{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:13:43Z","timestamp":1788444823404,"version":"build-2803163510"},"reference-count":34,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Yunnan Fundamental Research Projects","award":["202501AT070273"],"award-info":[{"award-number":["202501AT070273"]}]},{"name":"First-Class Discipline Team of Kunming Medical University","award":["2024XKTDYS05"],"award-info":[{"award-number":["2024XKTDYS05"]}]},{"name":"Key Research and Development Program of Yunnan Provincial Science and Technology Department","award":["202403AC100008"],"award-info":[{"award-number":["202403AC100008"]}]},{"name":"Basic Research Program Kunming Medical University Joint Special General Project in Yunnan Province","award":["202401AY070001-223"],"award-info":[{"award-number":["202401AY070001-223"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,2]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To analyse changes in the prevalence of suspected scoliosis among children and adolescents in Heqing County, South-West China, over different periods and to identify risk factors for its progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A mixed-methods study, including a cross-sectional survey and longitudinal follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single-centre study. An angle of torso rotation (ATR) \u22655\u00b0 was defined as a positive screening result and progression was defined as an increase in ATR \u22652\u00b0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>In November 2021, 22\u2009740 students aged 6\u201318 years were screened; in May 2023, 28\u2009009 students aged 6\u201318 years were screened. A total of 350 students with suspected scoliosis identified in 2021 were enrolled for longitudinal follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of suspected scoliosis was 2.47% in 2021 (22 740 students) and 3.14% in 2023 (28 009 students). Among 4468 students screened in both years, 109 (2.44%) tested positive in 2021 and 124 (2.78%) in 2023. Prevalence was significantly higher in girls (2.92% in 2021; 4.36% in 2023) than in boys (2.01% in 2021; 1.94% in 2023) and higher in the 10\u201318\u2009years age group (3.38% and 4.11%) than in the 6\u201310\u2009years age group (0.59% and 0.83%; both p&lt;0.001). From 2021 to 2023, overall prevalence, as well as prevalence among girls and the 10\u201318\u2009years age group, increased significantly (all p&lt;0.001), whereas no significant changes were observed in boys (p=0.71) or the 6\u201310\u2009years age group (p=0.07). Of 329 students with suspected scoliosis in 2021 who completed follow-up in 2023, 35 (10.6%) showed progression. Progression was significantly associated with lower body mass index (BMI) and higher baseline ATR, with correlation coefficients of \u22120.112 and 0.127, respectively (both p&lt;0.01). Binary logistic regression showed that higher BMI was associated with reduced progression risk (OR=0.827, 95%\u2009CI 0.700 to 0.978, p&lt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of suspected scoliosis in children and adolescents in Heqing County was higher in 2023 than in 2021. Approximately 10.6% of individuals with suspected scoliosis progressed over 1.5 years. BMI may serve as a protective factor against scoliosis progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-116029","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:00:38Z","timestamp":1783594838000},"page":"e116029","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of suspected scoliosis based on angle of torso rotation in children and adolescents in Heqing County at different periods: a large-sample mixed-methods study"],"prefix":"10.1136","volume":"16","author":[{"given":"Li","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhibo","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanrui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1906-3848","authenticated-orcid":false,"given":"Yingsong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genghao","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijie","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyue","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ni","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoquan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, China"},{"name":"Yunnan Research Center of Scoliosis and Spinal Deformities, Kunming City, China"},{"name":"Yunnan Provincial Department of Education Engineering Research Center of Innovative Technology for Spinal Deformities Prevention and Treatment, Kunming City, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"2026090306252593000_16.7.e116029.1","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-012-0457-4"},{"key":"2026090306252593000_16.7.e116029.2","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18158152","article-title":"Incidence and Surgery Rate of Idiopathic Scoliosis: A Nationwide Database Study","volume":"18","author":"Sung","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026090306252593000_16.7.e116029.3","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s43390-021-00297-4","article-title":"Intraoperative versus postoperative radiographic coronal balance for adult spinal deformity surgery","volume":"9","author":"Ha","year":"2021","journal-title":"Spine Deform"},{"key":"2026090306252593000_16.7.e116029.4","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1097\/BPO.0000000000001351","article-title":"The Natural History of Early-onset Scoliosis","volume":"39","author":"Karol","year":"2019","journal-title":"J Pediatr Orthop"},{"key":"2026090306252593000_16.7.e116029.5","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001350"},{"key":"2026090306252593000_16.7.e116029.