At the turn of the 20th century, many US public schools and colleges began to subject their students to posture tests, precursors to today's scoliosis examinations. That more than half of US states still conduct school-based scoliosis screening, despite the USPSTF's recommendation against it, points to the examination's deep historical roots. 7 These medical professionals believe that failure to screen for scoliosis would put thousands of adolescents at risk for developing a very real and, at times, disabling condition. 6 Although researchers at the University of Iowa have questioned the benefit of medical intervention in certain cases of idiopathic scoliosis, the Academy of Orthopedic Surgeons, the American Academy of Pediatrics, and the Scoliosis Research Society all endorse screening and bracing adolescents who have curvatures of greater than 10 degrees. 5 Proponents of scoliosis screening maintain that early detection is necessary to catch and treat spinal curvatures before they become severe enough to cause chronic pain and negatively affect cardiopulmonary functioning. 4ĭespite the USPSTF's stance, 33 US states still either mandate or recommend school-based scoliosis screening. 3 With this assessment, the USPSTF attempted to put America on the same path as many other industrialized nations (e.g., Canada, Great Britain, and Australia) that have overturned the long tradition of mandatory spinal screening of its school-aged citizens. ![]() 2 School-based screening not only diagnosed scoliosis in children who did not really have it but also often led those who did have a mild curvature to endure painful and unnecessary brace wear. The diagnostic tool-a visual inspection of a child performing a forward-bending test-remained unreliable, often leading to a sizable number of false-positive results. 1 According to its panel of medical and public health experts, scoliosis screening did not meet the criteria of evidence-based medicine, standards first articulated and upheld by the USPSTF and the US Public Health Service in 1984. ![]() IN 2004, THE US PREVENTIVE Services Task Force (USPSTF) called for an end to a century-long practice of screening adolescent schoolchildren for scoliosis.
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