From the Guidelines
Risk factors for scoliosis include genetic predisposition, age, gender, and certain neuromuscular and connective tissue disorders, as well as birth defects and environmental factors that strain the spine asymmetrically. According to the most recent study 1, idiopathic scoliosis accounts for at least 75% to 80% of childhood scoliosis, with no underlying structural abnormality or accompanying syndrome identified. The study also highlights that certain risk factors, such as left thoracic curve, short segment curve, absence of apical segment lordosis/kyphosis, long thoracolumbar curve, rapid curve progression, functionally disruptive pain, focal neurologic findings, male sex, and pes cavus, may indicate neural axis abnormalities.
Some key points to consider include:
- Genetic predisposition, with family history being a significant indicator as scoliosis often runs in families
- Age, with adolescence being a critical period when idiopathic scoliosis typically develops, particularly during growth spurts
- Gender, with females being more likely to develop curves requiring treatment
- Certain neuromuscular conditions, such as cerebral palsy, muscular dystrophy, and spina bifida, which increase the risk of scoliosis
- Connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, which also increase the risk
- Birth defects affecting spinal development, poor posture, and uneven leg lengths, which can contribute to scoliosis development
- Activities that repeatedly strain the spine asymmetrically, such as consistently carrying heavy bags on one shoulder, which may exacerbate existing spinal curvature
It's worth noting that while many risk factors cannot be modified, maintaining good posture, balanced physical activity, and proper backpack use may help minimize environmental contributions to spinal curvature, as suggested by 1. Additionally, regular screening during childhood and adolescence is important for early detection, as early intervention can prevent progression to severe curvature requiring surgical correction.
Other studies, such as 1 and 1, provide further insight into the relationship between scoliosis and other conditions, such as osteogenesis imperfecta and 22q11.2 deletion syndrome. However, the most recent and highest quality study, 1, provides the most relevant information for determining risk factors for scoliosis.
From the Research
Scoliosis Risk Factors
- Family history is a significant risk factor for scoliosis, with 51% of patients having one or more relatives with scoliosis 2
- Patients with a family history of scoliosis are more likely to have larger curve sizes and require treatment 2
- Cerebral palsy and spina bifida are also risk factors for scoliosis, with a higher incidence of scoliosis in patients with these conditions 3, 4, 5, 6
- Muscle weakness and imbalance are contributing factors to the development of scoliosis in patients with neuromuscular diseases 5, 6
- Asymmetric paraplegia, intraspinal and congenital anomalies of the spine, altered sensory feedback, and abnormal posture via central pathways are also factors that contribute to the development of neuromuscular scoliosis 6
Specific Risk Factors
- Having a relative with scoliosis increases the risk of developing a more severe curve 2
- Patients with cerebral palsy and spina bifida are at higher risk of developing scoliosis due to muscle weakness and imbalance 3, 4, 5
- Duchenne muscular dystrophy is also a risk factor for scoliosis, with surgical correction and stabilization often considered for patients with a deformity >40-50° 4