Re-evaluation of Incorrect Posture as a Diagnostic Criterion for Scoliosis in School Screenings: A Cross-Sectional Study in Vietnam

A cross-sectional study was performed to determine the prevalence of idiopathic scoliosis through school screening and to evaluate the correlation between incorrect posture identified during screening and the confirmed diagnosis of scoliosis, utilizing the gold standard criterion in 3,527 children aged 10 to 17 years from March 2023 to December 2023 in Ho Chi Minh City, Vietnam. The evaluation method included Adam's forward bending test with the angle of trunk rotation, and a cut-off point greater than or equal to 5°. Based on clinical examination, the research results show that 312 (8.7%) children were suspected of having scoliosis. Still, the prevalence of idiopathic scoliosis confirmed by X-rays was 130 (3.6%) children, with the standard being Cobb angle ≥10°. Most people with idiopathic scoliosis had moderate curves, including 119 (91.5%) and 130 (100%) demonstrated positive vertebral body rotation, with a female-to-male ratio of 2.11:1. The study identified a correlation between suspected scoliosis and incorrect posture seen during screening, including "shoulder-height difference", "any curve in the spine", and "humps on one side" (p < 0.001). However, no correlation was determined between these listed incorrect postures and a definitive diagnosis of idiopathic scoliosis by X-rays (p > 0.05). The results of the research suggest that incorrect posture found by clinical assessment shouldn't be used as the main criterion for scoliosis diagnosis during screening. The use of the angle of trunk rotation, combined with Adam's forward bending test and a suitable cut-off angle, is required to be considered for scoliosis screening in schools.