title: Adolescent Scoliosis Screening in Nara City Schools: A 23-Year Retrospective Cross-Sectional Study.
abstract: METHODS
  Retrospective cross-sectional study.
  
  
  OBJECTIVE
  To determine the prevalence of idiopathic scoliosis, define the distribution of the curve magnitude, evaluate the accuracy of Moiré topography as a screening tool, and investigate the cost-effectiveness of our screening system.
  
  
  BACKGROUND
  Early detection of idiopathic scoliosis provides the opportunity for conservative treatment before the deformity is noticeable. We believe that scoliosis screening in schools is useful for detection; however, screening programs are controversial owing to over referral of students who do not require further testing or follow-up. In Japan, school scoliosis screening programs are mandated by law with individual policies determined by local educational committees. We selected Moiré topography as the scoliosis screening tool for schools in Nara City.
  
  
  METHODS
  We selected Moiré topography as the scoliosis screening tool for schools in Nara City. We screened boys and girls aged 11-14 years and reviewed the school scoliosis screening results from 1990 to 2012.
  
  
  RESULTS
  A total of 195,149 children aged 11-14 years were screened. The prevalence of scoliosis (defined as ≥10° curvature) was 0.057%, 0.010%, and 0.059% in fifth, sixth, and seventh grade boys and 0.337%, 0.369%, and 0.727% in fifth, sixth, and seventh grade girls, respectively. The false-positive rate of our Moiré topography was 66.7%. The minimum cost incurred for scoliosis detection in one student was 2,000 USD.
  
  
  CONCLUSIONS
  The overall prevalence of scoliosis was low in the students of Nara City schools. Over 23 years, the prevalence of scoliosis in girls increased compared to that in the first decade of the study.
authors.affiliation: Department of Orthopedics and Surgery, Nara City Hospital, Nara, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Orthopedics and Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shigematsu
authors.affiliation: Department of Orthopedics and Surgery, Kadono Clinic, Nara, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kadono
authors.affiliation: Department of Orthopedics and Surgery, Tanaka Clinic, Nara, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Orthopedics and Surgery, Hanna Central Hospital, Nara, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Tatematsu
authors.affiliation: Department of Orthopedics and Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Okuda
authors.affiliation: Department of Orthopedics and Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Iwata
authors.affiliation: Department of Orthopedics and Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Munehisa
authors.initials: M
authors.lastname: Koizumi
authors.affiliation: Department of Orthopedics and Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
keywords: Costs and cost analysis; Mass screening; Moiré topography; Prevalence; Scoliosis