The Demographics and Epidemiology of Infantile, Juvenile, and Adolescent Idiopathic Scoliosis in a Southern California Integrated Health Care System

Abstract

Study Design. Prognostic study, Level III. Objectives. The aim of this study was to determine the incidence and demographics of idiopathic scoliosis (IS) in a large cohort of children in a Southern California integrated healthcare system, and to identify the demographic or clinical factors associated with the greatest risk of IS. Summary of Background Data. Although many authors have reported on the incidence and prevalence of IS in children, there have been few incidence studies in the United States on large, self-contained populations. Methods. A retrospective chart analysis was done on diagnosed cases of IS within our integrated health care system in patients under age 18 years during the entire 2013 calendar year. Patient demographics were recorded and the incidence of IS was determined. Odds ratios (ORs) for having IS and for having more severe initial curve magnitudes based on demographics were determined using logistic regression models. Results. IS Incidence was 3.9, 28.6, and 393 per 100,000, respectively, for the infantile, juvenile, and adolescent group. The female incidence was more than twice that of males in all age groups. Multivariate logistic regression analysis showed Asians and non-Hispanic Whites had the highest OR of IS (OR 1.54 and 1.32 with 95% confidence interval [CI] 1.33-1.79 and 1.19-1.47). Whites, Blacks, and mixed-race patients had a significantly higher initial curve magnitude than Hispanics; females also had a significantly greater initial curve magnitude than boys (18.18 vs. 16.78). Underweight patients had a 50% increased OR of IS versus normal weight (95% CI 1.16-1.94) with a progressively decreased OR of IS as weight increased. Conclusion. Our study of a large integrated healthcare system sheds light on the incidence of IS and the ORs based on weight, sex, and ethnicity/race. The overall incidence was lower overall than previously thought.

Socioeconomic Factors Correlation With Idiopathic Scoliosis Curve Type and Cobb Angle Severity

“…The association between race and ethnicity and the severity of the spinal curve severity as measured by Cobb angles varies greatly between studies. One study showed that Hispanic patients had lower Cobb angles in comparison to all other races, while other studies show that Black patients had the highest Cobb angles, and other studies further showed no difference in Cobb angle severity between races [11,13,25,26]. While no definite associations between race and curve severity can be concluded, there have been notable correlations between socioeconomic factors and race that may provide an explanation for the variability in the race and IS prevalence and curve severity.…”

“…The linear rank regression indicates that while the association between BMI and the Cobb proximal thoracic angle is statistically significant, BMI only explains 5% of the variability in the proximal thoracic Cobb angle. BMI has different associations with IS curve severity; some studies showing lower BMI is associated with higher Cobb angles [14,25], while others show a positive correlation between higher BMI and higher Cobb angles [27] as well as increased rates of inpatient and intraoperative complications related to IS [16,28,29]. Despite the variability in which BMI affects curve severity, both extremes in the literature suggest a correlation with increased Cobb angle and increased complication rates, which brings up nutrition as a possible contributing factor to BMI.…”

A Case Report on the Immediate Effects of Cytoskeletal Manual Therapy on Pain, Muscle Thickness, and Pressure Pain Threshold in a Patient with Scoliosis

“…To confirm this, it is primarily performed through X-ray images, and it is determined that the Cobb angle is 10° or more [3,4]. Idiopathic scoliosis, which accounts for 85% of scoliosis cases, has been reported with a prevalence of 0.9% to 12% worldwide [5]. The exact cause has not been identified, and it is classified into infancy (0-3 years), juvenile (3-10 years), and adolescence (10 years or older) according to the time of expression.…”

Patient Care for Adolescent Idiopathic Scoliosis

“…The cumulative incidence estimates are 1.0% for a Cobb angle ≥ 20° and 0.4% for a Cobb angle ≥ 40°. In the study conducted by Bondar et al (Bondar, Nguyen, Vatani, & Kessler, 2021) for the adolescent group in Southern California, the incidence rate was 28.6/100,000 person-year, in which females had a greater initial curve magnitude than boys (18.1° vs. 16.7°). In China (Qiu, 2017), the incidence rate of scoliosis varied from 0.6% to 2.0%.…”