Author/Authors :
AS, Deepak Department of Orthopaedic Surgery - Prince Court Medical Center - Kuala Lumpur, Malaysia , JY, Ong National Orthopaedic Center of Excellence for Research and Learning (NOCERAL) - University of Malaya - Kuala Lumpur, Malaysia , DSK, Choon National Orthopaedic Center of Excellence for Research and Learning (NOCERAL) - University of Malaya - Kuala Lumpur, Malaysia , CK, Lee National Orthopaedic Center of Excellence for Research and Learning (NOCERAL) - University of Malaya - Kuala Lumpur, Malaysia , CK, Chiu National Orthopaedic Center of Excellence for Research and Learning (NOCERAL) - University of Malaya - Kuala Lumpur, Malaysia , CYW, Chan National Orthopaedic Center of Excellence for Research and Learning (NOCERAL) - University of Malaya - Kuala Lumpur, Malaysia , MK, Kwan National Orthopaedic Center of Excellence for Research and Learning (NOCERAL) - University of Malaya - Kuala Lumpur, Malaysia
Abstract :
Introduction: There is no large population size study on school screening for scoliosis in Malaysia. This study is aimed to determine the prevalence rate and positive
predictive value (PPV) of screening programme for adolescent idiopathic scoliosis.
Materials and Methods: A total of 8966 voluntary school
students aged 13-15 years old were recruited for scoliosis
screening. Screening was done by measuring the angle of
trunk rotation (ATR) on forward bending test (FBT) using a
scoliometer. ATR of 5 degrees or more was considered
positive. Positively screened students had standard
radiographs done for measurement of the Cobb angle. Cobb
angle of >10° was used to diagnose scoliosis. The percentage
of radiological assessment referral, prevalence rate and PPV
of scoliosis were then calculated.
Results: Percentage of radiological assessment referral
(ATR >5°) was 4.2% (182/4381) for male and 5.0%
(228/4585) for female. Only 38.0% of those with ATR >5°
presented for further radiological assessment. The adjusted
prevalence rate was 2.55% for Cobb angle >10°, 0.59% for
>20° and 0.12% for >40°. The PPV is 55.8% for Cobb angle
>10°, 12.8% for >20° and 2.6% for > 40°. Conclusions: This is the largest study of school scoliosis
screening in Malaysia. The prevalence rate of scoliosis was
2.55%. The positive predictive value was 55.8%, which is
adequate to suggest that the school scoliosis screening
programme did play a role in early detection of scoliosis. However, a cost effectiveness analysis will be needed to firmly determine its efficacy.
Keywords :
adolescent idiopathic scoliosis , school screening , prevalence , positive predictive value
