Rick Sasso, MD

This blog entry is part of a series on scoliosis, and will address commonly asked questions about screenings.

At what age should I have my children screened for scoliosis and how frequently should this be done?

In that scoliosis is typically diagnosed between the ages of 10 and 16, I generally recommend that parents have their children screened for scoliosis as a part of their annual physical.  Depending on the school system, the school nurse may do scoliosis screenings as part of their wellness / health initiatives. 

Are there any visible symptoms of scoliosis that I can look for in my child? 

There are a few visible symptoms that as a parent you may notice in your child.  Some of these visible signs may be uneven shoulders, or a protrusion of one or both of the shoulder blades, an elevated hip, or uneven waist.  Sometimes, you may notice clothes do not fit properly – that pant legs may appear longer on one side than the other.  If you notice any of these symptoms in your child, it is recommended to talk to your family doctor.    

What is the screening test called that is commonly performed – when you are bending forward?

This is one of the most common initial screening tests for scoliosis and is called the Adam’s Forward Bending Test.  For this test, the individual puts his or her feet together,  leans forward and bends at the waist 90 degrees.  Often times, they are asked to put their hands together like they are diving.  The screener will then look at the spine for any abnormal curvatures and asymmetry of the trunk.  This screening can tell if there is a curve – but not the degree of the curve.

How do you determine the degree of spinal curvature?

If an initial screening such as the Adam’s Forward Bending Test indicated that they was a curvature – further testing then measures the degree of the spinal curvature.  To determine this – an X-ray of the spine is taken.  A process called the Cobb Method is then used to measure the amount of spinal curvature. 

With the Cobb method of measuring spinal curvature, lines are drawn on the X-ray parallel to the end plates of the vertebral bodies at the beginning and end of the curve.  A perpendicular line is then drawn – and the angle between these two lines equals the degree of curvature – called the Cobb measurement.  It is important to note, that the actual measurement can vary 3 to 5 degrees, depending upon the exact positioning of the patient for the X-ray.  That is why major treatment decisions are not made on one single X-ray.