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Table 16 Recommendation on assessment

From: 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth

Recommendation Strength Evidence Reference
1. School screening programmes are recommended for the early diagnosis of idiopathic scoliosis B IV [376, 378,379,380]
2. The schools screening should be performed using the Scoliometer during trunk forward bend (Adam’s test) B IV [376, 378,379,380]
3. It is recommended that for scoliosis screening programmes 5° and 7° of angle of trunk rotation should be used as criteria for referral B V [376, 378,379,380]
4. It is recommended that, every time they evaluate children aged from 8 to 15 years, pediatricians, general practitioners and sports physicians perform the Adam’s test for scoliosis screening purposes, using the Scoliometer B VI  
5. It is recommended for clinical follow-up to use validated assessment methods and standard clinical data collection forms B IV [376, 378,379,380]
6. It is recommended to take into account the measurement error for each method applied for the assessment of scoliosis patients A IV [56,57,58,59,60,61,62, 369, 371,372,373,374,375,376,377, 414]
7. It is recommended to clinically assess in scoliosis patients at least: angle of trunk rotation, aesthetics, and sagittal alignment of the spine. Other possible common evaluations include: pain, respiratory function, =spine and joint flexibility and strength, leg length discrepancy, balance and coordination, quality of life. B IV [396, 397, 462, 468, 482, 484]
8. The sagittal spine balance should be assessed with X-ray E III [164, 400, 408,409,410]
9. It is recommended that clinical follow-up examinations are performed at least twice a year, a part periods of rapid growth (pubertal spurt, first 3 years of life) D IV [400, 494]
10. It is recommended that frontal radiographic studies are made postero-anteriorly, using digital films with a ratio X-rays, including visualization of the femoral heads and protection of the gonads, in any standing position without the use of support aids or indication of correct posture, unless otherwise justified in the opinion of a clinician specialized in spinal deformities C IV [385, 495]
11. It is recommended that curve magnitude is measured using the Cobb method C IV [62]
12. On radiographic lateral view, the patient’s upper extremities should be placed in a position to uncover the upper thoracic spine. The recommended positions comprise: (1) 45° angle flexion of the arms, elbows extended and hands resting on a support to preserve the sagittal curvature of the spine, (2) the arms crossed over the breasts, (3) the hand resting on the ipsilateral shoulder without pressing it E IV [404, 405]
13. To reduce the invasiveness of follow-up, it is recommended that the least number of projections is made on radiographic studies C VI  
14. It is recommended that all idiopathic scoliosis patients, even if not treated, are regularly followed-up C VI