referrals.

The patient’s specific circumstances, the purpose of screening, and available resources need to be considered when selecting a screening method. An ideal screening method should be accurate, non-invasive, economical and easy to promote in order to better serve the broad population

Forethought Professional Version II Scoliosis Screening Instrument

Forethought’s proud Professional Version II Scoliosis Screening Instrument is a disruptive technological innovation designed to improve the efficiency and accuracy of scoliosis screening. This instrument not only brings together advanced hardware technology, but also combines intelligent algorithms and digital image processing, making it stand out in the field of spinal health.

Working principle and technical characteristics

The working principle of Forethought Professional Version II is based on advanced optical scanning technology. Through laser scanning, the instrument can obtain high-resolution three-dimensional images of the spine in a short time and accurately present the morphological structure of the spine. At the same time, digital image processing technology allows for real-time analysis of this data, providing doctors with detailed information to help them make accurate diagnoses.

Intelligent algorithms are another key technology of Forethought Professional Version II. Through machine learning and artificial intelligence, the instrument can continuously optimize its diagnostic capabilities, conduct pattern recognition based on large amounts of data, and improve the accuracy of scoliosis discrimination. This feature makes the instrument adaptable and can continuously improve the diagnostic effect on different individuals and situations.

Advantages of Using Forethought Professional Version II

1, Non-invasive design greatly reduces patient discomfort and risk of radiation exposure, making it especially suitable for teenagers and children. Secondly, fast and accurate diagnostic results can help detect potential spinal health problems early, providing earlier opportunities for treatment.

2, Forethought Professional Version II also offers ease of use and operability. Doctors can operate it easily through an intuitive interface and get instant results. This makes the instrument not only suitable for professional spine experts, but also can be used by a wider range of medical practitioners to provide patients with more comprehensive and efficient scoliosis screening services.

Références

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