Mark Driscoll (Spinologics, Montreal, Canada) and others report in Scoliosis that the combination of a medical device called the Scolioscreen and a smartphone can be used to reliably and consistently measure angle of trunk inclination for the early detection of spinal deformities. The authors state that the Scolioscreen-smartphone combination is an “accessible and convenient tool for all to use”.
Driscoll et al write that scoliosis screening programmes are conventionally reserved to healthcare professionals and are not widely practised, which they say is partly because the Scoliometer (Orthopedic Systems)—which measures angle of trunk inclination and is the gold standard method for screening for scoliosis—is a clinical tool. They add that smartphone apps that have been designed to measure angle of inclination are now available, but say these apps have not been validated as providing reliable clinical measures. The authors note: “The widespread convenience of using one’s smartphone as a scoliosis screening tool has an appeal that inspired the development of the Scolioscreen.”
According to Driscoll et al, the Scolioscreen (Spinologics) was designed to be used in combination with a smartphone. They explain that it is made from “medical grade thermoplastic rubber and sized to effectively hold all smartphones with or without a protective case and designed to mimic the undersurface of a Scoliometer.” In the present study, the authors compared efficacy of the Scolioscreen-smartphone combination to measure angle of trunk inclination with that of a smartphone alone as compared with the Scoliometer. “Furthermore, to encourage the widespread adoption of this medical tool, the study was performed by spinal surgeons, a nurse and the parent of the presenting patient.”
Patients were included in the study if they were aged between 10 and 18 and were presenting with adolescent idiopathic scoliosis, but were excluded in they presented with leg length discrepancy of 2cm, had undergone lower limb or spinal surgery other than scoliosis surgery, had a disease affecting posture or trunk shape (aside from scoliosis), or if their parent was not present at their appointment. A spinal surgeon, nurse, and the patient’s parent took measures using the Scolioscreen-smartphone, smartphone app alone, and the Scoliometer. The measures taken by the spinal surgeon with the Scoliometer were seen as the gold standard.
Driscoll et al report: “The spinal surgeon achieved intra-class correlation coefficients (ICC) of 0.86 and 0.99 [ie. in comparison with the measurements taken by the spinal surgeon with the Scoliometer] when using the smartphone and Scolioscreen-smartphone combination respectively. Similarly, the nurse ICC scores were 0.86 with the smartphone and 0.95 with the Scolioscreen-smartphone combination. The parent ICC scores were 0.85 with the smartphone and 0.91 with the Scolioscreen-smartphone combination.”
The authors comment: “This study demonstrates the reliability and accuracy of a new medical device for measuring the angle of trunk inclination when screening patients with spinal deformities. Perhaps most interestingly, this study reported that a parent of a child with a spinal deformity and using the Scolioscreen-smartphone combination is as accurate as a spinal surgeon using the gold standard, the Scoliometer.” They add that the Scolioscreen-smartphone combination enables parents “to take accurate measurements on their own, thus offering an accessible and convenient tool.”
Commenting, Driscoll told Spinal News International: “In light of the recent class I evidence in support of early treatments of spinal deformities via bracing and the ongoing developments of fusionless devices offering an earlier surgical treatment option to patients, the Scolioscreen provides an exciting platform to encourage the widespread adoption of early detection. Furthermore, the enablement of parents to assess their own child with a validated medical device will hopefully lead to better and earlier detection practices of spinal deformities.”