Prevalence Of Adolescent Idiopathic Scoliosis Research Articles

Etiopathogenesis of adolescent idiopathic scoliosis (AIS): Role of genetic and environmental factors.

Adolescent idiopathic scoliosis (AIS) has been known to be related closely to genetic factors. Higher prevalence of AIS among individuals with family history of scoliosis suggesting critical roles of genetic in the pathogenesis of AIS. However, evidence also suggested that environmental factors such as latitude and sun exposure also play a critical role in the pathogenesis of the disease. While genetic factors played an important role in the occurrence of AIS, environmental factors are more likely to affect the progression of the disease. Although the pathogenesis of AIS remains elusive, current knowledge suggests that genetic factors and its interaction with environmental factors are crucial in the development of the disease, explaining differences in clinical characteristics of AIS across the globe. The aim of this review is to summarize the current knowledge of genetic and environmental factors contributing to AIS and their interactions.

Prevalence of adolescent idiopathic scoliosis in Shijiazhuang, Hebei, China: a cross-sectional study

PurposeThis study is a large-scale screening supported by government departments to investigate the prevalence of scoliosis in Shijiazhuang.MethodsIn this cross-sectional study, all students underwent body posture evaluation and the Adam’s forward flexure test to examine the back, and also underwent radiographic evaluation when scoliosis was suspected.ResultsIn total, 181,935 students participated in the research, of which 289 students were diagnosed with scoliosis, with a prevalence of 2.5%, significantly higher in female (3.01%) than in male children (1.63%) (P < 0.001). Most of the patients (79.5%) had a Cobb angle from 10° to 19°.The mean Cobb angle of scoliosis was positively associated with age. The prevalence of a single curve (75.4%) was significantly higher than double curves (23.2%) and triple curves (1.38%). The percentage of scoliosis in which the thoracolumbar segment was involved (46.4%) was significantly higher than that of the single thoracic scoliosis (31.8%) and single lumbar scoliosis (21.8%).ConclusionsThe prevalence of adolescent idiopathic scoliosis in XXX was high (2.50%). It is necessary to strengthen the education of adolescent scoliosis, and improve the awareness and attention of social to scoliosis.Level of EvidenceIV.

Overview of adolescent idiopathic scoliosis and associated factors: a scoping review.

Around the world, idiopathic scoliosis accounts for the majority of occurrences of adolescent scoliosis. The absence of underlying congenital or neuromuscular problems distinguishes adolescent idiopathic scoliosis (AIS), which affects children ages 13 to 18, from other kinds of scoliosis. The prevalence of AIS is influenced by a number of variables, such as physical activity, gender, backpacks, body mass index, and others. AIS has an impact on the child's development not just physically but also psychologically, emotionally, and mentally. This study used nationwide databases to describe the prevalence of adolescent idiopathic scoliosis and associated risk variables. The current review analysis showed that AIS was significant worldwide and that adolescent gender, physical activity, body mass index, backpack carrying and backpack weight were all significant risk factors for developing AIS.

Pathogenesis and Intervention Study of Idiopathic Scoliosis in Elementary and Middle School Students