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12938-017-0427-7","article-title":"Application of two-parameter scoliometer values for predicting scoliotic Cobb angle","volume":"16","author":"Ma","year":"2017","journal-title":"Biomed Eng Online"},{"key":"2026090306252593000_16.7.e116029.7","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.jor.2018.05.032","article-title":"Evaluation of angle trunk rotation measurements to improve quality and safety in the management of adolescent idiopathic scoliosis","volume":"15","author":"Larson","year":"2018","journal-title":"J Orthop"},{"key":"2026090306252593000_16.7.e116029.8","doi-asserted-by":"crossref","first-page":"102628","DOI":"10.1016\/j.msksp.2022.102628","article-title":"Factors influencing of quality of life in adolescent idiopathic scoliosis","volume":"62","author":"Kaya","year":"2022","journal-title":"Musculoskelet Sci Pract"},{"key":"2026090306252593000_16.7.e116029.9","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-024-04912-8","article-title":"Determination of predictors associated with pain in non\u2011surgically treated adults with idiopathic scoliosis","volume":"19","author":"Yeti\u015f","year":"2024","journal-title":"J Orthop Surg Res"},{"key":"2026090306252593000_16.7.e116029.10","doi-asserted-by":"crossref","first-page":"68","DOI":"10.5312\/wjo.v8.i1.68","article-title":"Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis","volume":"8","author":"Prowse","year":"2017","journal-title":"World J Orthop"},{"key":"2026090306252593000_16.7.e116029.11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.11669"},{"key":"2026090306252593000_16.7.e116029.12","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.spinee.2020.01.008","article-title":"Prevalence of adolescent idiopathic scoliosis in Turkey: an epidemiological study","volume":"20","author":"Y\u0131lmaz","year":"2020","journal-title":"Spine J"},{"key":"2026090306252593000_16.7.e116029.13","first-page":"641","article-title":"The Prevalence of Scoliosis among Adolescent Chest Radiographs Obtained at Tikur Anbessa Specialized Hospital in 2019","volume":"33","author":"Jegnie","year":"2023","journal-title":"Ethiop J Health Sci"},{"key":"2026090306252593000_16.7.e116029.14","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2024.1399049","article-title":"Prevalence of scoliosis in children and adolescents: a systematic review and meta-analysis","volume":"12","author":"Li","year":"2024","journal-title":"Front Pediatr"},{"key":"2026090306252593000_16.7.e116029.15","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1590\/1984-0462\/;2017;35;2;00008","article-title":"Prevalence of Scoliosis in Public Elementary School Students","volume":"35","author":"Ciaccia","year":"2017","journal-title":"Rev Paul Pediatr"},{"key":"2026090306252593000_16.7.e116029.16","doi-asserted-by":"crossref","DOI":"10.1186\/s13018-024-05077-0","article-title":"The prevalence of scoliosis among adolescents in China: a systematic review and meta-analysis","volume":"19","author":"Fu","year":"2024","journal-title":"J Orthop Surg Res"},{"key":"2026090306252593000_16.7.e116029.17","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/BRS.0000000000001197","article-title":"Prevalence of Idiopathic Scoliosis in Chinese Schoolchildren: A Large, Population-Based Study","volume":"41","author":"Hengwei","year":"2016","journal-title":"Spine (Phila Pa 1976)"},{"key":"2026090306252593000_16.7.e116029.18","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s00586-023-08030-7","article-title":"Prevalence of adolescent idiopathic scoliosis in Shijiazhuang, Hebei, China: a cross-sectional study","volume":"33","author":"Liu","year":"2024","journal-title":"Eur Spine J"},{"key":"2026090306252593000_16.7.e116029.19","doi-asserted-by":"crossref","first-page":"512","DOI":"10.2340\/16501977-2240","article-title":"Epidemiological study of adolescent idiopathic scoliosis in Eastern China","volume":"49","author":"Zheng","year":"2017","journal-title":"J Rehabil Med"},{"key":"2026090306252593000_16.7.e116029.20","doi-asserted-by":"crossref","first-page":"108305","DOI":"10.1016\/j.isci.2023.108305","article-title":"Scoliosis school screening of 139,922 multi-ethnic children in Dali, southwestern China: A large epidemiological study","volume":"26","author":"Zhou","year":"2023","journal-title":"iScience"},{"key":"2026090306252593000_16.7.e116029.21","first-page":"901","article-title":"Prevalence characteristics of scoliosis in primary and secondary school students in Chinese Mainland: a meta-analysis of 72 studies","volume":"31","author":"Shuai","year":"2021","journal-title":"Chinese Journal of Spine and Spinal Cord"},{"key":"2026090306252593000_16.7.e116029.22","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-96398-1","article-title":"Factors affecting the prevalence of idiopathic scoliosis among children aged 8-15 years in Prishtina, Kosovo","volume":"11","author":"Tahirbegolli","year":"2021","journal-title":"Sci Rep"},{"key":"2026090306252593000_16.7.e116029.