Scoliosis - Risk Factors

Risk Factors

Risk Factors for Initial Scoliosis. Idiopathic scoliosis, the most common form, occurs most often during the growth spurt right before and during adolescence. (Between 12% and 21% of idiopathic cases occur in children aged three to 10 and less than 1% in infants.) Mild curvature (under 20 degrees) occurs about equally in girls and boys, but curve progression is 10 times more likely to occur in girls. Being taller than average at earlier ages may put some girls at risk, but other factors must be present to produce scoliosis. A risk factor that affects females is a delayed onset of menstruation, which can prolong the growth spurt period, thus increasing the possibility for the development of scoliosis.

Risk Factors for Curvature Progression. Once scoliosis is diagnosed, it is very difficult to predict who is at highest risk for curve progression. About 2 - 4% of all adolescents develop curvature of 10 degrees or more, but only about 0.3 -0.5% of teenagers have curves greater than 20 degrees, which requires some medical attention.

Medical Risk Factors

People with certain medical conditions that affect the joints and muscles are at higher risk for scoliosis.

Family History

In one study, idiopathic scoliosis occurred in about 5% of close family members of children with the condition.

Young Athletes

Scoliosis may be evident in young athletes, with a prevalence of between 2 -24%. The highest rates are observed among dancers, gymnasts, and swimmers.The scoliosis may have been due in part to loosening of the joints, delay in puberty onset (which can lead to weakened bones), and stresses on the growing spine. There have also been other isolated reports of a higher risk for scoliosis in young athletes who engage vigorously in sports that put an uneven load on the spine. These include figure skating, dance, tennis, skiing, javelin throwing and other sports. It should be strongly noted that in most cases the scoliosis is minor and everyday sports do not lead to scoliosis. Exercise has many benefits for people both young and old and may even help patients with scoliosis.

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Risk factors for idiopathic scoliosis: review of a 6-year prospective study.

This study identified factors associated with the prevalence of idiopathic scoliosis and curve evolution in schoolchildren from northwestern and central Greece. A total of 85,627 children aged 9-15 years were screened for scoliosis. A subset of children with curves of at least 10 degrees underwent clinical and radiographic follow-up. The total population screened and the cohort followed for curve progression were evaluated according to factors associated with curve evolution.

The prevalence of scoliosis was 1.7%, with most cases appearing at ages 13 and 14 years and small scoliotic curves (10 degrees-19 degrees) being most prevalent (prevalence 1.5%). Prevalence was associated with gender; age; and magnitude, apex, and direction of the curve. Progression of the curve occurred in 14.7% of 839 children, while 27.4% demonstrated spontaneous improvement of at least 5 degrees. A high risk of curve progression was associated with the following: sex--girls, curve pattern--right thoracic and double curves in girls and right lumbar in boys, maturity--girls before the onset of menses, age--time of pubertal growth spurt, and curve magnitude--curves > or = 30 degrees.

Although only a small percentage of scoliotic curves undergo progression, the pattern of the curve according to curve direction and the sex of the child plays a significant role in the ability to identify which curves will progress.

PMID: 10952046 [PubMed - indexed for MEDLINE]
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Medical Conditions : Risk Factors for Scoliosis

Medical Conditions

A number of medical conditions predispose children to scoliosis, including:

Turner's syndrome
Muscular dystrophy
Polio
Cerebral palsy
Marfan syndrome
Friedreich’s ataxia
Rheumatoid arthritis
Osteogenesis imperfecta
Spina bifida
Myelomeningocele

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Scoliosis Risk Factors

The cause of most scoliosis is unknown (idiopathic). Scoliosis is often first noticed around the time of adolescence, during a growth spurt. Growth is often the cause for worsening of an existing curve.

Other than growth, risk factors that make it more likely that a scoliosis curve will get worse include:

Sex. Curves in girls are more likely to worsen than are curves in boys.
Age. The younger the child when scoliosis appears, the greater the chance the curve will worsen.
Size of the curve. The greater the curve size, the higher the likelihood that it will worsen.
Location. Curves in the middle to lower spine are less likely to progress than are those in the upper spine.
Spinal problems at birth. Children who are born with scoliosis (congenital scoliosis) have a greater risk of worsening of the curve. Congenital scoliosis is thought of as a birth defect affecting the size and shape of the bones of the spine.

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