Scoliosis, also known as lateral curvature of the spine or spinal lateral deviation, is a three-dimensional spinal deformity characterized by the bending of one or multiple segments of the spine to the side accompanied by vertebral rotation. It appears in the shape of an "S" or "C" and can cause pain during standing, walking, or lifting heavy objects, leading to a reduction in physical activity. Scoliosis is the most common spinal disorder among children and adolescents. Adolescent Idiopathic Scoliosis (AIS) refers to scoliosis that occurs during the teenage years and its etiology remains unclear. AIS is a spinal condition characterized by a three-dimensional deformity in the coronal, sagittal, and axial planes, with a Cobb angle of 10 degrees or more. The global prevalence of AIS ranges from 0.47% to 5.2% (Erwin et al., 2020; Konieczny et al., 2013). According to a study by Qiu Guixing et al., the prevalence of scoliosis in China is estimated to be approximately 0.6% to 2.0%, with 90% of cases being AIS. Jia Juanjuan et al., conducted a scoliosis screening of 8,026 students in Jiaxing City in 2019, with initial screening identifying 218 positive cases. Among them, 132 cases were confirmed through X-ray examination, estimating a scoliosis prevalence rate of 5.46% among primary and secondary school students in Jiaxing City. Chen Xiaosheng, Ru Shouhang et al., conducted a scoliosis survey among students from the fourth grade of primary school to the second grade of high school in various districts of Shenzhen City from January to December 2020, with the results showing a scoliosis prevalence rate of 5.01% among primary and secondary school students in Shenzhen City. The prevalence rate was higher in females than males and increased with age. If scoliosis in adolescents is not promptly and effectively treated during their growth process, the spinal deformity can rapidly progress and lead to various complications. For example, scoliosis can cause changes in the shape of the ribs, resulting in unequal thoracic cavity volume and breathing difficulties. Prolonged restricted breathing can lead to complications such as chest tightness and shortness of breath. Additionally, scoliosis can affect the functioning of abdominal organs, leading to pulmonary dysfunction and hypoxia, and in severe cases, it can cause cardiorespiratory failure. Furthermore, scoliosis not only affects the physical health of patients but also their mental well-being. The physical appearance changes caused by scoliosis deformity can potentially lead to psychological disorders.

The Impact of Physical Activity on Adolescent Idiopathic Scoliosis.

The prevalence of adolescent idiopathic scoliosis (AIS) is increasing, partly due to a lack of physical activity. In a cross-sectional study with 18,216 pupils (5th, 6th, and 8th grades) from four Croatian counties using the forward bend test (FBT; presumed AIS), the prevalence of AIS and its correlation with physical activity were evaluated. Pupils with presumed AIS were less physically active than their peers without scoliosis (p < 0.001). Abnormal FBT was more prevalent among girls than boys (8.3% vs. 3.2%). Boys were more physically active than girls (p < 0.001). Pupils with presumed AIS were less physically active than their peers without scoliosis (p < 0.001). A higher prevalence of presumed AIS was found among inactive or just recreationally active schoolchildren than among those engaged in organized sports (p = 0.001), girls especially. Pupils with presumed AIS were less active and had fewer weekly sports sessions than their peers without scoliosis (p < 0.001). Notably low prevalence of AIS was detected among pupils engaged in soccer (2.8%, p < 0.001), handball (3.4%, p = 0.002), and martial arts (3.9%, p = 0.006), while it was higher than expected in swimming (8.6%, p = 0.012), dancing (7.7%, p = 0.024), and volleyball (8.2%, p = 0.001) participants. No difference was detected for other sports. A positive correlation was found between time spent using handheld electronic devices and the prevalence of scoliosis (rs = 0.06, p < 0.01). This study confirms the increasing prevalence of AIS, particularly among less athletic girls. Further, prospective studies in this field are required to explain whether the higher prevalence of AIS in these sports is due to referral or other aspects.

Idiopathic adolescent scoliosis and obesity: prevalence study.

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that affects 5% of the population. This pathology has multiple known etiological factors such as family predisposition, female gender, low body mass index, decrease in lean and fat masses. However, recent studies suggest that ciliary dysfunction could be the origin of certain types of obesity and AIS. This study aims to verify the existence of a link between these two pathologies. A retrospective, cross-sectional, descriptive and monocentric study, based on a cohort of adolescents with obesity treated in a paediatric rehabilitation centre for specific care between 1 January 2010 and 1 January 2019. The prevalence of AIS was calculated by radiographic measurements. The diagnosis of AIS was established if the Cobb angle was ≥ 10°, associated with intervertebral rotation. 196 adolescents with obesity were included in the study (mean age 13.2years, mean BMI 36kg/cm2, gender ratio 2.1 of female to male.) The prevalence of AIS in adolescents with obesity was 12.2%, twice the prevalence of AIS in the general population. The characteristics of AIS in adolescents with obesity are predominantly female, 58.3% left thoracolumbar or lumbar principal curvatures, mean Cobb angle 26° and progressive in 29% of cases. Our study established a correlation between AIS and obesity with a higher prevalence than in the general population. The morphology of these adolescents makes screening for AIS more difficult.

Advancing Use of DEXA Scans to Quantitatively and Qualitatively Evaluate Lateral Spinal Curves, for Preliminary Identification of Adolescent Idiopathic Scoliosis

Dual-energy X-ray absorptiometry (DEXA) scan is an emerging screening method for identifying likely adolescent idiopathic scoliosis (AIS). Using DEXA in an unbiased population sample (the Raine Study), we aimed to report the inter-rater reliability and minimal detectable change (MDC95) for scoliosis curve angle measurement, identify likely AIS prevalence, and the concordance between reported AIS diagnosis and DEXA-identified likely AIS. Scoliosis curve angles were measured using the modified Ferguson method on DEXA scans (n = 1238) at age 20 years. For curve angle inter-rater reliability, two examiners measured angles (6–40°) on 41 scans. Likely, AIS was determined with quantitative and qualitative criteria (modified Ferguson angles ≥ 10° and expert review of spinal curves).The inter-rater reliability for scoliosis curve angle measurement was good–excellent (ICC: 0.82; 95% CI: 0.71–0.89; p < 0.001), and MDC95 was 6.2°. The prevalence of likely AIS was 2.1% (26/1238). Diagnosis of AIS was reported despite little or no scoliosis curve (< 3.8°) for 20 participants (1.6%), and diagnosis of AIS was not reported despite scoliosis curve ≥ 10° for 11 participants (0.9%). Results support the use of modified Ferguson method to measure scoliosis curve angles on DEXA. There is potential utility for using a combination of quantitative measurement and qualitative criteria to evaluate DEXA images, to identify likely AIS for reporting prevalence. Without formal school screening, the analysis of DEXA in this population sample suggested that relying on current health professional diagnosis alone could result in 2.5% of this cohort being at risk of false positive diagnosis or delay in necessary management due to non-diagnosis of AIS.

PREVALENSI ADOLESCENT IDIOPATHIC SCOLIOSIS : LITERATURE REVIEW

Adolescent idiopathic scoliosis is a musculoskeletal disorder characterized by three-dimensional changes in the vertebrae that occur in children aged 10-18 years. The purpose of this study was to determine the prevalence of adolescent idiopathic scoliosis through a literature review. Research article searches were carried out in the PubMed and BMC Central databases using the keywords “adolescent”, “idiopathic”, “prevalence” and “prevalence” from 2010 to 2020. Articles in English and Indonesian were selected using keywords, and 389 articles were found. The articles were then selected based on the exclusion and inclusion criteria, leaving 5 articles to be reviewed. The prevalence of adolescent idiopathic scoliosis is higher in girls than boys and the prevalence increases with age. The prevalence of adolescent idiopathic scoliosis varies between 0.72-4.3%.

Prevalence of Back Pain and Idiopathic Scoliosis in Adolescents From the Semiarid Region of Brazil: A Cross-sectional Study

ObjectiveThe purpose of this study was to estimate the prevalence of adolescent idiopathic scoliosis (AIS), and back pain and its risk factors, in schoolchildren from the semiarid region of Brazil. MethodsA total of 520 adolescents aged 10 to 16 years old were assessed. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument questionnaire. The screening for AIS included measuring the angle of trunk rotation using a scoliometer in the Adams forward-bend test. Participants with an angle of trunk rotation ≥ 7° were referred for radiography. The prevalence ratio was estimated by multivariable analysis using a Poisson regression model (α = 0.05). ResultsAmong the participants, 3.1% (95% confidence interval, 3.2%-6.9%) had a confirmed AIS diagnosis: 1.9% girls and 1.1% boys. There was no difference between boys and girls in AIS prevalence. The prevalence of back pain in the previous 3 months was 63.7% (95% confidence interval, 59.5%-67.7%), at a moderate level (visual analog scale = 3.83; 95% confidence interval, 3.57-4.08). Multivariable analysis showed that back pain is associated with postural variables, sex, and age. ConclusionThe prevalence of AIS in the semiarid region of Brazil was 3.1%, and that of back pain was 63.7%. Only body mass index was different between adolescents with and without AIS, with those with AIS having a lower mean body mass index. Back pain was higher in girls and increased in older adolescents. Furthermore, behavioral and postural habits and hereditary factors were associated with an increased chance of back pain.

