Studies by Bunnell(1) have shown the value of quanitating the degree of trunk twist, rotation, or inclination with an inclinometer (scoliometer). Bunnell’s study showed, that with proper training in its use, the scoliometer is quite accurate in identifying significant curves. It is estimated that only 1/1000 children screened will have a curve of 20 degrees or more if the scoliometer reading is less than 5 degrees. This information is important since curves of less than 20 degrees require only observation. It also suggests that an x-ray is not needed if the scoliometer reading is less than 5 degrees.

Measuring vertebral rotation with scoliometer

On the other hand, the specificity of the scoliometer is low. Approximately 50% of children with a scoliometer reading of 5 degrees or more will have a curve measuring less than 20 degrees. These children require only periodic measurement of their trunk inclination until they have finished growing. This may be done by a physician or school nurse. Parents may also be taught how to do this with an inclinometer, used to measure the slope of a roof, bought at a hardware store.

There has been much discussion regarding the value of school screening, which is required in Texas and a number of other states. The usefulness of the program appears to be primarily for the child who does not have the opportunity for a regular evaluation by a physician. In the days before compulsory screening, many patients first appeared for care when they had already developed a very severe deformity.

1Bunnell, W.P. An Objective Criterion for Scoliosis Screening. J. Bone and Joint Surg. 66-A (9) 1381-1387, 1984.

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