脊柱侧凸测量仪在学校脊柱侧弯筛查中的截断点。

Cut-off point of the Scoliometer in school scoliosis screening.

作者信息

Huang S C

机构信息

Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei.

出版信息

Spine (Phila Pa 1976). 1997 Sep 1;22(17):1985-9. doi: 10.1097/00007632-199709010-00007.

DOI:10.1097/00007632-199709010-00007

PMID:9306527

Abstract

STUDY DESIGN

A large-scale study on school screening for scoliosis was conducted to assess the referral rate, prevalence rate, and positive predictive value using different angles of trunk rotation as criteria for referral.

OBJECTIVE

To determine an ideal angle of trunk rotation cut-off point to be used for referral in school screening for scoliosis.

SUMMARY OF BACKGROUND DATA

When using the Scoliometer (Orthopedic Systems, Inc., Hayward, CA) in school scoliosis screening, 5 degrees and 7 degrees angles of trunk rotation have been recommended as criteria for referral. Low positive predictive values and over-referral at these levels have been reported.

METHODS

The Adams forward bend test and Scoliometer measurement were combined for school scoliosis screening in 33,596 girls from the fifth, sixth and seventh grades. Nurses were the primary screeners. Girls with trunk rotation angles of 5 degrees or more were referred for radiography.

RESULTS

The referral rate was 5.2%. By selecting 6 degrees, 7 degrees, 8 degrees, 9 degrees or 10 degrees angles of trunk rotation as criteria for referral, the referral rate became 2.4%, 1.4%, 0.7%, 0.5%, or 0.3%, respectively. The prevalence rate for scoliosis equal to or larger than 10 degrees, 20 degrees, 30 degrees, or 40 degrees of the Cobb angle was 1.47%, 0.21%, 0.04% and 0.02%, respectively, by using a 5 degrees angle of trunk rotation as the criterion for radiography. The positive predictive value was 28.3% for scoliosis of 10 degrees or more, 4% for scoliosis of 20 degrees or more, 0.8% for scoliosis of 30 degrees or more, and 0.4% for scoliosis of 40 degrees or more with a 5 degrees angle of trunk rotation as the criterion for referral. By selecting angles of trunk rotation larger than 5 degrees as criteria for referral for radiography, the positive predictive value increased, but positive cases with larger Cobb angles also decreased markedly.

CONCLUSION

The optimal cut-off point for referral when using the Scoliometer in school screening of scoliosis is still difficult to determine.

摘要

研究设计

开展了一项关于学校脊柱侧弯筛查的大规模研究，以评估使用不同躯干旋转角度作为转诊标准时的转诊率、患病率和阳性预测值。

目的

确定在学校脊柱侧弯筛查中用于转诊的理想躯干旋转角度截断点。

背景数据总结

在学校脊柱侧弯筛查中使用脊柱侧凸测量仪（Orthopedic Systems, Inc., Hayward, CA）时，已推荐5度和7度的躯干旋转角度作为转诊标准。据报道，这些水平的阳性预测值较低且转诊过度。

方法

对33596名五、六、七年级女生进行了亚当斯前屈试验和脊柱侧凸测量仪测量，以进行学校脊柱侧弯筛查。护士是主要筛查人员。躯干旋转角度为5度或更大的女孩被转诊进行X光检查。

结果

转诊率为5.2%。以6度、7度、8度、9度或10度的躯干旋转角度作为转诊标准时，转诊率分别变为2.4%、1.4%、0.7%、0.5%或0.3%。以5度的躯干旋转角度作为X光检查标准时，Cobb角等于或大于10度、20度、30度或40度的脊柱侧弯患病率分别为1.47%、0.21%、0.04%和0.02%。以5度的躯干旋转角度作为转诊标准时，10度或更大脊柱侧弯的阳性预测值为28.3%，20度或更大脊柱侧弯的阳性预测值为4%，30度或更大脊柱侧弯的阳性预测值为0.8%，40度或更大脊柱侧弯的阳性预测值为0.4%。以大于5度的躯干旋转角度作为X光检查转诊标准时，阳性预测值增加，但Cobb角较大的阳性病例也明显减少。