Spine - 2026-08-06 - Journal Article
Global Prevalence of Adolescent Idiopathic Scoliosis Between 1975 and 2025: A Systematic Review and Meta-analysis.
Po EYP, Yang M, Takemura N, Cheung JPY, Cheung KMC, Lok KYW, Fong DYT
Topics
Key Takeaway
Global pooled prevalence of AIS is 1.26% for Cobb ≥10° and 0.28% for Cobb ≥20°, with higher ambient temperature (OR=1.03), non-orthopaedic screeners (OR=2.04), and higher study quality (OR=1.40) independently associated with greater detected prevalence of curves ≥20°.
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Summary
This systematic review and meta-analysis estimated global AIS prevalence from 57,701 screened records spanning 1975–2025, including radiographically confirmed cases in adolescents aged 10–19. Pooled prevalence was 1.26% (95% CI: 1.03–1.55) for Cobb ≥10° and 0.28% (95% CI: 0.23–0.34) for Cobb ≥20°. Multivariable meta-regression identified non-orthopaedic screening personnel (OR=2.04), higher mean surface air temperature (OR=1.03), and higher study quality (OR=1.40) as independently associated with higher detected prevalence of curves ≥20°, while forward bending test alone was associated with lower detected prevalence (OR=0.64).
Key Limitation
The temperature association (OR=1.03 per unit increase) is derived from ecological-level meta-regression data and cannot establish individual-level causality, making it susceptible to confounding by unmeasured regional factors such as physical activity patterns, nutrition, or genetic population differences.
Original Abstract
STUDY DESIGN
Systematic review and meta-analysis.
OBJECTIVE
To provide an updated global estimate of adolescent idiopathic scoliosis (AIS) prevalence, and to investigate its association with socioeconomic and environmental factors.
SUMMARY OF BACKGROUND DATA
AIS, a common spinal deformity in adolescents aged 10 to 19, with unclear aetiology, limits early diagnosis and prevention. Current global estimates of AIS prevalence require updating, and studies investigating the association with socioeconomic and environmental factors are limited.
METHODS
We systematically searched PubMed, Embase, Scopus, CINAHL, and Web of Science from inception to March 2025, without language restrictions. We included studies with radiographically confirmed AIS in adolescents aged 10 to 19 years. Pooled prevalence estimates for Cobb angles ≥10° and ≥20° were calculated using random-effects meta-analysis. Multivariable meta-regression was employed to explore associated factors.
RESULTS
From 57,701 records, 104 studies encompassing 5.4 million adolescents from 33 countries across six World Health Organization regions were included. The pooled prevalence was 1.26% (95% CI: 1.03 to 1.55) for Cobb angle ≥10°, and 0.28% (95% CI: 0.23 to 0.34) for Cobb angle ≥20°. For curves ≥20°, multivariable meta-regression revealed that higher annual mean surface air temperature (odds ratio [OR]=1.03; P=0.043), screening not involving orthopaedic surgeons (OR=2.04; P=0.003), and higher study quality (OR=1.40; P=0.010) were significantly associated with a higher prevalence. Using the forward bending test alone (OR=0.64; P=0.034) was associated with a lower prevalence.
CONCLUSION
The updated global prevalence of clinically significant AIS (Cobb angle ≥20°) was 0.28%, associated with environmental (such as temperature) and methodological factors (screening personnel, technique). These findings highlight the complex, multifactorial nature of AIS, underscoring the need for epidemiological surveillance and further assessment of screening strategies to optimize early detection and treatment of AIS worldwide.