The forward bend test for scoliosis hasn’t been a mandated back-to-school procedure in California for the last 7 years. But that doesn’t mean parents should be skipping it altogether, physicians say.
Orthopedic surgeon Michelle James sees the condition pretty often in her work at Shriners Hospital in Sacramento.
“Kids are no longer routinely being checked for this in all schools. Visits to the doctor may only occur once a year or so. And during the child’s growth spurt, if they have scoliosis, the curve can get worse pretty fast, and you don’t want to miss the window of opportunity when the treatment might be simple,” says James.
That’s why Shriners physicians developed Spine Screen - a free app that helps detect whether a child’s spine is starting to curve sideways.
Scoliosis usually hits right before puberty - around age 10 for girls and age 13 for boys. It affects about 4 percent of teens.
California 2010 decision to allow schools to skip scoliosis screenings was mostly a cost-saving measure.
But there were also a lot of lingering questions about whether the touch-your-toes test actually worked. The U.S. Preventive Task Force, which makes screening recommendations for primary care physicians, has recommended against scoliosis tests since 2004.
“They can lead to false positives, and false positives can lead to extra, unneeded testing as well as worry on behalf of, in this case, the adolescent," says Dr. Alex Kemper, an Ohio-based pediatrician and a member of the task force.
This June, he and other members decided to change the scoliosis recommendation from D for “discouraged” to I for “Insufficient evidence.” A lot of new studies have come out since 2004, he says. But he still can’t say for certain whether the test really helps.
“The kind of evidence raises more questions than answers,” says Kemper.
Dr. James agrees that the old forward bend wasn’t a surefire method. That’s where the app comes in.
“There can be a lot of different causes of one rib side looking higher than the other," says James. "And the app doesn’t get around all of those, but it does get around some of them, so a parent can maybe catch it earlier, when the treatment will be easier and maybe be a little bit more reliable than the traditional method of doing it.”