RESUMO
STUDY DESIGN: A cross-sectional study. OBJECTIVE: To estimate the prevalence of adolescent idiopathic scoliosis (AIS) in cities in the state of São Paulo, Brazil, as well as to identify demographic, clinical, and lifestyle factors associated with AIS. SUMMARY OF BACKGROUND DATA: AIS is a common three-dimensional spinal deformity. Epidemiological data about the condition in the southern hemisphere are scarce, and Brazil has no public health policies to implement school-based scoliosis screening programs. METHODS: We assessed 2562 adolescents between 10 and 14 years of age. The screening procedure included measurement of the angle of trunk rotation using a scoliometer in the Adams forward bend test and the radiographic examination. RESULTS: The overall prevalence of AIS was 1.5% (95% confidence interval [CI]: 1%-1.9%). The AIS prevalence was higher among the females than among the males-2.2% (95% CI: 1.4%-2.9%) and 0.5% (95% CI: 0.1%-0.9%), respectively. The following factors were associated with the development of AIS: being female (ORâ=â4.7, 95% CI: 1.8-12.2; Pâ=â0.001) and being in the 13- to 14-year age group (ORâ=â2.2; 95% CI: 1.0-4.8; Pâ=â0.035). Double curves and right laterality were more common (59.4% and 56.8%, respectively), although the curves were of low magnitude (75% of the curves having a Cobb angle ≤22°), as was the progression factor (≤1.2 in 75% of the cases). CONCLUSION: The prevalence of AIS in cities within the state of São Paulo was similar to that reported in the literature, was higher among females, and was higher during puberty (13-14 years of age). Because puberty occurs later for males than for females, the recommendation to screen both sexes at 10 to 14 years of age should be reconsidered. LEVEL OF EVIDENCE: 3.
Assuntos
Escoliose/epidemiologia , Adolescente , Fatores Etários , Brasil/epidemiologia , Criança , Cidades/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Escoliose/diagnóstico por imagem , Fatores SexuaisRESUMO
OBJECTIVE: The objective of this study was to describe the posture patterns of adolescents diagnosed with adolescent idiopathic scoliosis (AIS) in a scoliosis school screening (SSS). METHODS: Two-dimensional photogrammetry was used to assess the posture of 37 adolescents diagnosed with scoliosis (scoliosis group, SG) (Cobb angle ≥10°) and 76 adolescents with a false positive diagnosis (false positive group, FPG) (Cobb angle <10°, angle of trunk rotation ≥7°). In total, 2562 10- to 14-year-old adolescents were enrolled in the SSS, which was performed in public schools in the cities of Amparo, Pedreira, and Mogi Mirim in the state of São Paulo, Brazil. Their posture was analyzed using Postural Analysis Software. Continuous variables were tested using Student t test, and categorical variables were tested using a χ2 test. The SG, FPG, simple curve group, and double curve group were all compared. Bivariate analysis was used to identify associations between postural deviations and scoliosis. The adopted significance level was α = .05. RESULTS: The SG (2.7 ± 1.9°) had greater shoulder obliquity than the FPG (1.9 ± 1.4°) (P = .010), and this deviation was associated with scoliosis (odds ratio [95% CI] P = 1.4 [1.1-1.8] 0.011). The SG had asymmetry between the right- and left-side lower limb frontal angle, shoulder sagittal alignment, and knee angle. The double curve group (3 ± 1.7°) presented a greater value of the vertical alignment of the torso than the simple curve group did (1.9 ± 1°; P = .032). CONCLUSIONS: Adolescents diagnosed with AIS in an SSS had greater shoulder obliquity and asymmetry between the right and left sides. Shoulder obliquity was the only postural deviation associated with AIS.