Prevalence of idiopathic scoliosis in girls with central precocious puberty: effect of a gonadotropin-releasing hormone agonist.

PurposeAdolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and occurs in children between 10 to 18 years old, during periods of growth spurts and puberty changes. In patients with central precocious puberty (CPP), due to early growth spurt, AIS is expected to develop before 10 years of age. Both AIS and CPP are more common in girls than in boys. The aim of this study was to determine the prevalence of AIS in girls with CPP and to evaluate the effect of treatment with gonadotropin-releasing hormone (GnRH) agonists on progression of scoliosis in these patients.MethodsWe retrospectively reviewed medical records of 553 girls, 338 with CPP and 215 without CPP. Scoliosis angle was measured on the standing frontal radiograph of each patient according to the Cobb method. Patients with a Cobb angle of 10° or more were diagnosed with scoliosis. For girls with CPP, follow-up spine radiographs were collected 1 year after treatment with GnRH agonists. Progression of scoliosis before and after treatment was compared in terms of Cobb angle changes.ResultsAIS was more prevalent in girls that were affected by CPP compared tocontrols without CPP (11.5% vs. 6.0%, CPP girls vs. non-CPP girls, respectively, P=0.031). The peak serum luteinizing hormone level positively correlated with Cobb angle (R2=0.015, P=0.023) in the CPP group. No progression of scoliosis was observed in CPP girls after one year of GnRH agonist treatment. Additionally, the prevalence of scoliosis decreased in CPP girls after 1 year of the treatment.ConclusionsWe report that the prevalence of AIS is higher in girls with CPP than in non-CPP patients. A regular follow-up schedule for spine radiographs should be considered to reduce the risk of progression. Furthermore, GnRH agonist treatment for CPP may have a suppressive effect on progression of AIS.

SUN-LB17 The Association of Growth Hormone Treatment in Children With Short Stature With Idiopathic Scoliosis

Objectives: Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis, which occurs usually in the periods of growth spurts and puberty changes. The spinal curve progression in AIS is related to growth, skeletal maturity and sexual maturity. Growth hormone treatment has been used to improve final adult height by increasing growth velocity in children with short stature. Therefore, AIS is expected to occur more frequently in children treated with growth hormone. The aim of this study was to investigate the relationship between AIS and growth hormone treatment in short children. Methods: A total 115 subjects aged 2.1 to 16.9 years who had been treated with growth hormone because of growth hormone deficiency (n=83), idiopathic short stature (n=16) and small for gestational age (n=16) were included. Their medical records were reviewed retrospectively. The scoliosis angle of each subject was measured on the standing frontal radiograph according to the Cobb method. A curve with a Cobb angle of 10 degrees or more is defined scoliosis. Follow up Cobb angle were measured after 1-year of growth hormone treatment. Results: Cobb angle has been increased after 1-year growth hormone treatment (6.1±3.1 vs. 6.9±3.4, P=0.024). The change of Cobb angle was correlated with serum insulin like growth factor-1 level at baseline (r=0.274, P=0.003) and after 1-year of growth hormone treatment (r=0.220, P=0.020). There was no significant correlation between the change of Cobb angle and growth velocity. The prevalence of AIS has been increased after 1-yrear of growth hormone treatment (11.3% vs. 19.1%, P=0.009). Conclusion: Growth hormone treatment in children with short stature seems to be associated with occurring and worsening of AIS.

