Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
In Reply: We appreciate the comments by Dr
Mertz and are pleased that the ACA agrees that school-based scoliosis screening
should be continued only after careful consideration by each school system
and community. However, the suggestion that school scoliosis screening could
address the issues of adult and adolescent low back pain, chiropractic screening,
or the $50 billion reported to be spent yearly on low back pain may not be
We are unable to find any published data that link the "alarming increase"
of adolescent or adult low back pain and adolescent idiopathic scoliosis (AIS).
The single study we found that reported an association between AIS and an
increased prevalence of low back pain1
could account for only a 0.6% increase in the population rate of low back
pain. In fact, most researchers report no increase in adult low back pain
following a diagnosis of AIS compared with persons without a diagnosis of
AIS, whether or not the AIS was treated.2- 5
This suggests that screening for AIS would not be an effective method of identifying
a population at increased risk for low back pain.
Yawn BP, Yawn RA, Jacobsen SJ, Shaughnessy WJ, Hodge D, Ilstrup D. School-Based Scoliosis Screening—Reply. JAMA. 2000;283(13):1689. doi:10.1001/jama.283.13.1685