A prospective prevalence study of scoliosis in Southern Sweden.

In Malmö, Sweden, 17,181 school children born in the years 1961-1965 were screened for scoliosis once a year between the ages of 7 and 16 years, during 1971-1980. Children with clinical signs of scoliosis including a positive forward bending test were admitted to the Department of Orthopedic Surgery for reinvestigation and AP roentgenograms. There were 474 children with a scoliosis measuring 5 degrees of more (prevalence 2.8 per cent). Among the girls this prevalence was 4.3 per cent (n = 367) and among the boys 1.2 per cent (n = 107). This combined screening test revealed in girls a higher percentage of scoliosis measuring 10-14 degrees than 5-9 degrees, 1.3 and 1.1, respectively. In boys, however, the number of curves measuring 5-9 degrees was almost equal to the number exceeding 9 degrees. Thus, the rotational component of the scoliosis seems to be less pronounced in girls and curves less than 10 degrees can easily be missed in them. Therefore, 10 degrees is recommended as the lower limit when using this screening technique. With 10 degrees as the lower limit, the scoliosis prevalence was 3.2 per cent in girls and 0.5 per cent in boys. Ninety-six of the girls (1.1 per cent) had a scoliosis exceeding 19 degrees. 46 showed a progression of the scoliosis, which indicated brace treatment in 42 cases and surgical treatment in 4 cases. Among the boys 12 had curves measuring more than 19 degrees (0.14 per cent). Four boys with curves exceeding 24 degrees were treated with a brace. Thus, the risk of progression was higher in girls as compared with boys; 0.5 per cent of the girls and 0.05 per cent of the boys were treated. Another 0.2 per cent of the girls should also have been treated but, for various reasons, treatment was not carried out.