Guidelines for preventive activities in general practice

Musculoskeletal disorders

Scoliosis

      1. Scoliosis

Musculoskeletal disorders | Scoliosis

 

Scoliosis is a common paediatric condition with a prevalence of up to 5%.1 True scoliosis is three-dimensional, with rotation evident at the apex of the curve, and a Cobb angle >10°. Lateral curvature, from issues such as poor posture, muscle spasm or leg length discrepancy, can masquerade as scoliosis.2 The cause of structural scoliosis, where rotation is present, is idiopathic in 75% of cases, neuromuscular (eg cerebral palsy, spina bifida, muscular dystrophy) in 10% of cases, congenital (eg failure of formation or segmentation) in another 10% of cases and due to many other rare causes in 5% of cases.2

Idiopathic scoliosis most commonly occurs between the ages of 10 and 18 years. A typical adolescent idiopathic scoliosis patient is female with a convex right thoracic curve or convex left lumbar curve, right shoulder elevated, right rib prominence, no neurological deficits and no significant pain.2 Although boys and girls are equally affected with small curves, curves >40° are sevenfold more frequent in girls.1 Concerning curves include early onset scoliosis, premenarchal scoliosis with a curve >25° and skeletally mature patients with curves >50°.2

Screening

Recommendation Grade How often References
Screening for adolescent idiopathic scoliosis in children and adolescents aged 10-18 years is not recommended because of insufficient evidence. Not recommended (Strong) N/A 3

In 2018, the US Preventive Services Task Force (USPSTF) found no direct evidence on screening for adolescent idiopathic scoliosis and health outcomes.3 There was also inadequate evidence on the association between reduction in spinal curvature in adolescence and long-term health outcomes in adulthood.3

Further information on scoliosis assessment and management can be found in the article Paediatric scoliosis: Update on assessment and treatment.

There are no specific recommendations and advice for Aboriginal and Torres Strait Islander people.

  1. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 2013;7(1):3–9. doi: 10.1007%2Fs11832-012-0457-4.
  2. Parr A, Askin G. Paediatric scoliosis: Update on assessment and treatment. Aust J Gen Pract 2020;49(12):832–37. doi: 10.31128/ajgp-06-20-5477.
  3. US Preventive Services Task Force (USPSTF). Adolescent idiopathic scoliosis: Screening. USPSTF, 2018 [Accessed 2 February 2024].
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