Epidemiological Trends and Projections of Adolescent Idiopathic Scoliosis Patients Among 118 Thousand Patients.

INTRODUCTION

Suspected changes in adolescent idiopathic scoliosis (AIS) demographic distribution compared with historical cohorts emphasize the need for an updated understanding of epidemiological trends. We aimed to characterize AIS trends in the United States from 2016 to 2023, compare these findings with historical cohorts, and project trends through 2030.

METHODS

AIS cases from 2016 to 2023 were identified using the TriNetX US Collaborative platform. A subanalysis examined patients who underwent posterior spinal fusion (PSF) and cases during the COVID-19 pandemic. Primary outcomes included prevalence, incidence proportion (IP), and incidence rate (IR). Historical AIS cohorts were identified through a systematic search. Regression modeling projected trends to 2030.

RESULTS

In 2023, the TriNetX platform reported a notable rise in AIS prevalence of 110 cases per 100,000 patients compared with 2016 ( P < 0.05). The IP and IR of AIS also rose, with 14,733 additional cases identified in 2023. PSF occurred in 5,990 cases per 100,000 AIS patients. Female patients had higher AIS prevalence than male patients (140 vs. 71.3 cases per 100,000) and higher PSF prevalence (6,400 vs. 5,350 cases per 100,000 AIS patients) in 2023. Incidence of AIS was markedly lower compared with historical cohorts; however, the female-to-male ratio was comparable. The most marked decrease (16.52% decrease from 2019 to 2020) and increase (22.15% increase from 2020 to 2021) in cases occurred during the COVID-19 pandemic. Regression analysis indicated linear increases in both AIS and PSF, projecting a national AIS prevalence of 17,000 cases per 100,000 patients nationally and PSF prevalence among AIS patients of 10,230 cases per 100,000 patients by 2030.

CONCLUSION

These findings highlight rising national rates of AIS diagnoses and PSF procedures among AIS patients. Further research is warranted on the etiology underlying increased incidence of AIS in male patients and potential healthcare burdens associated with projected increases in AIS prevalence.