Prevalence of Scoliosis and Associated Risk Factors in Children and Adolescents: A Systematic Review

Background and Scoliosis is one of the most common spinal disorders and its delayed diagnosis and treatment may lead to complications in posture, sitting style and respiratory system. The purpose of this study was to systematically review previously published studies concerning the prevalence and associated risk factors of scoliosis among children and adolescents. A literature search was performed using PubMed, Elsevier, Scopus, Ovid and Science Direct databases for studies published during 2000-2014. The search keywords were scoliosis, prevalence, epidemiology, risk factors, children and adolescents. Iranian indexing databases including SID, Iran medex and Magiran were also searched for studies published in Iran. Fifteen articles were selected according to the inclusion criteria of the study. Of all identified studies, three studies were performed in Iran and 12 studies were conducted in other countries. Eight studies investigated only the prevalence of scoliosis and 7 studies investigated both the risk factors and the prevalence rate. To assess the prevalence of scoliosis one study used clinical examination, three studies performed plain radiography, and in one study clinical examination and plain radiography and bone mineral densitometry were applied. In other studies, clinical examination and plain radiography were applied. Three studies investigated the prevalence among girls and 12 studies investigated the prevalence among both genders. The prevalence of scoliosis among children and adolescents varied from 0.19% to 11.03% and it was higher among girls. Gender, onset age of deviation, weight, body mass index, family history of scoliosis and bone mineral density were reported as associated risk factors. The results indicate a relatively high prevalence of scoliosis among children and adolescents. Prevalence rate is higher among girls and those with family history of scoliosis and decreased bone mineral density.