The Canadian Scoliosis Screening Coalition

www.ScoliosisCanada.ca            contact us by email: CSSC@scoliosiscanada.ca

Links to Publications on the Impact of Adolescent Idiopathic Scoliosis (AIS) on children:

Below is just a curated list of publications.

1. Paradkar, R., Paradkar, R., Singh, M. et al. The impact of the social determinants of health on adolescent idiopathic scoliosis: a systematic review. Spine Deform 13, 997–1006 (2025). https://doi.org/10.1007/s43390-025-01065-4 "...Social determinants of health play a well-documented role in treatment and outcomes of various conditions, including AIS... Black adolescents with AIS presented with more severe forms of the condition that necessitated surgical management. Furthermore, lower socioeconomic status, along with residence in socioeconomically disadvantaged neighborhoods and enrollment in public insurance programs, often contributed to delayed clinical presentation, more severe curves at initial presentation, and delayed treatment. ...Conclusion This systematic review revealed disparities in the diagnosis and management of AIS based on race, ethnicity, language, insurance status, and socioeconomic status. These disparities highlight the urgent need for a multifaceted approach to improve equity in AIS care. Addressing these challenges requires systemic reforms targeted towards enhancing access and treatment for marginalized populations. Focused interventions should consider the unique social determinants that contribute to these disparities, ultimately promoting a more equitable healthcare system for all adolescents affected by idiopathic scoliosis." Level of evidence: Level II.
2. Griffin, J.T., Bagley, A., Iwinski, H. et al. Pain in individuals with adolescent idiopathic scoliosis: prevalence and association with physical function and psychosocial well-being using patient-reported outcome measures. Spine Deform (2025). https://doi.org/10.1007/s43390-025-01121-z " ...Conclusion Relationships among pain, physical function, psychosocial well-being PRO scores, and clinical measures were established but causality could not be demonstrated. Most patients did not report pain. HP (high pain) patients scored lower on physical function and psychosocial well-being PROs. HP threshold values can be used to identify HP patients so that interventions to reduce pain can be incorporated into their treatment plan."
3. Oeffinger, D.J., Iwinski, H., Talwalkar, V. et al. Examining the impact of adolescent idiopathic scoliosis on psychosocial well-being and physical function: revealing insights from patient-reported outcomes. Spine Deform (2025). https://doi.org/10.1007/s43390-025-01120-0 "...Using patient-reported questionnaires (PROs), the impact of adolescent idiopathic scoliosis (AIS) on psychosocial well-being domains of Self-Image, Self-Esteem, Mental Health and Peer Relationships, and the interplay between these domains, physical function and clinical measures was investigated....Scores on PsychoSocial Self-Image measures and PODCI Happiness, a mental health domain, and physical function measures of PODCI Transfer&Mobility and Sports&Physical Function were worse than typical population....scores were statistically worse than the RCs in many domains with effect sizes indicating clinically noticeable differences.'Patients' reported scores below typical peers on Mental Health, Self-Esteem and global self-image measures, while RC did not. Conclusions This research enhances the clinical utility of PROs for assessing psychosocial well-being in patients with AIS by establishing thresholds for identification of patients reporting scores worse than their AIS peers. Interventions targeting psychosocial well-being may help mitigate the potential negative impact of scoliosis on adolescents."
4. Feddema TJ, Miller FZA, Erickson MA, Garg S. Patient-Reported Mental Health and Quality of Life in Pediatric Adolescent Idiopathic Scoliosis Patients. J Am Acad Orthop Surg Glob Res Rev. 2025 Feb 7;9(2):e24.00253. doi: 10.5435/JAAOSGlobal-D-24-00253. PMID: 39928914; PMCID: PMC11810007."...Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity that can affect patients' mental health and overall quality of life...The reviewed studies consistently demonstrate that treatment may influence patients' mental health, emphasizing the vital role of questionnaires in measuring mental health and HRQoL throughout their treatment journey...AIS poses a risk factor for poor mental health and HRQoL...By prioritizing the mental well being of AIS patients and addressing mood and anxiety factors, we can potentially influence health-related outcomes... integrating mental health considerations into the treatment of AIS is essential..."