Prevalence of adolescent idiopathic scoliosis in Turkey: an epidemiological study

BACKGROUND CONTEXTStudies have shown that adolescent idiopathic scoliosis (AIS) prevalence varies between 0.35% and 5.2% and it is generally accepted as an average of 2%–3% in children under age 16. There are a few narrow-scope studies based on school screening performed on the epidemiology of AIS in Turkey. Prevalence rates reported by these studies are lower than reported in neighboring countries. Of note, they were conducted in single cities, generally based on small sample size, and are different from each other in terms of methodology and age groups. The present study was conducted based on a large population in 85 schools of 40 provinces in Turkey. PURPOSEThe aim of this study was to determine the prevalence of AIS in Turkey. Secondary outcomes were to determine age, gender, curve distribution, using standard tests, and radiological verification. STUDY DESIGNA cross-sectional epidemiological study. PATIENT SAMPLEThe sample size was calculated to estimate the prevalence of AIS in children aged 10–15 years in Turkey. OUTCOME MEASURESAdams’ forward bending test, angle of trunk rotation measurement, and posture analysis were used to screen. Students who had an angle of trunk rotation greater than or equal to five (≧5°) with scoliometer measurement or who had a positive forward bending test were referred to the mobile X-ray unit located in the school-yard on screening day. Their diagnosis was confirmed using Cobb angles of greater than or equal to 10 (≧10°). METHODSMedical personnel, mobile radiological tools, and logistical support needed during fieldwork were provided by the Directorate General for Health Research, Ministry of Health Republic of Turkey. Spine and posture were examined in upright standing position. Examiners looked for shoulder asymmetries, scapular prominence, unequal waist, and lower limb length discrepancy. Potential scoliosis diagnosis was verified with onsite radiographic examination. Cases with a Cobb angle of ≧10° detected in any region were accepted as scoliosis. The direction and location of scoliosis were determined according to the Scoliosis Research Society terminology criteria. RESULTSA total of 16,045 students were reached whose informed consent forms were signed by their parents. The prevalence of AIS was found to be 2.3% (female, 3.1%; male, 1.5%). Radiological confirmation rate was 98.8%; 256 (69.3%) of 369 adolescents with scoliosis had a single curvature and 108 (29.3%) had a double curvature. The most common single curve type was a lumbar curve. In all, 90.5% of cases with AIS had a mild (range of 10°–19°) Cobb angle. CONCLUSIONSThe prevalence of AIS was 2.3% in Turkey. This prevalence rate was considerably higher than the values in previous regional studies conducted in Turkey; however, it was close to generally accepted averages in the literature. One of the strongest aspects of the study was that radiologic confirmation of each suspected case was made during the screening.

Low Body Mass Index for Early Screening of Adolescent Idiopathic Scoliosis: A Comparison Based on Standardized Body Mass Index Classifications

PurposeScoliosis is a common musculoskeletal problem in adolescents. This study aimed to identify the prevalence of adolescent idiopathic scoliosis (AIS) and its associated factors among Korean adolescents. The prevalence of thin individuals among students with AIS was compared based on body mass index (BMI) classifications. MethodsThis study was a secondary data analysis and used the 2016 Korean National Health Examination for School Students data. Data from 16,412 students were analyzed using descriptive statistics, Chi-square tests, and logistic regression analysis. ResultsThe prevalence of AIS was higher in women (3.8%) than in men (1.6%), and a higher school year was a risk factor for AIS in both sexes. In woman adolescents, scoliosis was associated with thinness; however, the risk of AIS was inversely associated with overweight/obesity in both sexes. The prevalence of thin woman students with scoliosis differed based on the criteria used: 3.3% by the World Health Organization criteria and 14.3% by the International Obesity Task Force criteria. ConclusionThe prevalence of thin students with scoliosis could increase by up to four times depending on the BMI criteria. For early screening of thin people at risk of AIS among female students, the criterion of International Obesity Task Force should be used as it is more permissive of thinness. This is also because of the underestimation of AIS prevalence when using the BMI Z score of the World Health Organization cutoff.

