A descriptive study to assess the prevalence, associated factors and comorbidities of adolescent idiopathic scoliosis of children aged 11-15 years in selected schools of Colombo District, Sri Lanka

Introduction: Scoliosis is a common paediatric spinal deformity and it is usually idiopathic. Idiopathic scoliosis has 3 age peaks of onset, infantile, juvenile and adolescent. Early identification and effective conservative treatment could slow or arrest the curvature progression thereby improving long-term outcomes.
Objectives: To describe the prevalence, co-morbidities and associated factors of adolescent idiopathic scoliosis (AIS) among children aged 11-15 years in the Colombo District and to assess the feasibility of using scoliometer in conjunction with Adam’s Forward Bend Test (FBT) for screening. 
Method: A descriptive cross-sectional study was conducted on school children aged 11 to 15 years in selected government schools in the Colombo District. Scoliosis assessment included a complete physical examination, nutritional assessment, leg length measurements, assessment of spinal inclination using a scoliometer, and the use of FBT.
Results: Of a total of 324 participants, 178 (55%) were males. Mean age was 12.25±1.5 years. Ages ranged from 11–15 years. Body mass index (BMI) measurements revealed a significant association between AIS screen positivity and lower BMI compared to non-AIS participants (p=0.034). Significant leg length discrepancies were not observed in our sample and the mean leg length on both sides was 85cm. A positive scoliometer reading (defined as a reading >6o) was seen in 16 (4.9%) children. Total FBT positives in the study was 20 children, with at least 1 positive indicator of asymmetry. Shoulder elevation, shoulder blade prominence, waist fold difference and rib prominence on left side were significantly associated with AIS (p<0.05).  Children with AIS demonstrated significantly reduced exercise tolerance compared to their peers without scoliosis (p=0.02). A significant proportion of children with AIS reported quitting sports activities due to physical discomfort or functional limitations (p=0.04). There was an AIS prevalence of 4.3%.
Conclusions: AIS prevalence was 4.3%. Concomitant use of scoliometer together with FBT for screening AIS is feasible.