5. Jennifer A. Dermott, Liisa Jaakkimainen, Teresa To, Maryse Bouchard, Andrew Howard, David E. Lebel. Late referral of adolescent idiopathic scoliosis: the impact of socioeconomic status and health care utilization Canadian Journal of Surgery Vol. 67 (6 Suppl 1) November 13, 2024 doi: 10.1503/cjs.011424, CPSS-03. Abstract ID 164. The Hospital for Sick Children, Toronto, Ont.; the University of Toronto, Toronto, Ont.; ICES, Toronto, Ont.; the Sunnybrook Research Institute, Toronto, Ont.; the SickKids Research Institute, Toronto, Ont "...Results: In total, 2732 patients with AIS (2236 [82%] female) were seen in the study period. The average age (± standard deviation) was 14.1 (± 1.7) years (range 10.0–17.9 yr), mean Cobb angle 37.6° (± 14.4°) (range 10°–95°) and mean BMI 20.4 (± 5.2) (range 12.2–54.5). The percentage of late referrals was 27% (n = 728). Late referral was associated with younger age at presentation (13.8 yr v. 14.2 yr), less mature Risser stage and fewer physician outpatient visits (16.2 v. 18.7). The probability of being referred late increased with lower income (Q1 = 0.32 v. Q5 = 0.23) and higher level of material deprivation (Q5 = 0.3 4 v. Q1 = 0.22), and decreased when a pediatrician was the primary care provider (0.13 v. 0.35) or with regular annual health examinations (0.11 v. 0.32). Conclusion: Both lower SES and health care utilization increased the probability of late AIS referral, particularly when care was not provided by a pediatrician or when annual health examinations were infrequent"
6. Jessica Romeo, Holly Livock, Kevin Smit, James Jarvis, Andrew Tice. Postoperative suicide risk is elevated in patients under going posterior spinal instrumentation and fusion.Canadian Journal of Surgery Vol. 67 (6 Suppl 1) November 13, 2024 doi: 10.1503/cjs.011424, CPSS-09 Abstract ID 96, The Children’s Hospital of Eastern Ontario, Ottawa, Ont, "...The Ask Suicide-Screening Questions (ASQ) tool is an instrument to identify at-risk youth. It has been implemented at our institu tion since 2019 in patients over age 12 years admitted for any reason. The study objective was to determine the incidence and risk factors of positive ASQ screening findings in patients undergoing posterior spinal fusion (PSF)...Methods: Participants were retrospectively collected from a single-centre tertiary hospital. Patients diagnosed with a spine condition who had had PSF between 2019 and 2023, were aged 12–20 years and had completed the ASQ postoperatively were included... Conclusion: Twenty one percent of patients undergoing PSF had a positive ASQ screen, indicating the high incidence of suicidal risk in this patient population. Patients with a preoperative mental health diagnosis were at highest risk of screening positive. This initiative also identified a population of at-risk adolescents who access the medical system for targeted needs outside of a mental health origin. There is an opportunity to improve preoperative mental health screening in adolescents undergoing spinal surgery to optimize their postoperative mental health..." (Note: youth with significant AIS may be at risk for suicide ideation. )
7. Hoelen TA, Evers SMAA, Arts JJ, Willems PC, van Mastrigt GAPG. The societal burden associated with adolescent idiopathic scoliosis: a cross-sectional burden-of-disease study. BMC Public Health. 2024 Nov 6;24(1):3065. doi: 10.1186/s12889-024-20423-x. PMID: 39506705; PMCID: PMC11539827. "... the estimated mean nonoperative treatment costs over a 2-year observation period were higher for patients with more severe symptoms. Additionally, Glassman reported in an earlier study that patients with more severe clinical symptoms were more likely to be disabled and unemployed [15]. This poses a supplementary societal as well as an economic burden on an already burdened healthcare system. Thus, early detection and treatment are crucial in minimizing the impact of AIS and thus reducing potential surgical costs as well as mitigating long-term healthcare outcomes. One potential strategy for early detection is institutionalized screening for example by a school doctor....Conclusions AIS negatively impacts societal costs and the HRQoL. Reducing the burden that is posed on the productivity sector by AIS and further improving the HRQoL for AIS patients is needed."
