JAAOS - 2026-09-15 - Journal Article
Epidemiological Trends and Projections of Adolescent Idiopathic Scoliosis Patients Among 118 Thousand Patients.
Sanghvi PA, Burkhart RJ, Abid R, Berk AN, Adelstein JM, Moyal AJ, Glotzbecker MP, Mistovich RJ
Topics
Key Takeaway
AIS prevalence rose by 110 cases per 100,000 patients from 2016 to 2023, with PSF occurring in 5,990 per 100,000 AIS patients in 2023 and projected to reach 10,230 per 100,000 by 2030.
Summary Depth
Choose how much analysis to show on this article page.
Summary
Using TriNetX, this study characterized AIS prevalence, incidence, and PSF rates from 2016 to 2023, compared findings to historical cohorts, and projected trends to 2030. AIS prevalence increased by 110 cases per 100,000 from 2016 to 2023, with 14,733 additional cases identified in 2023; females had higher prevalence (140 vs. 71.3 per 100,000) and higher PSF rates (6,400 vs. 5,350 per 100,000 AIS patients). COVID-19 produced a 16.52% case drop in 2020 followed by a 22.15% rebound in 2021, and regression modeling projects national AIS prevalence of 17,000 per 100,000 and PSF prevalence of 10,230 per 100,000 AIS patients by 2030.
Key Limitation
TriNetX data reflect only patients who accessed participating healthcare networks, making it impossible to distinguish true incidence increases from improved detection or expanded healthcare access, which critically undermines causal interpretation of the observed trends.
Original Abstract
INTRODUCTION
Suspected changes in adolescent idiopathic scoliosis (AIS) demographic distribution compared with historical cohorts emphasize the need for an updated understanding of epidemiological trends. We aimed to characterize AIS trends in the United States from 2016 to 2023, compare these findings with historical cohorts, and project trends through 2030.
METHODS
AIS cases from 2016 to 2023 were identified using the TriNetX US Collaborative platform. A subanalysis examined patients who underwent posterior spinal fusion (PSF) and cases during the COVID-19 pandemic. Primary outcomes included prevalence, incidence proportion (IP), and incidence rate (IR). Historical AIS cohorts were identified through a systematic search. Regression modeling projected trends to 2030.
RESULTS
In 2023, the TriNetX platform reported a notable rise in AIS prevalence of 110 cases per 100,000 patients compared with 2016 ( P < 0.05). The IP and IR of AIS also rose, with 14,733 additional cases identified in 2023. PSF occurred in 5,990 cases per 100,000 AIS patients. Female patients had higher AIS prevalence than male patients (140 vs. 71.3 cases per 100,000) and higher PSF prevalence (6,400 vs. 5,350 cases per 100,000 AIS patients) in 2023. Incidence of AIS was markedly lower compared with historical cohorts; however, the female-to-male ratio was comparable. The most marked decrease (16.52% decrease from 2019 to 2020) and increase (22.15% increase from 2020 to 2021) in cases occurred during the COVID-19 pandemic. Regression analysis indicated linear increases in both AIS and PSF, projecting a national AIS prevalence of 17,000 cases per 100,000 patients nationally and PSF prevalence among AIS patients of 10,230 cases per 100,000 patients by 2030.
CONCLUSION
These findings highlight rising national rates of AIS diagnoses and PSF procedures among AIS patients. Further research is warranted on the etiology underlying increased incidence of AIS in male patients and potential healthcare burdens associated with projected increases in AIS prevalence.