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April 5, 2000

School-Based Scoliosis Screening—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(13):1689. doi:10.1001/jama.283.13.1685

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 justified.

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.