8. Chen JW, Koester SW, Liles C, Gannon S, Bonfield CM. Evaluating the prevalence of psychiatric comorbidities associated with pediatric scoliosis utilizing ResearchMatch. Spine Deform. 2024 Nov;12(6):1583-1593. doi: 10.1007/s43390 024-00926-8. Epub 2024 Aug 12. PMID: 39134889; PMCID: PMC11499428.”...In this national sample, over half of adolescent scoliosis patients report psychiatric comorbidity, often diagnosed years later. The most prevalent psychiatric condition is depression, anxiety, and body-image disturbances. These findings highlight the importance of awareness of the psychiatric impact of adolescent scoliosis, and importance of screening and treatment of comorbid mental health conditions. “
9. Kipper B, Rod J, Fron D, Nectoux E, Gouron R, Deroussen F, Bernardini I, Payen M, Luc F, Lechevallier J, Laquievre A, Bronfen C, Lobbedez T, Alves A, Dejardin O, Dolet N. Influence of socioeconomic deprivation and geographic disparities in the management of surgical adolescent idiopathic scoliosis: a multicentric retrospective cohort in Northern France. Eur Spine J. 2024 Nov 24. doi: 10.1007/s00586-024-08556-4. Epub ahead of print. PMID: 39581909. "...It seems that deprivation occurs only before special therapeutic management, strengthening the importance of systematic screening. Further studies are needed to assess the impact of different socioeconomic factors on this pathology...."
10. Sarkovich S, Leonardi C, Darlow M, Martin D, Issa P, Soria T, Bronstone A, Clement C. Back pain in adolescent idiopathic scoliosis: frequency and risk factors. Spine Deform. 2024 Sep;12(5):1319-1327. doi: 10.1007/s43390-024-00904-0. Epub 2024 Jun 23. PMID: 38910187; PMCID: PMC11344019."...Nearly half (48%) of newly diagnosed AIS patients experience back pain which is higher than the prevalence of 33% seen in the general adolescent population. Pain was more prevalent among patients over the age of 13... Pain was most commonly reported in the lumbar region, especially among patients with lumbar curves...."
11. Oeffinger DJ, Iwinski H, Talwalkar V, Dueber DM. Psychometric analysis and the implications for the use of the scoliosis research society questionnaire (SRS-22r English) for individuals with adolescent idiopathic scoliosis. N Am Spine Soc J. 2024 Jul 31;19:100545. doi: 10.1016/j.xnsj.2024.100545. PMID: 39290847; PMCID: PMC11405851.
12. Siwiec A, Domagalska-Szopa M, Kwiecień-Czerwieniec I, Dobrowolska A, Szopa A. Impact of Idiopathic Scoliosis on the Cardiopulmonary Capacity of Adolescents. J Clin Med. 2024 Jul 28;13(15):4414. doi: 10.3390/jcm13154414. PMID: 39124681; PMCID: PMC11312811. “Conclusion: Children and adolescents with mild-to-moderate scoliosis (with main thoracic curve) during CPET exhibited a lower ventilation capacity and lower VO2max than age-matched healthy adolescents. Furthermore, lower ventilation capacity and lower VO2max may be responsible for reduced exercise tolerance in adolescents with mild-to-moderate IS and the CRF parameters of children with mild-to-moderate scoliosis are not dependent upon the Cobb or rotation angles of the primary spinal curvature. Physiotherapy and physical activity should be recommended to prevent cardiorespiratory failure in later life in patients with scoliosis....”
13. Paramento M, Passarotto E, Maccarone MC, Agostini M, Contessa P, Rubega M, Formaggio E, Masiero S. Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review. PLoS One. 2024 May 22;19(5):e0303086. doi: 10.1371/journal.pone.0303086. PMID: 38776317; PMCID: PMC11111046.“We found significant evidence of impaired standing balance in individuals with AIS who greatly rely on visual and proprioceptive information to stay upright...Bracing appears to be an effective treatment for AIS, leading to improvements in static balance and gait.”
14. Regan C, Transtrum MB, Jilakara B, Milbrandt TA, Larson AN How Long Can You Delay? Curve Progression While Awaiting Vertebral Body Tethering Surgery. Clin Med. 2024 Apr 11;13(8):2209. doi: 10.3390/jcm13082209. PMID: 38673483; PMCID: PMC11050359. “...Surgical delays for AIS patients awaiting VBT may lead to significant curve progression and necessitate more invasive procedures.”
