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Scoliosis screening policies vary around the world depending on the situation. In China, based on the high prevalence and low consultation rate of scoliosis, the Clinical Practice Guidelines and Pathway Guidelines for Scoliosis Screening in Chinese Adolescents were released in 2021 to provide clinical guidance for the screening of this condition. However, public awareness of scoliosis screening is currently very low, and raising awareness among parents and teachers and promoting home-based screening are important tools to improve diagnosis rates. The guideline development group collected over 1000 questionnaires to identify the issues addressed in the guideline and invited 75 Chinese spine surgery experts to use the Delphi method to form the recommendations, ultimately resulting in the formation of this guideline. They proposed 11 recommendations addressing 9 issues, providing methods for both home screening and school screening. The guideline presents recommendations on the reasons for scoliosis screening, the target population, screening methods, post-screening diagnosis, and referrals. It also proposes standardized methods for home screening and school screening. Home screening method for scoliosis include back and spine shape observation and forward bending test. School screening methods for scoliosis include visual inspection, the forward bending test, portable scoliosis screening tools, scoliosis ultrasound screening tools and so on. The guideline can provide easy-to-understand knowledge on scoliosis screening in adolescents, thereby improving the diagnosis rate of the disease and promoting early treatment. Early intervention and management of scoliosis is expected to reduce the potential risks associated with scoliosis in adolescents in the future. This article can promote the application of various scoliosis screening methods in future scoliosis screenings (including portable scoliosis screening tools), extend Chinese perspectives on scoliosis screening to the global stage, advance the translation of research achievements in the field of scoliosis screening, enhance the diagnosis rate of early scoliosis, and reduce the incidence of severe adolescent scoliosis. Terminology Explanation: Cobb Angle: An indicator measuring the degree of spinal curvature, specifically referring to the angle formed by the lines perpendicular to the upper endplate of the vertebra at the apex of the curvature and the lower endplate of the vertebra at the base of the curvature, as observed in a standing full-spine X-ray.Idiopathic Scoliosis: The most common type of adolescent scoliosis, accounting for approximately 75 % of cases, with an unknown cause.Congenital Scoliosis: Scoliosis associated with abnormal vertebral development, often accompanied by deformities in other organs.Neuromuscular Scoliosis: Scoliosis caused by neurological or muscular disorders.Forward Bend Test: A crucial physical examination for scoliosis, where the individual stands with their back facing the examiner, hands clasped together, arms hanging straight down, and gradually bends forward. The examiner observes the contour of the back.Rib Hump: In the Forward Bend Test position, observers may notice that one side of the patient's back is higher than the other, resembling a razor's edge, hence the term "razorback."Spinous Process: A bony projection on the posterior aspect of the spine that can be palpated in the midline of the back, aiding in determining vertebral positions.
Zhao et al. (Wed,) studied this question.