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 central Greece. A total of 85,627 children aged 9-15 years were screened for scoliosis. A subset of children with curves of at least 10 degrees underwent clinical and radiographic follow-up. The total population screened and the cohort followed for curve progression were evaluated according to factors associated 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; and magnitude, apex, and direction of the curve. Progression of the curve occurred in 14.7% of 839 children, while 27.4% demonstrated spontaneous improvement of at least 5 degrees. A high risk of curve progression was associated with the following: sex--girls, curve pattern--right thoracic and double curves in girls and right lumbar in boys, maturity--girls before the onset of menses, age--time of pubertal growth spurt, and curve magnitude--curves > or = 30 degrees. Although only a small percentage of scoliotic 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.