15. Orellana, Kevin J. BS*; Lee, Julianna BA*; Yang, Daniel MS*; Hauth, Lucas BS*; Flynn, John M. MD*,†. Impact of Social Determinants of Health on Adolescent Idiopathic Scoliosis Curve Severity. Journal of Pediatric Orthopaedics 44(2):p e168-e173, February 2024. | DOI: 10.1097/BPO.0000000000002529 "...Conclusion: Socioeconomic status plays a significant role in the severity of AIS. Specifically, patients with lower COI tend to present with curve magnitudes beyond what is responsive to nonsurgical treatment, leading to larger curves at the time of surgery. Future work should focus on addressing social inequalities to optimize the treatment and outcomes of AIS patients."
16. Hannink E, Toye F, Newman M, Barker KL. The experience of living with adolescent idiopathic scoliosis: a qualitative evidence synthesis using meta-ethnography. BMC Pediatr. 2023 Jul 22;23(1):373. doi: 10.1186/s12887-023-04183-y. PMID: 37481537; PMCID: PMC10362777. “...The aim of this qualitative evidence synthesis (QES) was to systematically search for, identify, and synthesise qualitative research in order to improve our understanding of what it is like to live with AIS and to facilitate empathetic and effective healthcare...Both adolescents and parents expressed a shock at the diagnosis and fear of an unknown future, but parents expanded on their feelings of guilt and powerlessness to help their child...How children handled the diagnosis and lived with the condition exceeded parents’ expectations, which could be attributed to adolescents’ internalisation or their stage of AIS, experiencing minimal impact or seeing hope at the end of the tunnel with surgery”
17. Thomáy-Claire Ayala Hoelen, Paul C. Willems, Jacobus J. Arts, Ghislaine van Mastrigt, Silvia Evers, The economic and societal burden associated with adolescent idiopathic scoliosis: A burden-of-disease study protocol, North American Spine Society Journal (NASSJ), Volume 14, June 2023
18. Bisson DG, Sheng K, Kocabas S, Ocay DD, Ferland CE, Saran N, Ouellet JA, Haglund L. Axial rotation and pain are associated with facet joint osteoarthritis in adolescent idiopathic scoliosis. Osteoarthritis Cartilage. 2023 Aug;31(8):1101-1110. doi: 10.1016/j.joca.2023.03.007. Epub 2023 Mar 21. PMID: 36948383."... Both pain intensity and cartilage morphology scores show a high concordance of intensity across the back regions. The middle and upper back regions display the most degenerative changes in facet joint cartilage and the highest pain scores. These results are in concordance with previous findings in this study where facet joint degeneration is most prominent in upper thoracic segments. Notably, this region is also at risk of maximal ligamentous capsule distention which has been observed to produce nociceptive stimuli in response to axial intervertebral rotation30,31. Furthermore, Teles and al. demonstrated the same pattern of localized back pain in right thoracic curves (Lenke 1 and 2 curve types)1. These results suggest that facet joint osteoarthritis and rotational instability could be generating pain in scoliotic spines..."
19. Jalloh H, Andras LM, Sanders A, Iantorno S, Hamilton A, Choi PD, Skaggs DL. Adolescent idiopathic scoliosis patients treated with bracing, surgery, or observation showed no difference in behavioral and emotional function over a 2-year period. Medicine (Baltimore). 2023 Jan 20;102(3):e32610. doi: 10.1097/MD.0000000000032610. PMID: 36701729; PMCID: PMC9857555.
20. Motyer GS, Kiely PJ, Fitzgerald A. Adolescents' Experiences of Idiopathic Scoliosis in the Presurgical Period: A Qualitative Study. J Pediatr Psychol. 2022 Feb 14;47(2):225-235. doi: 10.1093/jpepsy/jsab095. PMID: 34524430; PMCID: PMC8841985.
21. Kempen DHR, Heemskerk JL, Kaçmaz G, Altena MC, Reesink HJ, Vanhommerig JW, Willigenburg NW. Pulmonary function in children and adolescents with untreated idiopathic scoliosis: a systematic review with meta-regression analysis. Spine J. 2022 Jul;22(7):1178-1190. doi: 10.1016/j.spinee.2021.12.011. Epub 2021 Dec 25. PMID: 34963629."...Conclusion: This meta-regression analysis of summary data (means) from 126 studies showed an inverse relationship between the thoracic Cobb angle and pulmonary function. In contrast to previous conclusions, the decline in pulmonary function appears to be gradual over the full range of Cobb angles between <20 and >120 degrees. These findings strengthen the relevance of minimizing curve progression in children with idiopathic scoliosis."
