Prevalence and determinants of suspected scoliosis in fifth-grade students: a population-based school screening study

The aim of this study was to conduct school-based scoliosis screening among fifth-grade students and to determine the rate of screening positivity for suspected scoliosis.

During the 2024-2025 academic year, scoliosis screening was conducted among 6,587 students attending all middle schools in Eskişehir province, Türkiye. Data were collected through scoliosis screening examinations performed by physiotherapists and a questionnaire administered to the students. The screening examinations included visual inspection, the forward bending test, and measurements using a scoliometer. Students with a trunk rotation ≥5° on scoliometer assessment and/or with physical signs such as visual asymmetry, scapular, shoulder, or pelvic imbalance, or apparent leg length discrepancy were referred for specialist evaluation. Chi-square test and logistic regression analysis were performed.

The ages of the students ranged between 10-11 years (mean ± standard deviation: 10.26±0.44). According to the assessments performed by physiotherapists, visual asymmetry suggestive of scoliosis was observed on inspection in 240 students (3.6%). Scoliometer measurements showed trunk rotation angles of 5 degrees or greater in 355 students (5.4%). As a result of the screening examinations, 725 students (11.0%) were screening-positive for suspected scoliosis and were referred to higher-level healthcare facilities for further evaluation. Risk factors were more prevalent among female students. In multivariate analysis, screening positivity for suspected scoliosis was significantly associated with female sex, low body mass index, a family history of scoliosis in first-degree relatives, chest stabbing sensation or pain during breathing, and skin findings on the back (discoloration, large nevi, or localized hypertrichosis).

This study determined that the screening positivity rate for suspected scoliosis among fifth-grade students was 11.0%. Factors that may be associated with scoliosis were found to be more common in female students; however, the multifactorial nature of scoliosis suggests that screening positivity may be influenced by a complex interaction of biological, anthropometric, familial, and postural factors. The findings also highlight the importance of early recognition and risk-based approaches in school-aged populations, and underscore the public health relevance of awareness and screening practices integrated within existing school health services and primary care.