The Canadian Scoliosis Screening Coalition

@2025CanadianScoliosiScreeningCoalition

Signs of Scoliosis (AIS) every Canadian Parent should look for:

For children in the high risk age group in grades 5-7, every parent of children should learn the signs of scoliosis to look for and check their children. The age to start checking for signs of Scoliosis (Adolescent Idiopathic Scoliosis, AIS) in your children is girls age 10 years and boys age 13, which is when the Scoliosis Research Society(1) advises screening to start by trained health professionals. A year before puberty and during puberty until skeletal maturity is reached and the child has finished growing. AIS is a genetic condition and runs in families so if there is a family history you might want to check earlier. Checking for signs of scoliosis can start at any age. AIS occurs more frequently in girls than boys and girls are 5-8X (2) at higher risk of developing curves that require treatment. Parents need to know that for girls with AIS, it has long been established that there is a higher risk of curve progression just before or at the age of menarche.

Perform a visual exam of your child by having them stand with their back towards you. Because the spine can curve in different ways, the signs of Scoliosis (AIS) can be different from one child to the next. So a child may have one or more of the following signs below.

Signs of Scoliosis include:

           

• The head is not centred over the body or tilts to one side.
• Uneven shoulders; one shoulder is higher than the other or
  one shoulder blade is more prominent than the other.
• Uneven hips; one hip is more prominent or lower than the other hip.
• Uneven waist creases or the waist appears uneven.
• Uneven space between hanging arms and the waist/trunk.
• Spine appears to curve and is not straight
• Changes in posture and walking gait.
• Clothes are not hanging evenly.
• Perform the Forward Bending Test (FBT) (aka Adam's Forward Bending Test).
  Have your child bend forward, legs straight and arms hanging freely, until their back is level with the floor and view their back from behind to see if both sides are the same. Check the waist, lower back and upper back to see if a ribcage or shoulder blade is protruding on one side. If the difference in height is more then 1 cm, your child may have Scoliosis.

More Screening Information & videos on Adolescent Idiopathic Scoliosis for Parents:

Watch How to detect Scoliosis at home, Explained under 1 minute from Setting Scoliosis Straight Foundation (US non-profit established by surgeons)
For more information,
Adolescent Idiopathic Scoliosis from the non-profit UK Scoliosis Support & Research.

Information on Scoliosis from Boston's Children's Hospital

Watch the SRS Educational Videos: Scoliosis Screening Exam     and    Use of a Scoliometer
Or watch How To Use A Scoliometer To Measure Scoliosis Curve Rotation and Monitor For Progression from a Physiotherapist at Align Therapy
PRINT a downloadable PDF brochure from non-profit Scoliosis Alberta Society
Scoliosis Screening Brochure

For information on Scoliosis from the Scoliosis Research Society (SRS) refer to: Diagnosis & Screening of Scoliosis FAQ   

Watch the Scoliosis Video Handbook chapters from (US non-profit) Setting Scoliosis Straight Foundation Video Channel of Setting Scoliosis Straight

Note: none of the above North American or UK (like Canada they stopped screening in the 1980s) sites promotes Schroth Physiotherapeutic Scoliosis-Specific Exercises PSSE as a conservative treatment for mild curves and practice 'observation only'. Read here about The Schroth Method from John Hopkins Health.

Early diagnosis and treatment is key, so if you are concerned your child has Scoliosis, please make an appointment for your child as soon as possible with your primary care provider or child's pediatrician. He or she may order x-rays of your child's entire spine to confirm a diagnosis and refer your child to a paediatric orthopaedic spine surgeon at a children's hospital who specializes in spinal deformities and Scoliosis, or the Scoliosis clinic at the closest children's hospital. The x-rays will be read by a specialist to measure the degree of your child's spinal curve which is called the COBB angle. Scoliosis is defined by a COBB angle that is greater than 10° . Curves under 20° Cobb angle are considered mild.

Parents must be aware and informed of a recent study from Toronto Sickkids, Kim DJ, Dermott JA, Mitani AA, Doria AS, Howard AW, Lebel DE. The diagnostic accuracy of community spine radiology for adolescent idiopathic scoliosis brace candidates Eur Spine J. 2024 Oct;33(10):3776-3783. doi: 10.1007/s00586-024-08389-1. Epub 2024 Jul 17. PMID: 39014076. "A recent study at Toronto SicKkids reveals a disturbing problem in high degree (over 34%) of inaccurate (underestimation of Cobb angle, degree of scoliosis curve) of community based x-rays that leads to missed opportunities for timely referrals and bracing. This contributes "to an increased number of avoidable spine surgeries due to missed opportunities for non-operative treatment.". There was a similar study published by the Department of Orthopaedic Surgery, University of Calgary, in March 2023.

