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Rinsho Seikei Geka Volume 49, Issue 3 （March 2014）

臨床整形外科 49巻3号（2014年3月発行）

Japanese English

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藤沢市（人口41万）における最近16年間の脊柱側弯症検診結果―側弯症発見数の推移，対象学年，Cobb角50°以上の見落とし例，検診費用，継続的検診の意義について A Study of School Screening for Scoliosis over the Past 16 Years in Fujisawa City (Population:410,000). Annual Changes in Numbers of Cases Detected, Age of Students Screened, Missed Cases with a Cobb Angle of 50° or More, (≧50°), Screening Costs, and Significance of Continuous Screening 檜山建宇 ¹ , 加藤俊明 ¹ , 武内鉄夫 ¹ , 渡辺仁美 ¹ , 飯塚健児 ¹ , 赤見恵司 ¹ , 西村和博 ¹ , 菅原秀樹 ¹ , 仲野靖司 ¹ , 小野彰夫 ¹ Kenu HIYAMA ¹ , Toshiaki KATO ¹ , Tetsuo TAKEUCHI ¹ , Hitomi WATANABE ¹ , Kenji IIZUKA ¹ , Keishi AKAMI ¹ , Kazuhiro NISHIMURA ¹ , Hideki SUGAWARA ¹ , Yasushi NAKANO ¹ , Akio ONO ¹ ¹藤沢市医師会整形外科医会 ¹Fujisawa Orthopedic Medical Association キーワード：側弯症学校検診 , school screening for scoliosis , 対象学年 , age of students screened , 検診費用 , screening costs Keyword: 側弯症学校検診 , school screening for scoliosis , 対象学年 , age of students screened , 検診費用 , screening costs pp.269-276

発行日 2014年3月25日 Published Date 2014/3/25

DOI https://doi.org/10.11477/mf.1408102995

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　背景：藤沢市で側弯症検診を開始してから30年が経過した今日，側弯症が減少しているのか，モアレ法による小・中学各1学年を対象にするなど特定の学年に限って検診する場合の見落とす可能性などを検討した．

　対象と方法：最近16年間に発見された15°以上の側弯症398例を対象に「経過例」と「新規例」の経年的人数と学年別人数を調査した．

　結果：①15°以上の側弯症が経年的に減少する傾向はなかった．②小学1年から中学3年の全学年で発見され，小学6年から中学3年の人数には差がなく(85～88人)，小学5年から中学3年の新期例数は学年間に統計学的有意差がなかった．この結果から小・中学1学年に限って検診した場合，他の学年の側弯症を見落とす可能性が示唆された．

　まとめ：15°以上の側弯症を可及的に拾い上げ早期治療につなげるために，小・中学生全員を対象に検診することに学校保健上意義があると思われた．

　Background：School screening for scoliosis in Fujisawa City was inaugurated 30 years ago.　At this point we are assessing the benefits of the school screening and the possibility of cases being missed by Moire topography, which has been widely used in 5th or 6th grade in elementary school and in the 1st year or 2nd year of middle school.

　Method：398 scoliosis cases with a Cobb angle of 15° or more in the past 16 year, we examined patients dividing them into two groups;new case：patients who were diagnosed with scoliosis within the last one year, follow-up case：patients who had been suspected of scoliosis in school screening of last year, and were diagnosed this year.

　Results：① There was no tendency for the proportion of students with scoliosis defined as a Cobb angle≧15° to decrease yearly.　② We detected scoliosis cases in every grade from 1st grade to 9th grade.　The number of cases detected in the 6th grade to the 9th grade has been almost the same (85-88), throughout the 16-year period, and there have been no significant differences in the number of newly detected cases from the 5th grade to the 9th grade.　This finding shows that cases may have been missed among students who were not examined by Moire topography.

　Conclusion：School screening of all students for scoliosis is of great significance as a means of early detection and treatment of scoliosis defined as a Cobb angle of 15° or more.