Scoliosis epidemiology is not the same all over the world: 加强围手术期管理 A study from a scoliosis school screening on Chongming Island (China) 保障医疗质量和安全 Du, Qing, Xin Hua Hospital, Shanghai, China Negrini, Stefano University of Brescia, Brescia, Italy Zhou, Xuan, Xin Hua Hospital, Shanghai, China Li, Jianan, Rehabilitation Department of Jiangsu Province 2013 Hospital, 年 Jiangsu 7 月 1 日 Province, China He, Xiaohua, Palmer College of Chiropractic, Florida, USA Zhao, Li, Xin Hua Hospital, Shanghai, China Chen, Peijie, Shanghai University of Sport, Shanghai, China 2014/5/12 1
School scoliosis screening is considered a powerful tool that can identify individuals with unrecognized scoliosis. 2014/5/12 2
In China, although there were school scoliosis screens in some regions, there are no systemic screen program. 2014/5/12 3
Aims To examine scoliotic parameters in children from Chongming Island and to determine whether the parameters differed from that of the previously published data through a Scoliosis School Screen Program. 2014/5/12 4
Methods A total of 6824 children (3477 boys and 3347 girls) aged from 6 to 17 were recruited from 352 classes in primary, junior and senior high schools and screened for scoliosis. This study was IRB approved. 2014/5/12 5
Methods Phase 1: Explanation Phase 2: Screen Phase 3: Rescreening and Radiographic Evaluation Phase 4: Statistics 2014/5/12 6
Results The prevalence of scoliosis (10 degrees or more) was 2.52% (172 of 6824 schoolchildren). The prevalence was significantly higher in girls (3.11%) than in boys (1.96%) (ratio 1.5:1). 2014/5/12 7
Table 1 Clinical and radiologically detected scoliosis in children aged 6 to 17 years according to age and gender Demographic variable No. of children included (N=6824) # of children referred for radiograph (N=442) # of children in which scoliosis was radiologically detected (N=172) Prevalence of scoliosis (%) Average Cobb angle (Degrees) Age 6~ 163 15(3.4) 4(2.3) 2.45 12.5 7~ 873 57(12.9) 16(9.3) 1.83 11.3 8~ 853 39(8.8) 12(7.0) 1.41 12.1 9~ 903 59(13.3) 24(14.0) 2.66 12.0 10~ 849 60(13.6) 23(13.4) 2.71 12.4 11~ 746 47(10.6) 16(9.3) 2.14 15.3 12~ 592 44(10.0) 17(9.9) 2.87 13.7 13~ 601 50(11.3) 19(11.0) 3.16 12.1 14~ 529 29(6.6) 18(10.5) 3.40 13.1 15~ 250 10(2.3) 8(4.7) 3.20 15.3 16~ 247 18(4.1) 10(5.8) 4.05 15.1 17 218 14(3.2) 5(2.9) 2.29 13.0 Gender 2014/5/12 Boys 3477 201(45.5) 68(39.5) 1.96 12.5 8 Girls 3347 241(54.5) 104(60.5) 3.11 13.3
Table 1 Clinical and radiologically detected scoliosis in children aged 6 to 17 years according to age and gender Demographic variable No. of children included (N=6824) # of children referred for radiograph (N=442) # of children in which scoliosis was radiologically detected (N=172) Prevalence of scoliosis (%) Average Cobb angle (Degrees) Age 6~ 163 15(3.4) 4(2.3) 2.45 12.5 7~ 873 57(12.9) 16(9.3) 1.83 11.3 8~ 853 39(8.8) 12(7.0) 1.41 12.1 9~ 903 59(13.3) 24(14.0) 2.66 12.0 10~ 849 60(13.6) 23(13.4) 2.71 12.4 11~ 746 47(10.6) 16(9.3) 2.14 15.3 12~ 592 44(10.0) 17(9.9) 2.87 13.7 13~ 601 50(11.3) 19(11.0) 3.16 12.1 14~ 529 29(6.6) 18(10.5) 3.40 13.1 15~ 250 10(2.3) 8(4.7) 3.20 15.3 16~ 247 18(4.1) 10(5.8) 4.05 15.1 17 218 14(3.2) 5(2.9) 2.29 13.0 Gender 2014/5/12 Boys 3477 201(45.5) 68(39.5) 1.96 12.5 9 Girls 3347 241(54.5) 104(60.5) 3.11 13.3
Results Figure 1 Correlation between age and Cobb angle 2014/5/12 10
Results Most of the curves were minor (from 10 to 19 degrees). The right curve was the most common type in the thoracic region (60.3% of all thoracic curves), while the left curve was the most common type in the thoracolumbar (75.5%) and lumbar regions (64.7%). 2014/5/12 11
Table 3 Curve type by age, gender and curve side among the 172 patients with scoliosis Demographic variable Age Thoracic (N=68) Single curve Thoracolumbar (N=53) Lumbar (N=34) Double curve (N=17) 6~ 1(1.5) 3(5.7) 0(0) 0(0) 7~ 7(10.3) 6(11.3) 3(8.8) 0(0) 8~ 8(11.8) 3(5.7) 1(2.9) 0(0) 9~ 9(13.2) 13(24.5) 1(2.9) 1(5.9) 10~ 8(11.8) 5(9.4) 5(14.7) 5(29.4) 11~ 3(4.4) 7(13.2) 3(8.8) 3(17.6) 12~ 4(5.9) 5(9.4) 6(17.6) 2(11.8) 13~ 9(13.2) 3(5.7) 6(17.6) 1(5.9) 14~ 9(13.2) 5(9.4) 2(5.9) 2(11.8) 15~ 2(2.9) 3(5.7) 3(8.8) 0(0) 16~ 4(5.9) 0(0) 3(8.8) 3(17.6) 17 4(5.9) 0(0) 1(2.9) 0(0) Gender Boys 28(41.2) 25(47.2) 11(32.4) 4(23.5) Girls 40(58.8) 28(52.8) 23(67.6) 13(76.5) 2014/5/12 12 Side (major curve) Right 41(60 3) 13(24 5) 12(35 3) 10(58 8)
The prevalence of scoliosis in schoolchildren on Chongming Island is higher than those previous reported studies in other regions of China. 2014/5/12 13
The positive but weak correlation between scoliosis and age is in agreement to some study, but not all study. 2014/5/12 14
Gender difference in this study is in agreement with most previous study. Based on recent publications, the male/female ratio(1:1.5) in this study is higher than most. 2014/5/12 15
The minor to moderate Cobb angles are dominant curvature in this study. Most common types of scoliotic curves were the thoracic and thoracolumbar. Most of the curves were to the left. 2014/5/12 16
Limitations Near 30% of subjects were lost, which could change the data if they were included. Larger population may also show different results. 2014/5/12 17
Conclusion The School Scoliosis Screen Program shows the screen has some similarity when compared to certain regions, but also difference to the other regions. 2014/5/12 18
谢谢 Thank you