Please know, for the majority of children, Scoliosis curves are mild and remain mild and do not cause health problems and according to studies mild curves do not cause pain for most children but can cause lower back pain for some children with lumbar curves (11) . But for some children Scoliosis, can lead to progressive curves that left undetected and untreated can lead to serious long-term health problems such as chronic back pain, respiratory issues, physical deformity, decreasing physical functioning, and psychosocial distress. Early-detection, diagnosis and early-treatment is critically important as during puberty for a small number of children curves can progress rapidly during growth spurts.

Treatments available for Scoliosis:

In North America. the standard of care has been for decades, one, for children with mild scoliosis curves are observed and monitored with x-rays at regular check-ups during growth, two they can be prescribed orthotic brace treatment for mild to moderate curves and wear a brace, fitted with new custom braces as they grow (much like buying new shoes for your child) until they are finished growing, or three, surgery is prescribed to correct and stop the curve progression for children with severe curves. The Canadian Scoliosis Screening Coalition is advocating that children with mild curves be offered conservative treatment with scoliosis-specific physiotherapy, as in Europe and now China, which has been documented to stop and correct mild curves in growing children and to add it as an adjunct treatment to orthotic bracing as studies have shown it increases the success rate of orthotic bracing to stop the progression of curves for over 70% of children.

For educational information and patient videos on bracing click on Bracing from the Scoliosis Research Society.

For some children, with moderate to severe curves and who are still growing, a newer growth-friendly surgery may be offered at some children's hospitals that corrects the curvature and no permanent implanted rods or screws fuse the spine, which restricts some movement of the spine. And the child is left with a more natural and flexible spine. The gold standard of surgery for treating severe curves is fusion to prevent curve progression and correct the deformity. All spine surgeries are invasive and carry risks and complications. But the complication rates are higher with the newer growth-friendly surgeries.

Note, if your chiid is a mature teenager who has completed growing and reached skeletal maturity, than conservative non-operative treatments of Schroth physiotherapy and Orthotic Bracing will likely be unsuccessful to correct curve deformity as the spine is no longer flexible.

Children diagnosed with AIS are exposed to radiation with repeated x-rays and have a slightly higher risk of cancer. However, many children's hospitals now have low-dose radiation 3D scanners called EOS that have signficantly reduced radiation and lessons the risk to cancer.

Screening and Monitoring Tools:

If you child has been diagnosed with Scoliosis by a physician and is still growing between 10-15 years, you may wish to purchase one of the following tools that health practitioners use,

• Scoliometer -inexpensive measuring tool that costs less then $20 online. As well, digital Scoliometer APPS exist. Recommended by the Scoliosis Research Society in their 2015 Position Statement on Screening for health professionals to use as a 2nd step in conjunction with the Forward Bend Test. Measures the degree of spinal deformity of the spine called trunk rotation, while doing the Forward Bend test called trunk rotation. The reading has to be at least 5-7 degrees for a Scoliosis diagnosis. The tool is similar to a carpenter's level.
• Momentum Health APP -new digital APP compatible with smartphones and utitizes their camera's, where parents screen their child in 45 seconds. Works with an AI interface to screen and detect Scoliosis curves more accurately then the Forward Bend test by human eye alone and allows for remote monitoring if used in collaboration with your health care provider. The APP is currently under testing at 3 Canadian Children's hospitals & in the US. Health Canada and FDA approved. A monthly fee of $16.99 is required.