Epidemiology of adolescent idiopathic scoliosis in Isfahan, Iran: A school-based study during 2014–2015

Background:Scoliosis is a three-dimensional deformity of the spine with lateral curvature in addition to the rotation of vertebral bodies. The aim of the present study was to determine the prevalence of adolescent idiopathic scoliosis (AIS) in our society and its demographic-related factors.Materials and Methods:This was a cross-sectional study that took place from November 2014 to March 2015 in Isfahan, Iran. During the period of study, 24 schools were randomly chosen from six zones by a simple random sampling method. In each school, about 120 students were randomly selected and evaluated. Anterior forward bending test and scoliometry were done in all students and suspicious ones referred to Alzahra spine clinic for further evaluation. The diagnosis of AIS was based on radiographic finding and Cobb angle more than 10°. Data about age, sex, height, body mass index, hand dominancy, and type of schoolbag were recorded.Results:A total number of 3018 children were evaluated and 19 were diagnosed with AIS that showed the prevalence of 0.62%. None of the study variables had a significant relation with the presence of AIS. The cutoff point for the detection of AIS with scoliometry was calculated as 3.5, with a sensitivity of 73.7% and specificity of 86.7%.Conclusion:The prevalence of AIS in our area was 0.62%, which was lower than previous reports and did not have a relation with demographic factors; however, screening surveys identify a significant number of children with AIS who could benefit from preventive treatment.

The Adolescent Idiopathic Scoliosis International Disease Severity Study: Do Operative Curve Magnitude and Complications Vary by Country?

BackgroundThe prevalence of adolescent idiopathic scoliosis (AIS) in diverse regions of the world has been studied. Access to care varies widely, and differences in disease severity and operative treatment outcomes are not well understood. This study aimed to determine variation in disease presentation and operative complications for AIS patients from an international cohort. MethodsThis is a retrospective study carried out at seven surgical centers in the United States (Manhattan and Miami), Ghana, Pakistan, Spain, Egypt, and China. A total of 541 consecutive patients with AIS were evaluated. Preoperative major curve magnitude, operative parameters, and complications were compared among sites using analysis of variance with post hoc tests and Pearson correlation coefficients. Univariate and multivariate forward stepwise binary logistic regressions determined the variables most predictive of complications. ResultsCountries with lowest-access to care (Ghana, Egypt, and Pakistan) displayed larger curves, more levels fused, longer operative time (OT), and greater estimated blood loss (EBL) than the other countries (p ≤ .001). Increasing curve magnitude was correlated with greater levels fused, longer OT, and greater EBL in all groups (p = .01). In the univariate regression analysis, Cobb magnitude, levels fused, EBL, and OT were associated with complication occurrence. Only OT remained significantly associated with complication occurrence after adjusting for Cobb magnitude, levels fused, and site (odds ratio [OR] = 1.005, 95% confidence interval 1.001-1.007, p = .003). Complications were greatest in Pakistan and Ghana (21.7% and 13.5%, respectively) and lowest in Miami (6.5%). ConclusionsLarger curve magnitudes in the least-access countries correlated with more levels fused, longer OT, and greater EBL, indicating that increased curve magnitude at surgery could explain the difference in operative morbidity between low- and high-access countries. With OT as the prevailing predictive factor of complications, we suggest that increased curve magnitude leads to longer OTs and more complications. A lack of access to orthopedic care may be the largest contributor to the postponement of treatment. Level of EvidenceLevel II.

Screening and Prevalence of Adolescent Idiopathic Scoliosis in Selected Urban and Countryside Schools in Egypt

Screening and Prevalence of Adolescent Idiopathic Scoliosis in Selected Urban and Countryside Schools in Egypt

Prevalence of Adolescent Idiopathic Scoliosis in the State of São Paulo, Brazil.

