The scoliometer is a small instrument that is easy to use. No morbidity has been associated with its use since the bowing maneuver is considered sensitive and with the scoliometer improves specificity. In uncooperative children or those who are not still, can give erroneous results in reading with the possibility of false positives or negatives. Its use, therefore, is recommended for people over 7 years of age.
Types of scoliometers that can be purchased:
a) Scoliometer (original described by Bunnell) or
The smarphones have a built-in microelectromechanical accelerometer ( MEMS ) and, with the applications developed for iOS and Android, allow an accurate measurement of the ART equivalentto that obtained by the classic scoliometer as Scoligauge. There are applications that allow scoliosis to be controlled by the patient’s relatives. : ScolioTrack .
What is Scoliosis?
Scoliosis is a frequent problem in childhood and especially in adolescence. The estimated prevalence is between 5-6% in males and between 10-14% in females. 80% of scoliosis are idiopathic, the most serious being children (0-3 years) since if it is progressive, it can affect lung function. The juvenile (4-6 years) can cause various alterations in its progression. Scoliosis of adolescents is the largest group of idiopathic patients, but only one in five requires orthopedic treatment and only 0.2-0.3% require surgical treatment. Because the progression is unpredictable and the curves worsen at ages of maximum growth velocity (12 years in girls and 14 years in boys) it is important that the pediatrician carefully explore the spine for these patients since,
As two of the fundamental characteristics of scoliosis are the lateral deviation of the spine and the vertebral rotation, the simplest clinical examination is to instruct the patient to perform the bowing maneuver (banding test, Adams test) to observe the prominence of the patient. a hemithorax in case of scoliosis. However, it has the disadvantage of producing many false positives (it is very sensitive, but not very specific).
The most accepted method to evaluate the severity of the curve is by means of a radiography of the column that will determine, by the angles of Cobb, the most appropriate treatment. In general, curves of up to 20º only require exercises such as gymnastics or swimming, between 20-40º orthosis and those greater than 40º, surgery should be considered. Pediatricians should carefully monitor progression and know when to refer the patient to the orthopedist.
As it is difficult only by clinical observation if a patient requires the practice of an RX or referral to the specialist, different non-invasive or aggressive systems have been developed to evaluate the degree of scoliosis and its progression such as radiography or topography of Moire. The one discussed here is the so-called scoliometer. This instrument, developed by Bunnell in 1984, to assess the degree of scoliosis is, in essence, a curved type level, filled with a liquid with a metallic ball inside. This level has a scale numbered between 0-30 degrees. The scoliometer is placed on the patient’s back at the time he is performing the Adams test. If there is an asymmetry the ball moves to one of the sides and gives us a figure on the scale called Trunk Rotation Angle (ART). The entire back of the patient should be examined, especially in the dorsal and lumbar areas. A close correlation between ART and the degree of scoliosis has been found. An ART of less than 5 degrees corresponds to a scoliosis less than 20º. Recently this margin has been recommended to increase it to 7º. Those who have a higher grade than the one indicated should be referred to the orthopedist for a more complete evaluation. Those who do not exceed this figure may or may not have a mild scoliosis so it is not necessary to send them to the orthopedist or perform a column XR. However, in these cases it is essential to re-evaluate the column between three and six months. An increase in the ATR of 3º would indicate a progression of the curve, thus requiring an immediate evaluation by the orthopedist.
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