Risk Factors, Lifestyle and Prevention among Adolescents with Idiopathic Juvenile Scoliosis: A Cross Sectional Study in Eleven First-Grade Secondary Schools of Palermo Province, Italy

Abstract

Adolescent idiopathic scoliosis (AIS) has an incidence of 2–3% in the general population and a multifactorial etiology. The present study aims to analyze modifiable risk factors and their interactions in the development of AIS in order to increase knowledge about the disease and to prevent the evolution of AIS in young students with tailored public health strategies. A cross-sectional study was conducted over two consecutive school years among students attending 11 first-grade secondary schools in the province of Palermo, Italy. A self-administered questionnaire that investigated socio-demographical, physical and anamnestic characteristics and habits, focusing on possible risk factors associated with idiopathic scoliosis, was administered. In addition, a clinical evaluation was performed with Adams’ test and Bunnel’s inclinometer. Suspected AIS cases were associated with the practice of high-risk sports (p < 0.05), weekly physical activity lasting ≥3 h (p < 0.05), lower back pain (p < 0.001), posture disorders (p < 0.01) and having had no contact with a physician (p < 0.01). Practice of high-risk sports (adj OR = 1.83; CI 95% 1.11–4.76) and suffering of posture disorders (adj OR = 1.67; CI 95% 1.12–3.60) showed a significant association with a confirmed diagnosis of AIS (Cobb angle ≥ 10° at X-ray). The risk factors associated with AIS are still unclear. Therefore, it is crucial to identify early modifiable and multiple risk factors to prevent the evolution of scoliosis in school-age children.

Is There a Relationship between Idiopathic Scoliosis and Body Mass? A Scoping Review

“…Idiopathic scoliosis has a high incidence among children all over the world and its multifactorial etiology is now accepted, although to date it is not fully known [ 16 , 23 , 27 , 28 ]. This condition can lead to important changes in the child’s physical appearance with a negative psychological effect on it [ 26 ].…”

“…In the literature, there is little clarity on the possible risk factors for idiopathic scoliosis, as the results appear quite conflicting [ 16 , 29 , 30 ].…”

“…The identification of risk factors appears to be of fundamental importance during the screening phase, which represents one of the most important secondary preventive tools. It allows for the implementation of adequate prevention strategies, especially in the groups most at risk (i.e., in the case of AIS, the age group 11–14 years) [ 16 , 17 , 18 ]. In many countries, screening programs have been established to detect deformity early while the spine is still amenable to bracing.…”

Which interventions may improve bracing compliance in adolescent idiopathic scoliosis? A systematic review and meta-analysis

“…Even though few studies suggested that spinal fusion surgery may not generate severe impairment afterward [6,7], the benefit of surgery is still controversial and more than 500 million dollars per year are spent in the United States alone on AIS surgeries [7,8]. Thus population-based screening and proper treatment at the onset of disease to prevent curve progression will not only improve AIS patients' health outcomes but also save healthcare dollars [9][10][11][12][13].…”

Cerebral White Matter Connectivity in Adolescent Idiopathic Scoliosis: A Diffusion Magnetic Resonance Imaging Study

“…AIS is accompanied by different risk factors, such as growth disturbances, postural disorders, environmental factors, visual and dental disorders, etc. [ 7 , 8 , 9 ]. AIS may also be related to high-risk sports (ballet, rhythmic gymnastics, swimming, some athletic activities, etc.)…”