Public awareness about Scoliosis is very low in Canada. AIS is the most common paediatric spinal condition, a 3 dimensional deformity of the spine, that affects children 10-18 years old, in 2-3% of the global popluation. "Idiopathic" means unknown. However, scientists have now established it is a genetic disorder (multifactorial polygenic also referred to as 'a complex trait') that runs in families and most medical literature and publications do not reflect that or have been updated. If someone in your family has Scoliosis, it is even more important to have your children screened. This is a iife-long genetic disorder but if detected, diagnosed and treated early most children can live normal healthy active and productive lives as adults. The majority of children diagnosed with scoliosis will only have mild Scoliosis and will not require any treatment. For curves less then a 20° Cobb angle at skeletal maturity, age 16, when most children are finished growing, the risk of curve progression is very low, according to the Scoliosis Research Society. However, studies show that even mild to moderate curves affects exercise tolerance. Please know, the following are

Common Myths and Misinformation about Adolescent Idiopathic Scoliosis:

• You did not drink enough milk or eat the right foods. Scoliosis is a genetic condition that runs in families. It is not caused by anything a child or parent did or did not do. But all children require a healthy diet that includes calcium and vitamin D in their daily diet for good bone health. (8)
• Bad posture or slouching does not cause scoliosis (but can cause kyphosis later in life).
• Heavy backpacks do not cause scoliosis (but should not weigh more then 10-15% of the body weight of a child).
• Swimming does not cause scoliosis.
• Gymnastics, Ballet and/or Rhythmic gymnastics does not cause scoliosis.
• Scoliosis (Adolescent Idiopathic Scoliosis (AIS)) does not make a person fragile.
• Scoliosis (AIS) will not restrict anyone (males or females) from having a family but since it is a genetic condition, it is important to closely monitor children where there is a family history of scoliosis and screen early.
• Scoliosis (AIS) is not a girls only disease. Boys can get it too. But it occurs more often in girls and girls are at much higher risk 5-7X of developing severe curves that require treatment.
• Scoliosis does not cause back pain. This is untrue. But during childhood the majority of children with scoliosis of mild to moderate curves according to studies do not suffer back pain any different from children without scoliosis. But children with lumbar curves can suffer from back pain. And most children with severe Scoliosis curves of all types report or feel significant back pain. And later in life untreated scoliosis can cause back pain and other health problems.

References:

Note, the references are publications and studies meant for health professionals. Note: the two top professional societies established for the treatment of Adolescent Idiopathic Scoliosis and Spinal Deformities are the Scoliosis Research Society (SRS), which includes over 1,000 of the world's leading spine surgeons, researchers, physician assistants and orthotists who are involved in research and treatment of spinal deformities. And SOSORT, the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment. SSORT is a non-profit International society of Doctors, Physical Therapists. Orthotists and Psychologists formed in 2003 for Scoliosis care whose focus is on non-operative care,

1. Position Statement Screening for the Early Detection of Idiopathic Scoliosis in Adolescents by The Scoliosis Research Society (SRS), American Academy of Orthopaedic Surgeons (AAOS), Pediatric Orthopaedic Society of North America (POSNA), and American Academy of Pediatrics (AAP).
2. Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O'Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018 Jan 10;13:3. doi: 10.1186/s13013-017-0145-8. PMID: 29435499; PMCID: PMC5795289.
3. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop. 2013 Feb;7(1):3-9. doi: 10.1007/s11832-012-0457-4. Epub 2012 Dec 11. PMID: 24432052; PMCID: PMC3566258.
4. Ogata, Yosuke et al. Timeline of curve progression around menarche in small adolescent idiopathic scoliosis curves without influence of braces: a single-center longitudinal cohort study of 1,090 patients The Spine Journal, 0 Volume 0, Issue "...Menarche is widely recognized as one of the prognostic factors for curve progression in patients with adolescent idiopathic scoliosis (AIS)..."
5. Curve Progression in Untreated Patients with Scoliosis (AIS) from the Scoliosis Research Society Education Resource Center. See table 1. "...Studies have consistently shown the more skeletally immature a patient is, the greater the chance of progression. It also shown the larger the curve at presentation, the higher the probability of progression of the deformity. There is also a greater risk of progression before the onset of menarche in females..."
6. Mao SH, Jiang J, Sun X, Zhao Q, Qian BP, Liu Z, Shu H, Qiu Y. Timing of menarche in Chinese girls with and without adolescent idiopathic scoliosis: current results and review of the literature. Eur Spine J. 2011 Feb;20(2):260-5. doi: 10.1007/s00586-010-1649-6. Epub 2010 Dec 14. PMID: 21153847; PMCID: PMC3030718. "...Age at menarche is closely related to scoliosis progression during adolescence..."
7. Paranjape CS, Welborn MC. Spine health: Back pain and deformity progression. J Pediatr Soc North Am. 2024 Apr 10;7:100062. doi: 10.1016/j.jposna.2024.100062. PMID: 40433264; PMCID: PMC12088328. "...Back pain is highly prevalent affecting up to a third of adolescents and is even more so in patients who are vitamin D deficient.(2)Scoliosis patients from various etiologies all experience higher rates of back pain and tend to have lower bone mineral density than their healthy pediatric peers.(3)There is an interplay between deformity and bone health, where deformity can both drive and be driven by bone health.(4)Treatments targeting bone health may positively affect both natural history and surgical outcomes for patients who have scoliosis with various underlying etiologies.(5)Further research is needed to elucidate mechanistic pathways that link bone health to deformity and to evaluate targets for therapy..."
8. Minkowitz B, Spingarn CM. Effective counseling for children's bone health. J Pediatr Soc North Am. 2024 Apr 10;7:100032. doi: 10.1016/j.jposna.2024.100032. PMID: 40433273; PMCID: PMC12088366.
   Key Concepts
   1. Bone health needs to be prioritized from a young age because the majority of peak bone mass is attained by the end of the second decade of life.
   2. Patient counseling and patient buy-in are imperative to create lasting impact.
   3. Bone health is a recipe and the amounts of ingredients needed will vary according to growth and body size.
   4. Vitamin D dosing should take weight and body mass into consideration to achieve optimal serum levels.
   
