Prevalence and associated factors of multi-ethnic adolescent idiopathic scoliosis in Longlin, Southwestern China: a school-based cross-sectional study.

OBJECTIVE

To determine the prevalence of adolescent idiopathic scoliosis (AIS) and its associated factors among multi-ethnic schoolchildren in Southwestern China.

METHODS

A cross-sectional school-based study was conducted involving 22,814 students aged 10-18 years. Screening comprised the Adams forward bend test; positives underwent radiographic confirmation (Cobb angle ≥10°). Demographic and behavioral data were collected via questionnaires. Multivariate logistic regression identified independent associated factors.

RESULTS

The screening positive rate was 3.83%, and the confirmed AIS prevalence rate was 1.37%. While no significant ethnic difference existed in screening positive rates (p = 0.078), the confirmed prevalence rates differed (p = 0.029), being relatively higher in Yi (1.52%) and GeLao (1.54%) adolescents. Girls showed a significantly higher screening positive rate than boys (4.64% vs. 3.12%, p < 0.001), but no statistically significant gender difference was found in the confirmed prevalence rates (p = 0.157). Notably, the positive predictive value was higher in boys (40.90%) than girls (31.72%). Multivariate analysis revealed several factors independently associated with AIS, including abnormal BMI, lack of desk/chair adjustment, poor sleep posture, physical inactivity, improper reading/writing posture, excessive electronic device use, insufficient outdoor activity, inadequate sleep, and frequent sweet consumption.

CONCLUSION

The AIS prevalence in this multi-ethnic region aligns with global figures. School screening coupled with health interventions targeting modifiable associated factors is essential for AIS prevention and control. Comprehensive health promotion and early intervention targeting the identified significant factors should be an important future direction for AIS prevention.