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Updated: Jun 2, 2026
Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis
Published on: December 2, 2025
Low oxygen content as a potential risk factor for scoliosis: a school-based cross-sectional study
Jiahao Hao1, Li Zhang1, Zhi Zhao1
1Department of Orthopaedic, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Background:
Scoliosis is a complex three-dimensional spinal deformity. While its clinical and imaging features are well established, the exact etiology and pathogenesis remain unclear. Previous studies have identified altitude as a significant environmental factor associated with scoliosis development. High-altitude regions are characterized by lower oxygen levels, raising the question of whether hypoxia contributes to the higher prevalence of scoliosis observed in these areas.
Methods:
This cross-sectional study used school-based scoliosis screening data. Individuals with an angle of trunk rotation (ATR) ≥ 5° were recorded as positive cases. Demographic information and regional environmental data were collected. Statistical analyses were conducted to identify risk factors associated with scoliosis.
Results:
The positive screening rate was 1.9%. Females and adolescents aged 10-18 years had significantly higher positivity rates than males and younger children (both p < 0.001). Han students showed slightly lower positivity compared with Bai and other minority groups (p = 0.001). Participants living above 2000 m and those in regions with oxygen content <235 g/m3 demonstrated higher positivity rates (both p < 0.001). Across all demographic subgroups, positivity increased with higher altitude and lower oxygen content. Further LASSO regression analysis showed that higher altitude and oxygen density below 235 g/m³ were positively associated with positive screening results, suggesting that individuals living in high-altitude, low-oxygen environments were more likely to screen positive(Coefficient=0.3527). In contrast, age 6-10 years was strongly negatively associated with positive screening results, indicating a relatively lower risk compared with other age groups(Coefficient = -1.3370). Correlation analysis further confirmed a significant negative association between environmental oxygen concentration and scoliosis detection rate (r = -0.784, P < 0.001).
Conclusion:
Lower ambient oxygen content is associated with higher scoliosis screening positivity.
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