   
9. 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..."
10. Herdea A, Dragomirescu MC, Ulici A, Lungu CN, Charkaoui A. Controlling the Progression of Curvature in Children and Adolescent Idiopathic Scoliosis Following the Administration of Melatonin, Calcium, and Vitamin D. Children (Basel). 2022 May 21;9(5):758. doi: 10.3390/children9050758. PMID: 35626935; PMCID: PMC9140159."Abstract...In this perspective, randomized, case-control, interventional study, the impact of using melatonin, calcium, and vitamin D, respectively, on idiopathic scoliosis patients was analyzed. Our preliminary results showed that these drugs positively affected the illness progression quantified by the spine curvature. Patients with idiopathic scoliosis may benefit from a novel treatment by supplementation with vitamin D, calcium, and melatonin....The treatment of childhood and adolescent idiopathic scoliosis follows the guidelines based on Cobb angle and other factors such as age, gender, or menarche status for girls. The staging of treatment includes physiotherapy, wearing a brace, and surgery for advanced cases. None of these steps takes into account the possible existence of a metabolic factor that aggravates the evolution of the disease...."
11. Beauséjour M, Aubin D, Fortin C, N'dongo Sangaré M, Carignan M, Roy-Beaudry M, Martinez C, Bourassa N, Jourdain N, Labelle P, Labelle H. Parents can reliably and accurately detect trunk asymmetry using an inclinometer smartphone app. BMC Musculoskelet Disord. 2022 Aug 5;23(1):752. doi: 10.1186/s12891-022-05611-3. PMID: 35932044; PMCID: PMC9354306. (Note, inclinometer is another name for Scoliometer)
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 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. 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 "Among those who reported back pain, 63.2% specified a location with the majority reporting pain in the lumbar region (56%) and, less commonly, in the thoracic (39%) and scapular (8%) regions. Lumbar pain was associated with significantly higher pain intensity (p = 0.033).... 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, with heavier body weight... Pain was most commonly reported in the lumbar region, especially among patients with lumbar curves....
14. 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.
15. Wong AYL, Samartzis D, Cheung PWH, Cheung JPY. How Common Is Back Pain and What Biopsychosocial Factors Are Associated With Back Pain in Patients With Adolescent Idiopathic Scoliosis? Clin Orthop Relat Res. 2019 Apr;477(4):676-686. doi: 10.1097/CORR.0000000000000569. PMID: 30516661; PMCID: PMC6437349.
16. 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...."
17. Théroux J, Stomski N, Hodgetts CJ, Ballard A, Khadra C, Le May S, Labelle H. Prevalence of low back pain in adolescents with idiopathic scoliosis: a systematic review. Chiropr Man Therap. 2017 Apr 20;25:10. doi: 10.1186/s12998-017-0143-1. PMID: 28439404; PMCID: PMC5399433."Conclusion: The results of this systematic review indicate that adolescents with idiopathic scoliosis frequently experience low back pain...."
18. Sato T, Hirano T, Ito T, Morita O, Kikuchi R, Endo N, Tanabe N Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan. Eur Spine J. 2011 Feb;20(2):274-9. doi: 10.1007/s00586-010-1657-6. Epub 2010 Dec 17. PMID: 21165657; PMCID: PMC3030705. “...Scoliosis group experienced significantly more severe pain, and of a significantly longer duration with more frequent recurrences in comparison to No scoliosis group.
19. 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....”
20. 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..."
21. Serhan, Karolina A. MD1; Abraham, Vivek M. MD1; Shirley, Eric D. MD1,a. The Impact of Adolescent Idiopathic Scoliosis on Pregnancy. The Journal of Bone and Joint Surgery 107(7):p 771-777, April 2, 2025. | DOI: 10.2106/JBJS.24.00850

