Scoliosis in adolescents with autism spectrum disorder: A retrospective case series

To describe the curve patterns and behaviors, clinical presentation, treatment modalities, and complications for adolescents with both scoliosis and autism spectrum disorders, but no additional concomitant diagnoses.

A single-center, retrospective review of adolescents with scoliosis and autism spectrum disorder treated between 2001 and 2021. Patient demographics, clinical characteristics, and radiographic assessments were described across the scoliosis treatment plans (i.e. observation, bracing, and surgery).

Forty patients with scoliosis and autism spectrum disorder (80% male, mean age at 13.2 ± 1.7) met eligibility criteria. Twenty-one patients were managed with observation initially. Of these patients, 55% (n = 11) didn't require further treatment and had an average change in curvature of 5° ± 6°. Twenty-one total patients were managed with bracing. In this group, 76% (n = 16) did not receive further treatments and had an average increase in curvature of 15° ± 11°. Five patients (24%) proceeded to surgery following brace treatment. Thirteen patients (33%) in total required surgery, with n = 5 requiring surgery as their initial treatment. The initial curve magnitude for this group was 55° ± 7° and had an average correction of 47% following posterior spinal fusion.

Although curves in adolescents with scoliosis and autism spectrum disorder had a similar presentation to adolescents with just scoliosis, the current cohort did have an increase in curve progression when managed with bracing, with an unclear explanation. Further study is warranted in this unique population, and families should be counseled that the prognosis may not be the same as adolescents with scoliosis alone.

Level IV.