September 18, 2019
Adolescent Idiopathic Scoliosis (AIS) and Conservative Therapy – Does it Work?
Scoliosis screening in schools was something all year 7 girls did when I was in school. None of us knew what scoliosis even was. But we all lined up, bent over and were told yes or no. I was told I had mild scoliosis and I remember this sense of relief that it was only mild. I didn’t even think to question what happened to the girls that had a more severe deformity. I imagine there were plenty of parents around the country grateful for that early diagnosis. And then it all stopped. Why?
Screening for any condition involves simple testing to decide whether or not that person needs to see a specialist of some sort for that condition for more detailed testing. In the case of scoliosis, we all performed the Adams test, or the forward bend test, whereby the nurse (or whoever was doing it) would assess to see if we had a hump on our back that may indicate the presence of scoliosis.
When you screen for anything in the medical world, you are trying to identify those who may have the condition, and directing people to the right team to do further investigations. In other words, you are trying to get in early! Trying to avoid progression and unnecessary poor outcomes. This gives the person the best chance at a good outcome. But in years gone by there was little support for any type of treatment for scoliosis, other than surgery. So, if the support for conservative therapy was lacking, what was the point of early detection and screening programs?
Support for Physiotherapeutic Scoliosis Specific Exercises (PSSE) such as the Schroth method or Scientific Exercise Approach to Scoliosis (SEAS) methods, was limited at the time that Scoliosis School Screening was abolished. Support for the efficacy of bracing was also limited. So, if scoliosis surgeons didn’t believe that any therapy other than surgery worked, what was the point of early screening? This was the mentality, and thus the approach, adopted. Consequently Scoliosis School Screening was abolished.
Unfortunately when Scoliosis School Screening stopped, more kids missed out on early detection and surgery rates increased. We now know that there is more and more growing support for the efficacy of PSSE and in some cases combining PSSE and bracing, in order to try to prevent a curve progressing to the point of needing surgery.
Did you know that Scoliosis School Screening does happen in some places around the world? So why do the others not follow? Australia is definitely one country that is yet to get on board with this simple prevention approach. We feel so strongly about Scoliosis School Screening that we contacted a large group of local schools near our clinic, offering an inexpensive ‘opt-in’ approach to school screening. The response was dismal to non-existent! It was a good experiment to see where the local mindset was at, and despite parents asking me almost daily what happened to Scoliosis School Screening, it seems that the higher powers in schools are not aware of the importance of early detection, or are putting it in the ‘too hard’ basket.
I guess when you really think about it, one of the main reasons things like this stop is the cost. I recognise that Scoliosis School Screening is a costly exercise. But wouldn’t even an ‘opt-in’ and user pay approach for parents be useful? And when does money come before the health of our future population anyway? It seems so wasteful that countries with the means to screen just don’t!
If you are the Principal of a School, or know a Principal, who wants to get involved in Scoliosis School Screening, please contact us at email@example.com