Idiopathic Scoliosis in Singapore Schoolchildren: A Prevalence Study 15 Years Into the Screening Program


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Abstract

Study Design.A point prevalence survey of 72,699 schoolchildren in four age groups was performed.Objectives.To determine the prevalence rates of idiopathic scoliosis and to compare with a previous prevalence study done 15 years earlier.Summary of Background Data.Prevalence rates for idiopathic scoliosis of 5° or more in schoolchildren were established in a study performed in 1982. There have been no previous data on prevalence rate changes over time.Methods.A total of 35,558 boys and 37,141 girls from randomly selected schools were screened for scoliosis. Those with scoliometer readings of more than 5° underwent radiographic evaluation. Prevalence rates were calculated for scoliosis at a predefined Cobb angle of 10° and 5°, the latter for comparison with the previous prevalence study. Curve type and distribution, pubertal status, and symptoms were correlated with the prevalence data.Results.Prevalence rates were 0.05% for girls and 0.02% for boys at 6 to 7 years of age, 0.24% for girls and 0.15% for boys at 9 to 10 years of age, 1.37% for girls and 0.21% for boys at 11 to 12 years of age, and 2.22% and 0.66%, respectively, for girls and boys at 13 to 14 years of age. The ratio of girls to boys increased from 1.6 at 9 to 10 years of age to 6.4 at 11 to 12 years of age. Thoracolumbar curves were the most common (40.1%), followed by thoracic curves (33.3%), double/triple curves (18.7%), and lumbar curves (7.9%). Older children had greater proportions of larger curves. Compared with the previous prevalence study in 1982, there was a significant increase in the prevalence rate in girls 11 to 12 years of age. Screening of 11- to 12- and 13- to 14-year-old girls detected curves in the range suitable for bracing, with nearly 96% and 32% of the age groups, respectively, still amenarche or within a year of menarche, and 57% and 34% of the age groups, respectively, having low Risser grades of 0, 1, and 2.Conclusions.The overall prevalence rate of idiopathic scoliosis in our school population in 1997 was 0.93% in girls and 0.25% in boys. The prevalence rates were low at 6 to 7 and 9 to 10 years of age but increased rapidly to 1.37% and 2.22% for girls at 11 to 12 and 13 to 14 years ofage, respectively. The prevalence rate increased significantly in 11- to 12-year-old girls over a 15-year period from 1982 to 1997. Screening of 11- to 12- and 13- to 14-year-old girls identified a significant number who could benefit from brace treatment.

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