22. G Bisson D, Lama P, Abduljabbar F, Rosenzweig DH, Saran N, Ouellet JA, Haglund L. Facet joint degeneration in adolescent idiopathic scoliosis. JOR Spine. 2018 May 24;1(2):e1016. doi: 10.1002/jsp2.1016. PMID: 31463443; PMCID: PMC6686828. “...AIS facet joint cartilage shows hallmarks of OA including proteoglycan loss, overexpression of pro-inflammatory mediators, increased synthesis of matrix-degrading proteases and fragmentation of SLRPs. As with patients with age-related OA, the premature joint degeneration seen in scoliotic patients is likely to contribute to the pain perceived in some individuals....”
23. Théroux J, Le May S, Hebert JJ, Labelle H. Back Pain Prevalence Is Associated With Curve-type and Severity in Adolescents With Idiopathic Scoliosis: A Cross-sectional Study. Spine (Phila Pa 1976). 2017 Aug 1;42(15):E914-E919. doi: 10.1097/BRS.0000000000001986. PMID: 27870807.
24. Alzakri A, AlMuhid F, Almousa N, Aljehani M, Alhalabi H. Saudi patients outcomes after surgical treatment of adolescent idiopathic scoliosis. J Orthop Surg Res. 2023 Jun 23;18(1):450. doi: 10.1186/s13018-023-03925-z. PMID: 37353815; PMCID: PMC10290359.
25. Çimen, Osman MD; Öner, Ali MD; Köksal, Alper MD; Dirvar, Ferdi MD; Mert, Muhammed MD. Evaluation of the Parameters Affecting Respiratory Functions at Adolescent Idiopathic Scoliosis Patients. Clinical Spine Surgery 35(1):p E236-E241, February 2022. | DOI: 10.1097/BSD.0000000000001206
26. Kempen DHR, Heemskerk JL, Kaçmaz G, Altena MC, Reesink HJ, Vanhommerig JW, Willigenburg NW. Pulmonary function in children and adolescents with untreated idiopathic scoliosis: a systematic review with meta-regression analysis. Spine J. 2022 Jul;22(7):1178-1190. doi: 10.1016/j.spinee.2021.12.011. Epub 2021 Dec 25. PMID: 34963629.
27. Mitsiaki I, Thirios A, Panagouli E, Bacopoulou F, Pasparakis D, Psaltopoulou T, Sergentanis TN, Tsitsika A. Adolescent Idiopathic Scoliosis and Mental Health Disorders: A Narrative Review of the Literature. Children (Basel). 2022 Apr 22;9(5):597. doi: 10.3390/children9050597. PMID: 35626775; PMCID: PMC9139262.
28. Motyer GS, Kiely PJ, Fitzgerald A. Adolescents' Experiences of Idiopathic Scoliosis in the Presurgical Period: A Qualitative Study. J Pediatr Psychol. 2022 Feb 14;47(2):225-235. doi: 10.1093/jpepsy/jsab095. PMID: 34524430; PMCID: PMC8841985. “...Understanding and addressing adolescents’ psychosocial support needs as they manage the challenges associated with idiopathic scoliosis is a key component of promoting better outcomes among this patient group. Clinical implications and opportunities for support provision are discussed.”
29. Wang H, Tetteroo D, Arts JJC, Markopoulos P, Ito K. Quality of life of adolescent idiopathic scoliosis patients under brace treatment: a brief communication of literature review. Qual Life Res. 2021 Mar;30(3):703-711. doi: 10.1007/s11136-020-02671-7. Epub 2020 Oct 24. PMID: 33098493; PMCID: PMC7952337.
30. Kan MMP, Negrini S, Di Felice F, Cheung JPY, Donzelli S, Zaina F, Samartzis D, Cheung ETC, Wong AYL. Is impaired lung function related to spinal deformities in patients with adolescent idiopathic scoliosis? A systematic review and meta-analysis-SOSORT 2019 award paper. Eur Spine J. 2023 Jan;32(1):118-139. doi: 10.1007/s00586-022-07371-z. Epub 2022 Dec 12. PMID: 36509885."...Conclusion: Larger thoracic Cobb angles, greater apical vertebral rotation angle, or hypokyphosis were significantly associated with greater pulmonary impairments in patients with AIS, although the evidence was limited. From a clinical perspective, the results highlight the importance of minimizing the three-dimensional spinal deformity in preserving lung function in these patients. More research is warranted to confirm these results."
