One in 20 children in Gozo at risk of scoliosis

Trunk measurements of all Gozitan children aged 13 to 15 have revealed that at least 5.3% have a hump in their body trunk, a condition known as “trunk asymmetry”.

The study, published in the Malta Medical Journal, also shows that 69% of those experiencing this condition were females.

Children with trunk asymmetries are at a greater risk of developing adolescent idiopathic scoliosis, a condition that develops into an abnormal curvature of the spine during late childhood or adolescence. 

Instead of growing straight, the spine develops a side-to-side curvature, usually in an elongated S or C shape, and the bones of the spine become slightly twisted or rotated. A small percentage of affected children develop more severe, pronounced spinal curvature.

The children participating in the study performed the Adam Forward Bending Test in which they had to bend forward as if they were diving. If the patient has trunk asymmetries, their back often has a prominent line where the spine is, and one side is higher than the other. A patient’s back is completely straight if they do not have scoliosis.

In the study a scholiometer was placed along the spine whenever a rib hump was noted, to measure its angle. All children with a trunk asymmetry of more seven degrees were referred for further tests to confirm the diagnosis.

The study suggests that the 5% rate appears to be “relatively high when compared to other countries” but comparisons are difficult due to different methodologies used.

Similar studies in other countries have reported a different incidence of trunk asymmetry, with the prevailing view being that trunk asymmetry is higher in northern European countries than in Mediterranean countries. This is usually attributed to differences in hours of sunshine and the onset of menstruation.

But the study suggests a higher rate of trunk abnormalities in Gozo than in some Scandinavian countries. Meanwhile, a similar study in Crete registered an even higher rate of 10% of children at risk of developing scoliosis.

The high rate of trunk asymmetries in Gozo may also reflect a “certain amount of inbreeding” which may influence the prevalence of trunk asymmetries.

The study authors recommend greater awareness on trunk asymmetry among medical practitioners as they would help in the early intervention by physiotherapists to prevent further complications which may require surgery.

Physiotherapists Mark Sacco and Michaela Catania authored the study.