A cross-sectional study. To estimate the prevalence of adolescent idiopathic scoliosis (AIS) in cities in the state of São Paulo, Brazil, as well as to identify demographic, clinical, and lifestyle factors associated with AIS. AIS is a common three-dimensional spinal deformity. Epidemiological data about the condition in the southern hemisphere are scarce, and Brazil has no public health policies to implement school-based scoliosis screening programs. We assessed 2562 adolescents between 10 and 14 years of age. The screening procedure included measurement of the angle of trunk rotation using a scoliometer in the Adams forward bend test and the radiographic examination. The overall prevalence of AIS was 1.5% (95% confidence interval [CI]: 1%-1.9%). The AIS prevalence was higher among the females than among the males-2.2% (95% CI: 1.4%-2.9%) and 0.5% (95% CI: 0.1%-0.9%), respectively. The following factors were associated with the development of AIS: being female (OR = 4.7, 95% CI: 1.8-12.2; P = 0.001) and being in the 13- to 14-year age group (OR = 2.2; 95% CI: 1.0-4.8; P = 0.035). Double curves and right laterality were more common (59.4% and 56.8%, respectively), although the curves were of low magnitude (75% of the curves having a Cobb angle ≤22°), as was the progression factor (≤1.2 in 75% of the cases). The prevalence of AIS in cities within the state of São Paulo was similar to that reported in the literature, was higher among females, and was higher during puberty (13-14 years of age). Because puberty occurs later for males than for females, the recommendation to screen both sexes at 10 to 14 years of age should be reconsidered. 3.

A Case-Control Study of Body Composition, Prevalence, and Curve Severity of the Patients With Adolescent Idiopathic Scoliosis in the East Part of China

ObjectiveThe purpose of the study is to investigate the characteristics of prevalence and curve severity in patients with adolescent idiopathic scoliosis (AIS) and the body composition alterations between the patients with AIS and healthy controls. MethodsInformation on the study sample was obtained from a screening database. The AIS cohort was paired with an age- and gender-matched healthy cohort. The stratification of BMI and curve severity was conducted according to the criteria developed by the US Centers for Disease Control and Prevention and the Scoliosis Research Society. The prevalence and curve severity of the patients with AIS were investigated. Multigroup comparison of body composition parameters was conducted according to BMI between the patients with AIS and healthy controls. ResultsA total of 1,202 patients with AIS and an age- and gender-matched cohort were recruited from local schools. The underweight cases had the highest prevalence of AIS and significantly higher Cobb angle compared with the other three BMI subgroups. Although the patients with AIS had lower body weight, body fat mass, percentage of body fat, and fat-free mass compared with healthy controls, converse results were observed in the underweight cases after stratification according to BMI. ConclusionBased on the sporadic body composition of the patients with AIS observed in the current study, it is predictable that the pathophysiological alterations may be different before and after the onset of scoliosis. Well-designed human or animal studies for underweight patients would be helpful to reveal the mechanisms of pathophysiological alterations and better predict the development of AIS.

Epidemiological study of adolescent idiopathic scoliosis in Eastern China.

Previous epidemiological studies of adole-scent idiopathic scoliosis in mainland China have had diverse results. The aim of this cross-sectional study was to determine the epidemiology of adolescent idiopathic scoliosis based on a representative sample city, Wuxi, in eastern China. Primary and secondary school students aged 10-16 years were enrolled in the study. Physical examination and Adam's forward bending test, combined with scoliometer measurements were performed at school-based screening. Students with an angle of trunk inclination of 5° or more were referred for whole-spine X-ray. The threshold for confirmed diagnosis was a Cobb angle of 10° or more. A total of 79,122 students were screened. The overall prevalence of adolescent idiopathic scoliosis in Wuxi City was estimated as 2.4%. Girls had a higher prevalence in each age subgroup compared with boys. Higher prevalence was found in individuals with lower body mass index. Mild and moderate curves were the most common types in our study. The prevalence of adolescent idiopathic scoliosis in this region was slightly higher. Medical resources should be considered for children with lower body mass index and high risk of scoliotic progression. Measurement with a scoliometer would be suitable for mild-to-moderate scoliotic deformities, while alternative methods should be developed for those with severe deformities or higher body mass index.

The prevalence of adolescent idiopathic scoliosis in São Paulo, Brazil

The prevalence of adolescent idiopathic scoliosis in São Paulo, Brazil