Prevalence and Correlation of Suspected Scoliosis with Sagittal Spinal Deviations in Early Adolescents

Overview

This school-based cross-sectional study found that 21.2% of early adolescents aged 12 to 14 years exhibited combined suspected scoliosis and sagittal spinal deviations, with flattened thoracic curvature being the most common sagittal abnormality. Greater body height and lower knowledge, attitude, and practice (KAP) scores were significantly associated with these combined spinal deformities, while screen time showed a limited association.

Background

Early adolescence is a critical period for musculoskeletal development, during which asynchronous growth can lead to spinal curvature deviations. Spinal deviations often occur in both frontal and sagittal planes, but prior research has largely focused on isolated abnormalities such as scoliosis or forward head posture. Recent evidence suggests that multiple spinal deviations frequently coexist, yet the prevalence and associated factors of combined frontal and sagittal deviations remain underexplored, especially in developing countries. Understanding these patterns is essential for early identification and prevention of long-term musculoskeletal complications.

Data Highlights

Key Findings

• 21.2% of early adolescents showed combined suspected scoliosis and sagittal spinal deviations.
• Flattened thoracic curvature was the most common sagittal spinal abnormality observed.
• Greater body height was significantly associated with higher odds of combined spinal deviations (AOR=1.06).
• Lower knowledge, attitude, and practice (KAP) scores correlated with increased risk of combined spinal deformities (AOR=0.80).
• Screen time had a limited but notable association with combined spinal deviations (AOR=1.22).
• Participants with suspected scoliosis reported more frequent upper back pain and lower self-postural awareness compared to peers without deviations.

Clinical Implications

These findings underscore the importance of incorporating comprehensive posture assessments that evaluate both frontal and sagittal spinal alignments in school health programs. Early identification of adolescents at risk, particularly those with greater height and lower postural health knowledge, can facilitate timely interventions. Additionally, promoting postural awareness and healthy lifestyle behaviors, including moderated screen time, may help reduce the risk of developing combined spinal deformities and associated musculoskeletal pain.

Conclusion

A significant proportion of early adolescents exhibit combined spinal deviations linked to biological and psychosocial factors. Integrating posture screening and health education into school-based initiatives is vital to improve spinal health outcomes and prevent long-term musculoskeletal complications.

References

1. Dop et al. 2024 -- Prevalence of Postural Defects in School-Aged Children
2. Afanasieva et al. 2020 -- Incidence of Posture Pathology Among School-Age Children