31. Makino T, Kaito T, Sakai Y, Takenaka S, Yoshikawa H. Health-related Quality of Life and Postural Changes of Spinal Alignment in Female Adolescents Associated With Back Pain in Adolescent Idiopathic Scoliosis: A Prospective Cross-sectional Study. Spine (Phila Pa 1976). 2019 Jul 15;44(14):E833-E840. doi: 10.1097/BRS.0000000000002996. PMID: 30817729. “Conclusion. Psychological distress and large postural changes of spinal alignment played an important role in the occurrence of back pain. Physicians should pay more attention to mental healthcare of AIS patients as well as to radiographical assessments of curve severity for better health-related quality of life.”
32. Jagger F, Tsirikos AI, Blacklock S, Urquhart DS. Adaptation to reduced lung function in children and young people with spinal deformity. J Clin Orthop Trauma. 2020 Mar-Apr;11(2):191-195. doi: 10.1016/j.jcot.2019.12.013. Epub 2020 Jan 3. PMID: 32099278; PMCID: PMC7026554.
33. Wang Y, Yang F, Wang D, Zhao H, Ma Z, Ma P, Hu X, Wang S, Kang X, Gao B. Correlation analysis between the pulmonary function test and the radiological parameters of the main right thoracic curve in adolescent idiopathic scoliosis. J Orthop Surg Res. 2019 Dec 16;14(1):443. doi: 10.1186/s13018-019-1451-z. PMID: 31842920; PMCID: PMC6915929. "...scoliosis can lead to restrictive pulmonary dysfunction...Conclusion: Severe scoliosis leads to an increased degree of thoracic deformity, which increases the risk of lung damage in AIS. Moreover, a more accurate assessment of pulmonary function is achieved through radiological parameters and PFTs."
34. Gallant JN, Morgan CD, Stoklosa JB, Gannon SR, Shannon CN, Bonfield CM. Psychosocial Difficulties in Adolescent Idiopathic Scoliosis: Body Image, Eating Behaviors, and Mood Disorders. World Neurosurg. 2018 Aug;116:421-432.e1. doi: 10.1016/j.wneu.2018.05.104. Epub 2018 May 23. PMID: 29803063.
35. Sanders AE, Andras LM, Iantorno SE, Hamilton A, Choi PD, Skaggs DL. Clinically Significant Psychological and Emotional Distress in 32% of Adolescent Idiopathic Scoliosis Patients. Spine Deform. 2018 Jul-Aug;6(4):435-440. doi: 10.1016/j.jspd.2017.12.014. PMID: 29886916. "...AIS patients undergoing observation, bracing, and surgery are all at risk for clinically significant psychological symptoms." Level of evidence: Level II.
36. G Bisson D, Lama P, Abduljabbar F, Rosenzweig DH, Saran N, Ouellet JA, Haglund L. Facet joint degeneration in adolescent idiopathic scoliosis. JOR Spine. 2018 May 24;1(2):e1016. doi: 10.1002/jsp2.1016. PMID: 31463443; PMCID: PMC6686828."...AIS facet joint cartilage shows hallmarks of OA including proteoglycan loss, overexpression of pro‐inflammatory mediators, increased synthesis of matrix‐degrading proteases and fragmentation of SLRPs. As with patients with age‐related OA, the premature joint degeneration seen in scoliotic patients is likely to contribute to the pain perceived in some individuals...."
37. Balioglu MB, Aydin C, Kargin D, Albayrak A, Atici Y, Tas SK, Kaygusuz MA. Vitamin-D measurement in patients with adolescent idiopathic scoliosis. J Pediatr Orthop B. 2017 Jan;26(1):48-52. doi: 10.1097/BPB.0000000000000320. PMID: 27089048."...Vitamin-D levels were lower in the AIS group, with no sex-specific effects, indicative of a possible vitamin-D resistance in AIS. Vitamin-D levels correlated positively with Ca levels and negatively with Cobb’s angle, indicative of a possible role of vitamin D in the etiopathogenesis of AIS. Patients with AIS should be monitored for vitamin-D deficiency/insufficiency..."
