Is lower-limb length discrepancy a risk factor for curve progression in adolescent idiopathic scoliosis? A systematic review.

We evaluated whether lower-limb length discrepancy (LLLD) is a risk factor for curve progression in adolescent idiopathic scoliosis (AIS). A systematic review of observational studies was conducted. On April 18, 2025, two independent reviewers searched Medline (PubMed and Ovid), Embase, PsycINFO, BIREME, PEDro, and Google Scholar using a PECO framework: population (AIS), exposure (LLLD), comparator (AIS without LLLD), and outcome (Cobb angle progression). The search identified 730 records; after removing 75 duplicates, 655 titles and abstracts were screened. Of these, 644 were excluded, and 11 full-text articles were assessed for eligibility. Eight were excluded for not meeting inclusion criteria, leaving three studies that partially met eligibility requirements. Because of the small number of included studies and the absence of appropriate control groups, meta-analysis and formal assessment of publication bias were not feasible. Current evidence is insufficient to determine whether LLLD is a risk factor for curve progression in AIS.