Ohtsuka Y, Yamagata M, Arai S, Kitahara H, Minami S
National Sanatorium Chiba Higashi Hospital, Japan.
Spine (Phila Pa 1976). 1988 Nov;13(11):1251-7. doi: 10.1097/00007632-198811000-00008.
The screening program for scoliosis started by Chiba University in 1979 consists of using moiré topography, low-dose roentgenography and a final ordinary x-ray examination. The number of children screened through this Chiba University Medical School (CUMS) screening program to 1986 amounted to 1,246,798. The incidence of scoliosis of more than 15 degrees increased linearly according to age from the fifth grade primary school children (0.07% in boys, 0.44% in girls) to the second grade junior high school students (0.25% in boys, 1.77% in girls). The female predominance of scoliosis cases with curvatures of more than 20 degrees detected during the total period was 10:1 and this female predominance was the same for primary school children and junior high school students. According to a study of the incidence of scoliosis by districts, (areas were divided according to population density and urbanization) there were no significant differences in the fifth grade primary school children between the sparsely and densely populated areas. In the cases of children beyond the fifth grade primary school level, however, the incidence in the densely populated areas were significantly higher than those in the sparsely populated districts. The incidence of scoliosis of more than 20 degrees decreased significantly every year among junior high school students, because they were screened periodically in school and the scoliotic students who had already been detected were left out of the next screening. This study establishes that screening for scoliosis by the CUMS screening program is cost-effective with a low risk of radiation hazards.
千叶大学于1979年启动的脊柱侧弯筛查项目包括使用莫尔条纹地形测量法、低剂量X线摄影以及最后的普通X线检查。截至1986年，通过千叶大学医学院（CUMS）筛查项目筛查的儿童数量达1,246,798名。脊柱侧弯超过15度的发病率从小学五年级儿童（男孩0.07%，女孩0.44%）到初中二年级学生（男孩0.25%，女孩1.77%）随年龄呈线性增加。在整个期间检测出的侧弯超过20度的脊柱侧弯病例中，女性占主导，男女比例为10:1，且小学儿童和初中学生的这种女性主导情况相同。根据对不同地区（根据人口密度和城市化程度划分区域）脊柱侧弯发病率的研究，小学五年级儿童中，人口稀少地区和人口密集地区之间没有显著差异。然而，对于小学五年级以上的儿童，人口密集地区的发病率显著高于人口稀少地区。初中学生中，侧弯超过20度的脊柱侧弯发病率每年显著下降，因为他们在学校定期接受筛查，且已检测出的脊柱侧弯学生不会参加下一次筛查。这项研究表明，CUMS筛查项目对脊柱侧弯进行筛查具有成本效益，且辐射危害风险较低。