    "Abstract: ➢ Physiologic changes during pregnancy alter the biomechanics of the spine, including increased ligamentous laxity, lumbar lordosis, and pelvic tilt. ➢ Patients with adolescent idiopathic scoliosis treated with a fusion construct with the lowest instrumented vertebra of L3 and below have an increased risk of developing low back pain during pregnancy. ➢ There is a low risk of curve progression during pregnancy for patients with adolescent idiopathic scoliosis treated with spinal fusion. ➢ Although neuraxial anesthesia is possible in patients who had previously undergone spinal fusion for adolescent idiopathic scoliosis, successful placement may require a more experienced provider and more attempts to place the epidural."

22. Normand É, Franco A, Parent S, Lombardi G, Brayda-Bruno M, Colombini A, Moreau A, Marcil V. Association between the GLP1R A316T Mutation and Adolescent Idiopathic Scoliosis in French Canadian and Italian Cohorts Genes (Basel). 2024 Apr 11;15(4):481. doi: 10.3390/genes15040481. PMID: 38674415; PMCID: PMC11050147. "...To date, several genetic variants have been associated with AIS. The identified associated genes are involved in conjunctive tissue structures, growth and puberty, bone formation, metabolism, melatonin pathway, and ciliary functions...Our results support that the GLP1R A316T polymorphism is associated with a higher risk of developing AIS, but without being associated with disease severity and progression....”
23. Baschal EE, Terhune EA, Wethey CI, Baschal RM, Robinson KD, Cuevas MT, Pradhan S, Sutphin BS, Taylor MRG, Gowan K, Pearson CG, Niswander LA, Jones KL, Miller NH.Idiopathic Scoliosis Families Highlight Actin-Based and Microtubule-Based Cellular Projections and Extracellular Matrix in Disease Etiology. G3 (Bethesda). 2018 Jul 31;8(8):2663-2672. doi: 10.1534/g3.118.200290. PMID: 29930198; PMCID: PMC6071588. “Idiopathic scoliosis (IS) is a structural lateral spinal curvature of ≥10° that affects up to 3% of otherwise healthy children and can lead to life-long problems in severe cases. It is well-established that IS is a genetic disorder..."
24. Zhu Z, Xu L, Qiu Y. Current progress in genetic research of adolescent idiopathic scoliosis.Ann Transl Med. 2015 May;3(Suppl 1):S19. doi: 10.3978/j.issn.2305-5839.2015.02.04. PMID: 26046064; PMCID: PMC4437942. “...Recently, two genome-wide association studies of AIS performed in Japan revealed that ladybird homeobox 1 (LBX1) gene and G protein–coupled receptor 126 (GPR126) gene could play a role in the etiopathogenesis of the disease. Since the association between these two genes and AIS were successfully validated in the Caucasian and the Chinese population, LBX1 gene and GPR126 gene were the most reliable genetic variants underling the development of AIS.”
25. Labelle H, Richards SB, De Kleuver M, Grivas TB, Luk KD, Wong HK, Thometz J, Beauséjour M, Turgeon I, Fong DY. Screening for adolescent idiopathic scoliosis: an information statement by the Scoliosis Research Society international task force.Scoliosis. 2013 Oct 31;8:17. doi: 10.1186/1748-7161-8-17. PMID: 24171910; PMCID: PMC3835138. “...Adolescent idiopathic scoliosis (AIS) is a complex 3-D deformation of the trunk, with a prevalence of 2-4%. Among patients with AIS, 8% to 9% will be treated by brace and 0.1% will need surgery using spinal instrumentation and fusion...TF members agreed that the recommended threshold for the use of the scoliometer should be between 5° and 7° when used alone...members agreed that screening should be conducted two years before onset of menses. ..After a critical review of the available evidence, the SRS International Task Force on Scoliosis screening, supported by the SRS Board of Directors, makes the following statements and recommendations regarding scoliosis screening:...Scoliosis screening is recommended as valuable in the following domains: technical efficacy, clinical, program and treatment effectiveness...”