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-016-1140-6","article-title":"Scoliosis epidemiology is not similar all over the world: a study from a scoliosis school screening on Chongming Island (China)","volume":"17","author":"Du","year":"2016","journal-title":"BMC Musculoskelet Disord"},{"key":"2026090306252593000_16.7.e116029.24","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/BRS.0000000000000664","article-title":"Prevalence of Scoliosis Among Primary and Middle School Students in Mainland China","volume":"40","author":"Zhang","year":"2015","journal-title":"Spine"},{"key":"2026090306252593000_16.7.e116029.25","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.773594","article-title":"The Prevalence of Scoliosis Screening Positive and Its Influencing Factors: A School-Based Cross-Sectional Study in Zhejiang Province, China","volume":"10","author":"Zou","year":"2022","journal-title":"Front Public Health"},{"key":"2026090306252593000_16.7.e116029.26","first-page":"218","article-title":"Spine growth modulation with titanium implant: comparisons to observation and bracing in early adolescent idiopathic scoliosis","volume":"280","author":"Bylski-Austrow","year":"2021","journal-title":"Stud Health Technol Inform"},{"key":"2026090306252593000_16.7.e116029.27","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1097\/01.brs.0000229230.68870.97","article-title":"Progression risk of idiopathic juvenile scoliosis during pubertal growth","volume":"31","author":"Charles","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"2026090306252593000_16.7.e116029.28","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1007\/s00586-023-07681-w","article-title":"Prediction of future curve angle using prior radiographs in previously untreated idiopathic scoliosis: natural history from age 6 to after the end of growth (SOSORT 2022 award winner)","volume":"32","author":"Parent","year":"2023","journal-title":"Eur Spine J"},{"key":"2026090306252593000_16.7.e116029.29","doi-asserted-by":"crossref","first-page":"536","DOI":"10.2340\/17453674.2024.41911","article-title":"Prognostic model development for risk of curve progression in adolescent idiopathic scoliosis: a prospective cohort study of 127 patients","volume":"95","author":"Dufvenberg","year":"2024","journal-title":"Acta Orthop"},{"key":"2026090306252593000_16.7.e116029.30","doi-asserted-by":"crossref","DOI":"10.3390\/medsci13020062","article-title":"Idiopathic Scoliosis Progression: Presenting Rib and Segmental Rib Index as Predictors-A Literature Review","volume":"13","author":"Grivas","year":"2025","journal-title":"Med Sci (Basel)"},{"key":"2026090306252593000_16.7.e116029.31","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/j.spinee.2022.03.016","article-title":"The incidence and prevalence of early-onset scoliosis: a regional multicenter epidemiological study","volume":"22","author":"AlNouri","year":"2022","journal-title":"The Spine Journal"},{"key":"2026090306252593000_16.7.e116029.32","first-page":"2318","article-title":"Ten-year follow-up evaluation of a school screening program for scoliosis. Is the forward-bending test an accurate diagnostic criterion for the screening of scoliosis?","volume":"PMID","author":"Karachalios","year":"1976","journal-title":"Spine (Phila Pa 1976)"},{"key":"2026090306252593000_16.7.e116029.33","doi-asserted-by":"crossref","first-page":"16730","DOI":"10.3390\/ijerph192416730","article-title":"Application of the Schroth Method in the Treatment of Idiopathic Scoliosis: A Systematic Review and Meta-Analysis","volume":"19","author":"Dimitrijevi\u0107","year":"2022","journal-title":"IJERPH"},{"key":"2026090306252593000_16.7.e116029.34","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1515\/ijamh-2023-0166","article-title":"Overview of adolescent idiopathic scoliosis and associated factors: a scoping review","volume":"35","author":"Almahmoud","year":"2023","journal-title":"Int J Adolesc Med Health"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-116029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:25:57Z","timestamp":1788441957000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-116029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":34,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,9]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2025-116029"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-116029","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}