38. Théroux J, Le May S, Hebert JJ, Labelle H. Back Pain Prevalence Is Associated With Curve-type and Severity in Adolescents With Idiopathic Scoliosis: A Cross-sectional Study. Spine (Phila Pa 1976). 2017 Aug 1;42(15):E914-E919. doi: 10.1097/BRS.0000000000001986. PMID: 27870807. "...Conclusion: Spinal pain is common among patients with AIS, and greater spinal deformity was associated with higher pain intensity. These findings should inform clinical decision-making when caring for patients with AIS."
39. Chang WP, Lin Y, Huang HL, Lu HF, Wang ST, Chi YC, Hung KS, Chen HY. Scoliosis and the Subsequent Risk of Depression: A Nationwide Population-based Cohort Study in Taiwan. Spine (Phila Pa 1976). 2016 Feb;41(3):253-8. doi: 10.1097/BRS.0000000000001187. PMID: 26579956.
40. Huh S, Eun LY, Kim NK, Jung JW, Choi JY, Kim HS. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children. Korean J Pediatr. 2015 Jun;58(6):218-23. doi: 10.3345/kjp.2015.58.6.218. Epub 2015 Jun 22. PMID: 26213550; PMCID: PMC4510355."...the purpose of this study was to find an association between preoperative cardiopulmonary function and scoliosis severity before surgery. We performed tissue Doppler imaging in addition to conventional echocardiograph measurements to evaluate diastolic and systolic myocardial function... tissue Doppler E'/A' showed a negative correlation with Cobb angles in thoracic scoliosis, implying that scoliosis deteriorates diastolic myocardial function. In conclusion, children with idiopathic scoliosis should undergo an evaluation of cardiopulmonary function regardless of symptoms, especially patients with larger Cobb angles In the future, the idiopathic scoliosis children should be followed for their cardiopulmonary function after the spine correction operation."
41. Dolan, L., Weinstein, S. & the BrAIST Study Group. Health, function, quality of life and self-esteem in AIS; preliminary results from BrAIST. Scoliosis 9 (Suppl 1), O80 (2014). https://doi.org/10.1186/1748-7161-9-S1-O80
42. Czaprowski D, Kotwicki T, Biernat R, Urniaż J, Ronikier A. Physical capacity of girls with mild and moderate idiopathic scoliosis: influence of the size, length and number of curvatures. Eur Spine J. 2012 Jun;21(6):1099-105. doi: 10.1007/s00586 011-2068-z. Epub 2011 Nov 22. PMID: 22101867; PMCID: PMC3366128.
43. Barrios C, Pérez-Encinas C, Maruenda JI, Laguía M. Significant ventilatory functional restriction in adolescents with mild or moderate scoliosis during maximal exercise tolerance test. Spine (Phila Pa 1976). 2005 Jul 15;30(14):1610-5. doi: 10.1097/01.brs.0000169447.55556.01. PMID: 16025029."...Conclusion: Although patients with mild or moderate scoliosis do not exhibit cardiopulmonary restrictions in basal static conditions, they do show a significant lower tolerance to maximal exercise. Respiratory inefficiency together with lower ventilation capacity and lower VO2 max may be responsible for reduced exercise tolerance in adolescents with idiopathic scoliosis. Exercise deconditioning in scoliotic patients cannot be attributed to brace treatment.
44. Mayo NE, Goldberg MS, Poitras B, Scott S, Hanley J. The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part III: Back pain.Spine (Phila Pa 1976). 1994 Jul 15;19(14):1573-81. doi: 10.1097/00007632-199407001-00005. PMID: 7939993. “...In comparison to controls, AIS subjects reported pain that was more intense, continuous, generalized throughout the back, and radiating into the extremities. AIS subjects were also more restricted in many usual daily activities. Little variability was observed in the prevalence of current back pain and back pain in the past year according to treatment and degree of curvature. Difficulty with managing pain, lifting, walking, and socializing was, however, associated with severity. The results of this study suggest that back pain is responsible for a considerable amount of disability and handicap in later life. Health professionals involved with the management of persons with AIS need to consider this important outcome and need to put in place procedures for the identification, investigation, prevention, and treatment of back pain.”
45. Please also read about Halo Gravity Traction treatment necessary when curves become extremely severe in children.