History of Scoliosis Screening in Minnesota
The first Minnesota training session for scoliosis screening was held in Duluth (1973). The Minnesota Department of Health (MDH) was the lead agency and organized trainings, developed resource materials and collected screening results from schools. Scoliosis school screening forms were provided to schools and these were submitted to the MDH Minnesota Children & Youth with Special Health Needs (CYSHN) Section upon completion of screening. This data was used to estimate prevalence of scoliosis in Minnesota. It also provided an estimate of scoliosis school screening effectiveness in maintaining early detection and preventing progressive spinal deformity.
MDH discontinued data surveillance in 2000, in part due to incomplete data reporting and decreased data submission. MDH continued to encourage schools to maintain their own system for data collection to estimate the incidence and prevalence of scoliosis in the school district/community. MDH currently does not maintain a database of scoliosis.
Although scoliosis screening in schools has never been mandated in Minnesota, it has been strongly recommended. Until 2008, MDH supported screening both boys and girls, generally grades 5-9, with girls starting at younger ages and boys finishing at older ages. The Adam's Forward Bending Test (FBT) was the first screening method used. Later the FBT and scoliometer were recommended for screening, with a 5° Angle of Trunk Rotation (ATR) as the criterion for referral to the primary care provider.
MDH, Gillette Children's Specialty Healthcare, Shriners Hospitals for Children/Twin Cities and the Twin Cities Spine Center have maintained a long-term collaboration on scoliosis screening programs, training and training materials. In 2002 Gillette Children's Specialty Healthcare took the lead in this collaboration and now provides education, training, and consultation on scoliosis screening for schools.
2008 Scoliosis School Screening Workgroup: Revised Recommendations
The 2008 review and revision of recommendations were conducted in accordance with the MDH Maternal and Child Health Section mission to provide statewide leadership and public health information essential for promoting, improving or maintaining the health and well-being of women, children and families throughout Minnesota. To accomplish this mission, MDH periodically reviews well-child screening practice recommendations in such topics as hearing, vision, oral/dental and developmental screening. Reviews take into consideration current research, screening resources at the state and local level as well as feedback from public and private providers, parents, researchers and other key stakeholders.
MDH initially conducted a literature review of current adolescent idiopathic scoliosis research, data, trends and technology.
The review covered:
- Risk factors and prevalence of adolescent idiopathic scoliosis
- School screening programs
- Available screening tools
- Referral criteria and processes
- Cost-effectiveness of screening programs
- Recommendations by several professional organizations and literature sources
MDH invited leading experts and representatives of major professional organizations involved in scoliosis screening, outreach, referral and treatment to participate in the MDH Scoliosis School Screening Workgroup. The workgroup was formed to provide recommendations on school-based scoliosis screening to MDH.
Representatives from the following groups were invited to participate:
- Minnesota Department of Health
- Minnesota Department of Education
- Minnesota Department of Human Services
- Minnesota chapter of the American Academy of Pediatrics (AAP)
- Minnesota American Academy of Family Practice (AAFP)
- Minnesota Chiropractic Association (MCA)
- Minnesota Orthopaedic Society (MOS)
- National Association of Pediatric Nurse Practitioners (NAPNAP), MN chapter
- School Nurse Organization of Minnesota (SNOM)
- Local Public Health Nurse
- Local School Health Nurse
- Gillette Children's Specialty Healthcare
- Shriners Hospitals for Children-Twin Cities
- Twin Cities Spine Center
- Olmsted Medical Center
- University of Minnesota Department of Orthopaedic Surgery
- Parent of child with scoliosis