Prevalence of Scoliosis in Female Teenagers
The prevalence of scoliosis in female teenagers ranges from 2-4%, with significantly higher rates in girls compared to boys, showing a female-to-male ratio of up to 7.2:1 for curves greater than 40 degrees. 1, 2
Epidemiological Data
General Prevalence
- Overall prevalence of adolescent idiopathic scoliosis (AIS) ranges from 0.47% to 5.2% in the general adolescent population 2
- The most recent comprehensive epidemiological study from Turkey (2020) found a prevalence of 2.3% overall, with 3.1% in females and 1.5% in males 3
- American Family Physician reports a prevalence of 2-4% in children between 10-16 years of age 1
Age-Related Prevalence in Females
A Singapore study examining 93,626 female students showed a clear age-related increase in prevalence 4:
- 9-year-old females: 0.27%
- 10-year-old females: 0.64%
- 11-year-old females: 1.58%
- 12-year-old females: 2.22%
- 13-year-old females: 2.49%
This demonstrates a significant increase in prevalence between ages 10-11 (OR 1.7; 95% CI 1.1-2.4) and again between ages 12-13 (OR 2.2; 95% CI 1.4-3.3) 4.
Gender Disparity
- Female-to-male ratio ranges from 1.5:1 to 3:1 overall 2
- This ratio increases substantially with curve severity:
- 1.4:1 for curves 10°-20°
- 7.2:1 for curves >40° 2
Curve Characteristics
- 69.3% of adolescents with scoliosis have a single curvature
- 29.3% have double curvatures
- Lumbar curves are the most common single curve type
- 90.5% of AIS cases have mild curves (10°-19° Cobb angle) 3
Risk Factors for Progression
The Scoliosis Treatment Guidelines highlight important risk factors for curve progression 5:
- Skeletal immaturity (Risser stages 0-3)
- Female gender (10:1 ratio compared to boys for developing curves >40°)
- Initial curve magnitude >20° (up to 70% likelihood of progression)
Screening Recommendations
Based on the significant increase in prevalence with age, particularly in females, screening is recommended:
- For females, screening should be performed annually from age 10 (Primary 5) through age 13 (Secondary 2) 4
- Referral to a spine specialist is recommended if:
- Curve >10° in patients younger than 10 years
- Curve >20° in patients 10 years or older
- Atypical features, back pain, or neurological abnormalities are present 5
Diagnostic Approach
- Scoliosis is defined as a lateral curvature of the spine greater than 10° on standing posteroanterior radiographs, typically associated with trunk rotation 5
- Initial screening typically uses the Adam's forward bend test and scoliometer measurement of trunk rotation 1, 3
- Radiographic confirmation with standing posteroanterior and lateral radiographs is required for diagnosis 5
Common Pitfalls in Evaluation
- Delayed referral or inadequate monitoring, particularly during periods of rapid growth
- Overlooking non-idiopathic causes (especially when pain is present or curve pattern is atypical)
- Neglecting the psychological impact of diagnosis, particularly in adolescent females 5