Medical experts point to gaps in scoliosis screening for Quebec children

Scoliosis screening in children in Quebec is lacking, laments a specialist, meaning that many are seen so late that only surgery is available.

“There’s been a rebound in the number of patients, and children are presenting too late,” summarized Dr. Jean Ouellet, an orthopedic surgeon at the Montreal Children’s Hospital.

Scoliosis has not been screened in Quebec schools for about 40 years, partly because it was long believed that the progression of the disease was irreversible.

We now know that this is false, said Dr. Ouellet: if the problem is detected early enough and corrective measures are implemented, three out of four children will avoid the knife.

“Studies show that if we screen them early and are able to get them into a brace, we can minimize what we call the medical burden of scoliosis,” said Dr. Ouellet.

That’s why, he continued, a pan-Canadian coalition was created, which also includes Sainte-Justine Hospital, to get a screening program back on track, especially during the growth spurt in young people.

Because that’s when, Dr. Ouellet pointed out, the problem can worsen to the point of becoming obvious to uninitiated children like parents, teachers, or coaches. Unfortunately, it then becomes apparent very, very late.

“We need to raise awareness of the problem,” he said. “Especially since not all children follow (the same path); some have growth spurts earlier or later. And during growth spurts, things can change quite quickly.”

Parents are therefore encouraged to keep an eye out “when (children’s) pants are getting shorter and shorter and there’s a sort of acceleration,” explained Dr. Ouellet.

Screening was once performed by nurses, who were found in virtually every school in Quebec.

But today, even if a child appears healthy, they will very rarely be seen by a doctor. This is especially true in the current, well-known context of the healthcare system, where even those who need to see a doctor struggle to do so.

“About 40 per cent of the patients we see don’t have scoliosis,” said Dr. Ouellet. “But for 30 per cent of those we see, it’s already too late and we can only offer them surgery. So we’re inundated with patients who don’t actually have scoliosis, while patients who have an acute need aren’t seen. I prefer to see more patients and reassure them, but we have to find a happy medium.”

And even if the child is seen by a healthcare professional, some “say ‘we’ll wait until you’re done growing,’ but it’s too late,” said Dr. Ouellet.

“We really need to catch this early, start braces very early, to be able to change the natural history of scoliosis,” he said.

–This report by La Presse Canadienne was translated by CityNews