Epidemiological characteristics and influencing factors of scoliosis in adolescents aged 7 to 18 years in Shanghai, China: a population-based study on prevention and control strategies

Epidemiological characteristics and influencing factors of scoliosis in adolescents aged 7 to 18 years in Shanghai, China: a population-based study on prevention and control strategies | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Epidemiological characteristics and influencing factors of scoliosis in adolescents aged 7 to 18 years in Shanghai, China: a population-based study on prevention and control strategies Na Li, Liuxia Li, Yi Zhang, Guohua Wu, Hongze Chang, Peng Zhou, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9139550/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Adolescent scoliosis is a common spinal health problem that can lead to pain, functional limitation, psychological burden, and avoidable health-care costs when not identified early. Although school-based screening is widely recommended in China, local epidemiological evidence from large urban communities remains limited. This study aimed to investigate the epidemiological characteristics of scoliosis and identify associated factors among adolescents aged 7 to 18 years in Shanghai, China, in order to inform prevention and control strategies. Methods A population-based school screening study was conducted in Fenglin Subdistrict, Xuhui District, Shanghai, from June 2024 to May 2025. A total of 7979 adolescents from three primary schools, four junior high schools, and one senior high school were included. Screening followed a standardized three-step protocol comprising visual inspection, scoliometer measurement, and confirmatory radiography when indicated. A structured questionnaire collected information on demographics, parental history of scoliosis, nutritional status, schoolbag characteristics, sedentary time, physical activity, and exercise type. Chi-square tests and binary logistic regression were used to examine factors associated with scoliosis. Results Among 7979 adolescents, 255 scoliosis cases were identified, corresponding to an overall detection rate of 3.20%. Girls had a higher detection rate than boys (3.91% vs 2.56%), and detection increased from 1.58% in the 7 to 9 year age group to 4.18% in the 13 to 18 year age group. In multivariable analysis, female sex (OR 1.853, 95% CI 1.233–2.786), age 10 to 12 years (OR 1.808, 95% CI 1.056–3.093), age 13 to 18 years (OR 2.136, 95% CI 1.080–4.225), parental history of scoliosis (OR 1.536, 95% CI 1.125–2.097), malnutrition (OR 1.413, 95% CI 1.045–1.911), heavy or very heavy schoolbag burden (OR 1.390, 95% CI 1.062–1.818), single-shoulder bag use (OR 1.806, 95% CI 1.142–2.857), sedentary time of at least 10 hours per day (OR 1.608, 95% CI 1.132–2.284), daily physical activity of less than 1 hour (OR 1.868, 95% CI 1.253–2.787), and unilateral-dominant exercise (OR 1.670, 95% CI 1.066–2.617) were associated with higher odds of scoliosis. Conclusions Scoliosis was relatively common in this urban adolescent population in Shanghai. The findings support regular school-community screening, family history assessment, improved schoolbag ergonomics, nutrition support, and strategies to reduce prolonged sedentary time while promoting adequate physical activity. These measures may strengthen local prevention and control of scoliosis in children and adolescents. adolescents scoliosis influencing factors epidemiological characteristics Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9139550","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":619232165,"identity":"48cab8d6-84e0-4abe-bf7a-4a87934ac67e","order_by":0,"name":"Na Li","email":"","orcid":"","institution":"Fenglin Street Community Health Service Center, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Na","middleName":"","lastName":"Li","suffix":""},{"id":619232166,"identity":"18170e66-93de-4ab7-b52e-0efc4e70112c","order_by":1,"name":"Liuxia Li","email":"","orcid":"","institution":"Fenglin Street Community Health Service Center, 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characteristics","lastPublishedDoi":"10.21203/rs.3.rs-9139550/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9139550/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAdolescent scoliosis is a common spinal health problem that can lead to pain, functional limitation, psychological burden, and avoidable health-care costs when not identified early. Although school-based screening is widely recommended in China, local epidemiological evidence from large urban communities remains limited. This study aimed to investigate the epidemiological characteristics of scoliosis and identify associated factors among adolescents aged 7 to 18 years in Shanghai, China, in order to inform prevention and control strategies.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA population-based school screening study was conducted in Fenglin Subdistrict, Xuhui District, Shanghai, from June 2024 to May 2025. A total of 7979 adolescents from three primary schools, four junior high schools, and one senior high school were included. Screening followed a standardized three-step protocol comprising visual inspection, scoliometer measurement, and confirmatory radiography when indicated. A structured questionnaire collected information on demographics, parental history of scoliosis, nutritional status, schoolbag characteristics, sedentary time, physical activity, and exercise type. Chi-square tests and binary logistic regression were used to examine factors associated with scoliosis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong 7979 adolescents, 255 scoliosis cases were identified, corresponding to an overall detection rate of 3.20%. Girls had a higher detection rate than boys (3.91% vs 2.56%), and detection increased from 1.58% in the 7 to 9 year age group to 4.18% in the 13 to 18 year age group. In multivariable analysis, female sex (OR 1.853, 95% CI 1.233\u0026ndash;2.786), age 10 to 12 years (OR 1.808, 95% CI 1.056\u0026ndash;3.093), age 13 to 18 years (OR 2.136, 95% CI 1.080\u0026ndash;4.225), parental history of scoliosis (OR 1.536, 95% CI 1.125\u0026ndash;2.097), malnutrition (OR 1.413, 95% CI 1.045\u0026ndash;1.911), heavy or very heavy schoolbag burden (OR 1.390, 95% CI 1.062\u0026ndash;1.818), single-shoulder bag use (OR 1.806, 95% CI 1.142\u0026ndash;2.857), sedentary time of at least 10 hours per day (OR 1.608, 95% CI 1.132\u0026ndash;2.284), daily physical activity of less than 1 hour (OR 1.868, 95% CI 1.253\u0026ndash;2.787), and unilateral-dominant exercise (OR 1.670, 95% CI 1.066\u0026ndash;2.617) were associated with higher odds of scoliosis.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eScoliosis was relatively common in this urban adolescent population in Shanghai. The findings support regular school-community screening, family history assessment, improved schoolbag ergonomics, nutrition support, and strategies to reduce prolonged sedentary time while promoting adequate physical activity. These measures may strengthen local prevention and control of scoliosis in children and adolescents.\u003c/p\u003e","manuscriptTitle":"Epidemiological characteristics and influencing factors of scoliosis in adolescents aged 7 to 18 years in Shanghai, China: a population-based study on prevention and control strategies","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-08 20:28:25","doi":"10.21203/rs.3.rs-9139550/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5ad6b4b8-e036-49f4-9bbb-61cc4350c7c7","owner":[],"postedDate":"April 8th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-04T03:42:09+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T03:55:15+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-08 20:28:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9139550","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9139550","identity":"rs-9139550","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}