Patient characteristics at the initial visit to a scoliosis clinic: a cross-sectional study in a community without school screening

Abstract

Study design: A cross-sectional study was conducted of all patients referred for an initial visit to the orthopedic outpatient clinic of a metropolitan pediatric hospital in Canada for suspected adolescent idiopathic scoliosis (AIS).

Objective: To document the appropriateness of current referral patterns for AIS in comparison to those that were prevailing before discontinuation of school screening in Canada.

Summary of background data: The consequences of the discontinuation of school scoliosis screening programs on the referral patterns of AIS patients remain unknown.

Methods: The clinical and radiologic charts of the 636 consecutive patients referred for scoliosis evaluation over a 1-year period were reviewed. Patients were classified according to defined criteria of appropriateness of referral based on skeletal maturity and curve magnitude.

Results: Of the 489 suspected cases of AIS, 206 (42%) had no significant deformity (Cobb angle <10 degrees ) and could be considered as inappropriate referrals. In subjects with confirmed AIS, 91 patients (32%) were classified as late referrals with regards to brace treatment indications.

Conclusions: These findings suggest that current referral mechanisms for AIS are leading to a suboptimal case-mix in orthopedics in terms of appropriateness of referral.