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The aim of study: 1. To investigate the prevalence of scoliosis, other spinal deformities, myopia, and visual impairments in adolescents (aged 6-18) in Zhejiang Province.
2.To track 8-year dynamic changes in spinal curvature and analyze associations between scoliosis, vision disorders, and potential risk factors.
3.To deliver scoliosis health education during screenings.
4.To mitigate scoliosis progression through early detection and intervention.
Scoliosis is the most common pediatric musculoskeletal disorder, affecting up to 4% of otherwise healthy children worldwide. Approximately 80-90% of cases are idiopathic scoliosis (IS), predominantly emerging during adolescence. While mild IS often causes no symptoms, moderate cases may lead to spinal deformity and mild respiratory dysfunction, with severe cases potentially resulting in cardiopulmonary compromise or even paralysis.
Despite extensive research exploring potential causes - including genetic, neuroendocrine, skeletal, muscular, postural, biomechanical and lifestyle factors - the underlying mechanisms of IS remain unclear. Bracing currently stands as the only proven conservative treatment to slow progression, yet 20-30% of braced patients still require eventual surgical correction. Adolescence represents both a critical window for rapid curve progression and the optimal period for effective intervention. Early screening has been demonstrated to significantly improve outcomes, highlighting the importance of preventive strategies during this developmental stage.
Recent studies across various populations have reported scoliosis prevalence rates ranging from 0.27% to 3.5%, with notable regional variations:
Singaporean studies found rates between 0.27%-2.49%
Greek research reported 1.7% prevalence
Large-scale US screening showed 0.9% prevalence
Chinese studies documented rates from 1.07% (Guangzhou) to 3.5% (Hong Kong)
Most existing research has been cross-sectional in design, lacking prospective data on curve progression patterns and associated risk factors.
This prospective cohort study aims to:1. To investigate the prevalence of scoliosis, other spinal deformities, myopia, and visual impairments in adolescents (aged 6-18) in Zhejiang Province.
2.To track 8-year dynamic changes in spinal curvature and analyze associations between scoliosis, vision disorders, and potential risk factors.
3.To deliver scoliosis health education during screenings.
4.To mitigate scoliosis progression through early detection and intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IS with Myopia | diopathic scoliosis with untreated myopia | ||
| IS without Myopia | diopathic scoliosis without myopia |
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| Measure | Description | Time Frame |
|---|---|---|
| Scoliosis Curve Angle | A long standard standing whole spine radiograph will be used for measuring curve size in terms of Cobb angle according to the standard Cobb method | Baseline, 24 months (±1 month), and 48 months (±1 month) after enrollment; data will be analyzed through study completion, up to 96 months.] |
| Angle of Trunk Rotation | In addition to spinal x-rays, a Scoliometer can also help monitor curve progression. The Scoliometer is an inclinometer that measures the asymmetries between the sides of the trunk by measuring axial rotation in degrees. Numerous studies have found a high correlation between trunk axial rotation (ATR) values and the Cobb angles. | Baseline, 24 months (±1 month), and 48 months (±1 month) after enrollment; data will be analyzed through study completion, up to 96 months.] |
| Measure | Description | Time Frame |
|---|---|---|
| Cycloplegic Mean Spherical Equivalent (MSE) for Myopia Diagnosis | MSE (diopters) will be calculated as [sphere + ½ cylinder] using autorefraction (Topcon KR-800) under cycloplegia (1% cyclopentolate). Myopia is defined as MSE ≤-0.50D. Triplicate measurements will be averaged per eye. | Baseline and every 24 months (±1 month) until study completion, up to 96 months. |
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Inclusion Criteria:
Exclusion Criteria:
• Patients with scoliosis other than idiopathic, or with other musculoskeletal or neurodevelopmental conditions that might be responsible for the scoliosis
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Adolescents participating in the Zhejiang Adolescent Spine and Vision Health Screening Program, China
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Xiangyang Wang | Contact | 86-13506663458 | Xiangyangwang@wmu.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Xiangyang Wang | Second Affiliated Hospital of Wenzhou Medical University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000 | Recruiting | Wenzhou | Zhejiang | 325600 | China |
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| ID | Term |
|---|---|
| D009216 | Myopia |
| D014786 | Vision Disorders |
| ID | Term |
|---|---|
| D012030 | Refractive Errors |
| D005128 | Eye Diseases |
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
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| Daily Near-Work Duration (UVD) Assessed by 30-Minute Block Questionnaire | Daily near-work activities (reading/digital screen use) will be recorded through the validated 20-item Near-Vision Activity Questionnaire (NVAQ). Total daily UVD will be calculated by summing 30-minute activity blocks (maximum 16 blocks/day). | Baseline, 24 months (±1 month), and 48 months (±1 month) after enrollment; data will be analyzed through study completion, up to 96 months. |
| Axial Length (AL) Growth Rate Measured by Swept-Source OCT | AL (mm) will be measured using swept-source optical coherence tomography (Topcon Triton Plus). Annualized growth rates (mm/year) will be calculated by linear regression of AL against time between baseline and each follow-up. | Baseline, 24 months (±1 month), and 48 months (±1 month) after enrollment; data will be analyzed through study completion, up to 96 months. |
| D009422 |
| Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |