Risk factors for idiopathic scoliosis: Review of a 6-year prospective study

This study identified factors associated with the prevalence of idiopathic scoliosis and curve evolution in schoolchildren from northwestern and centr al Greece. A total of 85,627 children aged 9-15 years were screened for sco liosis. A subset of children with curves of at least 10 degrees underwent c linical and radiographic follow-up. The total population screened and the c ohort followed for curve progression were evaluated according to factors as sociated with curve evolution. The prevalence of scoliosis was 1.7%, with most cases appearing at ages 13 and 14 years and small scoliotic curves (10 degrees-19 degrees) being most prevalent (prevalence 1.5%). Prevalence was associated with gender; age; an d magnitude, apex, and direction of the curve. Progression of the curve occ urred in 14.7% of 839 children, while 27.4% demonstrated spontaneous improv ement of at least 5 degrees. A high risk of curve progression was associate d with the following: sex-girls, curve pattern-right thoracic and double cu rves in girls and right lumbar in boys, maturity-girls before the onset of menses, age-time of pubertal growth spurt, and curve magnitude-curves great er than or equal to 30 degrees. Although only a small percentage of scoliot ic curves undergo progression, the pattern of the curve according to curve direction and the sex of the child plays a significant role in the ability to identify which curves will progress.