Hi, I’m Dr. Fabio Ferri, paediatric orthopaedic surgeon and the current president of the Canadian paediatric spine society.
I would like to draw your attention to the issue of access of care for children and youth with scoliosis. Our main challenge is to facilitate timely diagnosis and treatment of this condition. I would like to invite you to collaborate with our group by engaging in our mission of strengthening primary care surveillance and management of eligible children and youth with scoliosis. The most common form is called Adolescent Idiopathic Scoliosis. Most children do not require any form of treatment for this condition, which is usually noticed by the children themselves, by their parents or by their sports coaches. Parents and children can be very anxious with the diagnosis, and this can be mitigated with timely access to information.
Primary care engagement with decision support provided by specialists has been increasingly recognized as a cost-effective strategy to reduce overcrowding of tertiary care centres, thereby improving the overall access to and the quality of care. Currently in Canada there is a preventable burden of spinal deformity, which we are trying to address with continuing medical education.
Once detected, the assessment by a primary care physician is a critical step to confirm the diagnosis and to ensure that there are no other associated health problems. Scoliosis is diagnosed with the Adam’s forward bending test, using a tool called “Scoliometer”. If the measurement reads more than seven degrees, standard radiographic assessment is required. The Cobb angle measurement of over 10 degrees on the radiograph confirms the clinical diagnosis. Children who are still growing from their spines and who have scoliosis over twenty degrees may benefit from brace treatment. The goal is to prevent aggravation of the spinal deformity. Full time bracing can prevent the need for surgery, and this is a time sensitive intervention. This form of bracing is publicly funded in Alberta. Alternative forms of treatment, which are not publicly funded, and which can be very costly out of pocket expenses have not shown the same effectiveness to prevent the need for surgery.
Thank you for watching this instructional video and for your collaboration in mitigating the burden of spinal deformity in Canada.