Scoliosis (policy currently in consultation)
The UK NSC policy on Scoliosis screening in children
More Information
Scoliosis is an abnormal curvature of the spine to one side. In those who have the condition, the spine bends either to the left or to the right. The bend can occur at any point along the spine from the top to the bottom. The curvature also varies from slight to severe. However, the chest area (thoracic scoliosis) and the lower part of the back (lumbar scoliosis) are the most common regions to be affected.
» Read more about scoliosis on NHS Choices
Policy Position
The UK NSC reviewed the evidence on screening for scoliosis and decided that screening should not be offered.
When replying to the current consultation, please use the comments form that you can download at the bottom of this page.
This policy is currently being reviewed as part of the UK NSC's regular review cycle of all policies.
The review process began in Jan 2012 and is estimated to be completed by Mar 2013.
» Download the expert review for Scoliosis (PDF document, 559KB)
The UK NSC welcomes comments and feedback on the expert review during the consultation period that lasts from 23 Mar 12 until 23 Jun 12. Please send comments to Esther Rose
When replying to a consultation, please state whether you are happy for your views to be made public on the UK NSC website or whether you would prefer them to be seen by UK NSC members only. We will assume comments can be published on the website unless told otherwise.
Evidence Supporting the Policy
In 2004, the US Preventive Services Task Force reviewed all the evidence and concluded:
"The USPSTF found fair evidence that treatment of idiopathic scoliosis during adolescence leads to health benefits (decreased pain and disability) in only a small proportion of people. Most cases detected through screening will not progress to a clinically significant form of scoliosis. Scoliosis needing aggressive treatment, such as surgery, is likely to be detected without screening.
The USPSTF found fair evidence that treatment of adolescents with idiopathic scoliosis detected through screening leads to moderate harms, including unnecessary brace wear and unnecessary referral for specialty care. As a result, the USPSTF concluded that the harms of screening adolescents for idiopathic scoliosis exceed the potential benefits."
In essence, there is little evidence that screening would be necessary to pick up children needing surgery. On the other hand, many children would be subjected to unnecessary X-rays and treatment, which may themselves be harmful. This could cause unnecessary stress to children and their families. Since this review, there has been no further evidence that screening would be of overall benefit.
Stakeholders
British Orthopaedic Association
British Scoliosis Society
Institute of Child Health
Royal College of General Practitioners
Royal College of Surgeons
Scoliosis Association (UK)
The stakeholder groups will be involved when the policy is next reviewed. If you think your organisation should be added, please contact us.
Related documents
Appendix to knowledge update on screening for scoliosis (February 2011) (PDF document, 129KB, 24/08/11)August 2011 update to the February 2011 knowledge update on screening for scoliosis (2011) (PDF document, 35KB, 24/08/11)
Consultation submission comments form (Word document, 48KB, 23/03/12)
Knowledge update on screening for scoliosis (February 2011) (PDF document, 80KB, 24/08/11)
Screening for Idiopathic Scoliosis in Adolescents (2004) (PDF document, 166KB, 01/09/10)
