| Objective:To further understand the prevalence of scoliosis among adolescents in Tianjin through this screening in school,and to further analyze the impact of scoliosis on the coronal,sagittal and cross-sectional aspects of the spine by evaluating the imaging data of scoliosis patients.In the process of screening,the information related to scoliosis should be brought to schools to improve the awareness of adolescents about scoliosis,so as to achieve early detection and treatment.Teachers,students and parents are urged to take care of adolescent spinal health.Methods:The eighth grade students of 96 middle schools in six districts of Tianjin were selected as the research objects.A total of 15038 students signed the informed consent and agreed to screen,including 7960 boys and 7078 girls,aged 13-16.From October2017 to May 2018,students were screened for scoliosis.The combined screening method of physical examination+Adam's Forward Bending Test,Scoliometer + X-ray photography was used.The X-ray Cobb angle>10°was used as the diagnostic criterion for scoliosis.Finally,the results were described and analyzed according to the screening data and image data.Results:1.The positive rate of the second test of scoliosis among eighth grade students in six districts of Tianjin was was 2.9%(435/15038).The participation rate of the three examinations was 50.11%(218/435).The diagnostic accuracy of the three examinations was 85.78%(187/218).187 patients were diagnosed as scoliosis,all of them were idiopathic scoliosis,including 75 male patients and 112 female patients.2.The prevalence of scoliosis among eighth grade students in six districts of Tianjin was 2.48%.There was no significant difference in the incidence among districts(P>0.05).The prevalence of male patients was 1.89% and that of female students was3.16%.The ratio of male to female prevalence was 1:1.67.The prevalence of female patients was significantly higher than that of male patients(P<0.01).There was a positive correlation between trunk rotation angle and Cobb angle in 187 patients(r =0.734,P < 0.01).3.There were 144 people with mild scoliosis(20°>Cobb angle ?10°),accounting for77.01%;43 people with moderate scoliosis(40°>Cobb angle ?20°),accounting for22.99%.4.Among 187 patients,the scoliosis types of 137 patients were single bend,including 45 patients with single chest bend(9 left and 36 right),43 patients with single waist bend(23 left and 29 right),49 patients with thoracolumbar bend(32 left and 17 right),and 50 patients with double bend(2 double chest bend and 48 thoracolumbar double bend).5.Among the 187 patients,36.36%(68/187)had BMI lower than 18.5,of which 25 boys accounted for 36.76% and 43 girls accounted for 63.24%.53.48%(100/187)had BMI between 18.5 and 23.9,and 10.16%(19/187)had BMI higher than 24.6.Among the 187 patients,64 patients had lower thoracic curvature and 1 increased lumbar curvature,28 patients had lower lumbar curvature and 3 patients had greater lumbar curvature.7.According to Nash-moe method,142 persons with 1 degree of vertebral rotation were measured.Among them,115 persons with 10-19 degree of Cobb angle,20 persons with 20-29 degree of Cobb angle and 7 persons with 30-39 degree of Cobb angle were distributed;19 persons with 2 degree of vertebral rotation,including 5persons with 10-19 degree of Cobb angle,12 persons with 20-29 degree of Cobb angle and 2 persons with 30-39 degree of Cobb angle;only 1 person with 3 degree of vertebral rotation had 20 degree of Cobb angle.There was no significant correlation between vertebral rotation and Cobb angle(P > 0.05).8.Of the 187 patients,36 were below grade 2 of Risser's sign,68 were below grade 3of Risser's sign and 122 were below grade 4 of Risser's sign.9.Of the 187 patients,92 persons with coronal imbalance(26 persons with mild and66 persons with moderate scoliosis,69 with single and 23 with double scoliosis),and60 with sagittal imbalance(20 with mild scoliosis,40 with moderate scoliosis,40 with single and 20 with double scoliosis).Conclusion:The overall prevalence of scoliosis screened in Tianjin is higher than that in other areas.There is no significant difference in the prevalence among the six districts in Tianjin,but the prevalence of girls is higher than that of boys.According to the analysis of imaging data,the main type of scoliosis in patients is single curvature,the degree of scoliosis is small and the spine rotation is small.However,most patients have the problem of trunk imbalance,and the patients are in the growth stage,so the risk of disease progression is high.In addition,most patients have lower thoracic curvature and lower body mass index,we should also attach great importance to it.Screening for scoliosis among school students can promptly identify early scoliosis patients,thus giving them effective treatment and slowing down the possibility of scoliosis progression. |
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