26. Liang ZT, Guo CF, Li J, Zhang HQ. The role of endocrine hormones in the pathogenesis of adolescent idiopathic scoliosis. FASEB J. 2021 Sep;35(9):e21839. doi: 10.1096/fj.202100759R. PMID: 34387890. ”...Accumulating evidence shows that the abnormal levels of many hormones including estrogen, melatonin, growth hormone, leptin, adiponectin and ghrelin, may be related to the occurrence and development of AIS. The purpose of this review is to provide a summary and critique of the research published on each hormone over the past 20 years, and to highlight areas for future study...”
27. Lee CF, Fong DY, Cheung KM, Cheng JC, Ng BK, Lam TP, Yip PS, Luk KD. A new risk classification rule for curve progression in adolescent idiopathic scoliosis. Spine J. 2012 Nov;12(11):989-95. doi: 10.1016/j.spinee.2012.05.009. Epub 2012 Jun 21. PMID: 22727318. "...Results The new classification rule identified four risk groups of curve progression. Patients with a curvature of 26° and more and less than 18° constituted the highest and lowest risk groups, respectively. The two intermediate groups were identified by the age (11.3 years), menarcheal status, and body height (154 cm)... Conclusions The risk classification rule only uses information at the first presentation and can aid physicians in deriving an efficient management.
28. Yang, Y., Chen, Z., Huang, Z. et al. Risk factors associated with low bone mineral density in children with idiopathic scoliosis: a scoping review. BMC Musculoskelet Disord 24, 48 (2023). https://doi.org/10.1186/s12891-023-06157-8 "...This scoping review showed that BMD was generally lower in children with IS than in asymptomatic controls. Genetic, endocrine, and lifestyle-related factors might be associated with low BMD in children with IS. Bone synthesis or absorption may be directly regulated by endocrine factors, while genetic and lifestyle-related factors may influence BMD via the endocrine pathway. Comprehensive screening for low BMD risk factors may be reasonable to prevent osteoporosis and progression in children with IS....
29. Rose LD, Williams R, Ajayi B, Abdalla M, Bernard J, Bishop T, Papadakos N, Lui DF. Reducing radiation exposure and cancer risk for children with scoliosis: EOS the new gold standard. Spine Deform. 2023 Jul;11(4):847-851. doi: 10.1007/s43390-023-00653-6. Epub 2023 Mar 22. PMID: 36947393; PMCID: PMC10261215.
30. Nishida M, Yagi M, Suzuki S, Takahashi Y, Nori S, Tsuji O, Nagoshi N, Fujita N, Matsumoto M, Nakamura M, Watanabe K. Persistent low bone mineral density in adolescent idiopathic scoliosis: A longitudinal study. J Orthop Sci. 2023 Sep;28(5):1099-1104. doi: 10.1016/j.jos.2022.07.005. Epub 2022 Aug 16. PMID: 35985936.
31. Nandoliya KR, Sadagopan NS, Alwakeal A, Kemeny H, Cloney M, Dahdaleh NS, Koski T, El Tecle N. Adolescent Idiopathic Scoliosis and Pregnancy. Cureus. 2023 Oct 10;15(10):e46782. doi: 10.7759/cureus.46782. PMID: 37954752; PMCID: PMC10633849. “...Conclusions Patients with AIS had comparable rates of c-section to the general population, and even among patients with AIS, a history of spinal fusion was not associated with an increased incidence of c-section. Adolescent idiopathic scoliosis may be associated with difficulty administering anesthesia in a minority of patients, which can lead to a lower rate of combined spinal and epidural anesthesia usage. Furthermore, most patients with AIS will experience increased back pain during and after pregnancy. Changes in Cobb angle are seen in many patients, but the clinical significance of these changes remains unknown....”
32. See also Parent & Patient Support Groups & Resources and (Note: these following publications, from trusted sources, are written for health professionals.) Links to Impact Adolescent Scoliosis has on children and links to AIS references, Publications on Curve Progression and Bone Density/Osteopenia. and Links to Schroth PSSE and Orthotic Bracing and Links to Current Research Publications.

Contact us at: CSSC@scoliosiscanada.ca