Duke Medicine: New approaches to scoliosis

Most of us remember Adam’s Forward Bend Test, though few of us are familiar with that name: you fold forward at the waist, arms dangling, and an examiner eyes your spine for any swerves in the ridgeline of vertebrae connecting your neck and the small of your back.

Children lined up for such annual scoliosis screenings used to be a familiar sight in school gyms across North Carolina. The problem was, says Duke orthopaedic surgeon Robert Fitch, MD, the process was expensive and largely ineffective.

Scoliosis includes any curvature of the spine that measures 10 degrees or greater; it’s quite common, says Fitch, who specializes in children and adolescents, and the vast majority of people who have it require no treatment at all. “After mass screenings, I’d end up with a flood of referrals. It amounted to a lot of unnecessary anxiety for parents.”

Those schoolwide screenings are no longer the norm -- nowadays pediatricians and general practitioners are the ones who keep their eyes on growing spines -- and a great deal more has changed in the way scoliosis is addressed.

For kids and still-growing teens whose curves are at 25 to 40 degrees, those awkward, cumbersome back braces once worn 24/7 have for the most part given way to lightweight devices that fit easily under clothing and allow for greater movement. “For certain curve patterns, a nighttime brace may even be sufficient,” says Fitch.