Prevalence of early-onset and adolescent scoliosis and its associates among primary and secondary school students in Qinghai province: a screening survey

  Objective  To explore the prevalence and influencing factors of early-onset scoliosis (EOS, which appears before the age of 10) and adolescent scoliosis (manifesting at the age of 10 and above) among primary and secondary school students in Qinghai province.

  Methods  Totally 3 582 students aged 5 – 18 years were recruited in 24 primary and secondary schools in 2 municipalities of Qinghai province with stratified cluster sampling. A scoliosis screening was conducted among the students during October 2020 – February 2021 using national standard method (GB/T 16133 – 2014); whole spine X-ray examination was recommended to the students with the angle of trunk rotation (ATR) of ≥ 5° measured with Bunnell Scoliometer. Relevant information of the students were collected from their guardians with a self-designed questionnaire. Detect rates of EOS and juvenile-type scoliosis among the students were compared in statistical analysis and unconditional multivariate logistic regression model was adopted to explore influencing factors of scoliosis.

  Results  The overall detection rate of scoliosis in the students was 5.6% (201/3 582) and the detection rate of EOS was significantly lower than that of adolescent scoliosis (2.9% 58/1 549 vs. 9.3% 143/2 033, P < 0.05). The results of unconditional multivariate logistic regression analysis showed that for adolescent scoliosis, age increment (odd ratio OR = 1.23), paternal occupation (herder versus farmer: OR = 5.89), maternal occupation compared to being farmer (herder: OR = 59.85, doing business: OR = 10.62, being self-employed: OR = 19.41) were significant risk factors; but higher body mass index (OR = 0.75) and higher maternal education (OR = 0.55) were significant protective factors against scoliosis; while for EOS, age increment was a significant risk factor (OR = 1.88) and significant protective factors including higher parity number ( ≥ 2 versus 1: OR = 0.27), being born in summer (OR = 0.27) and in autumn (OR = 0.19) in contrast to being born in spring.

  Conclusion  Among 5 – 18 years old primary and secondary school students in Qinghai province, the detection rate of adolescent scoliosis is higher than that of EOS; the prevalence of adolescent scoliosis is influenced significantly by body mass index, maternal education and parental occupation but that of EOS is affected by parity and birth season.