{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T02:29:53Z","timestamp":1782959393729,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The average altitude of Qinghai-Tibetan Plateau is 4,500 m and most of the residents are Tibetan ethnicity. The purpose of this study was to investigate the prevalence of scoliosis and associated factors among children in this region through a scoliosis screening program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study was preformed between May 2020 and December 2020 in Qinghai-Tibetan Plateau. A total of 9,856 children aged 6\u201317 years from schools and nearby villages were screened using visual inspection, the Adams forward-bending test, the angle of trunk rotation, and radiography. A self-designed questionnaire was used to collect demographic data. The prevalence of scoliosis and associated factors were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%, with 5.38% for females and 2.11% for males. The prevalence of scoliosis was 3.50% in children resided below 4,500 m while 5.63% in those resided above 4,500 m (<jats:italic>P<\/jats:italic> = 0.001). The prevalence of congenital scoliosis (2.14 vs. 0.42%, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) and neuromuscular scoliosis (0.34 vs. 0.07%, <jats:italic>P<\/jats:italic> = 0.041) were significantly higher in the altitude above 4,500 m. 50.00% of patients resided above 4,500 m were recommended for surgery while 16.24% in those resided below 4,500 m (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). Independent associated factors were detected as female (OR = 2.217, 95 CI% 1.746\u20132.814, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), BMI &amp;lt; 18.5 (OR = 1.767, 95 CI% 1.441\u20132.430, <jats:italic>P<\/jats:italic> = 0.005), altitude of residence \u2265 4,500 m (OR = 1.808, 95 CI% 1.325\u20132.483, <jats:italic>P<\/jats:italic> = 0.002), and sleep time &amp;lt; 8 h (OR = 2.264, 95 CI% 1.723\u20132.846, <jats:italic>P<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prevalence of scoliosis among children in Qinghai-Tibetan Plateau was 3.69%. With increasing altitudes, the prevalence of scoliosis and its major type were different from that at lower altitudes. Female, BMI &amp;lt; 18.5, altitude of residence \u2265 4,500 m, and sleep time &amp;lt; 8 h were independently associated with the prevalence of this disease. Early screening should be carried out before the age of 7 years, especially in the high-altitude, underdeveloped, and rural areas.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.983095","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T06:54:32Z","timestamp":1660892072000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Scoliosis among children in Qinghai-Tibetan Plateau of China: A cross-sectional epidemiological study"],"prefix":"10.3389","volume":"10","author":[{"given":"Lijin","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Hai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junrui Joanthan","family":"Hai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunzhong","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jincai","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangpu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2592","DOI":"10.1097\/00007632-199912150-00006","article-title":"Natural history","volume":"24","author":"Weinstein","year":"1999","journal-title":"Spine."},{"key":"B2","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3233\/BMR-130438","article-title":"Scoliosis: review of types of curves, etiological theories and conservative treatment","volume":"27","author":"Shakil","year":"2014","journal-title":"J Back Musculoskelet Rehabil."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.1007\/s00381-018-3915-6","article-title":"A comprehensive review of the diagnosis and management of congenital scoliosis","volume":"34","author":"Mackel","year":"2018","journal-title":"Childs Nerv Syst."},{"key":"B4","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/j.pmrj.2013.05.015","article-title":"Neuromuscular scoliosis","volume":"5","author":"Allam","year":"2013","journal-title":"PM R."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1097\/BRS.0000000000003134","article-title":"Syndromic scoliosis: national trends in surgical management and inpatient hospital outcomes: a 12-year analysis","volume":"44","author":"Chung","year":"2019","journal-title":"Spine."},{"key":"B6","doi-asserted-by":"publisher","first-page":"494","DOI":"10.4184\/asj.2017.11.3.494","article-title":"Severe rigid scoliosis: review of management strategies and role of spinal osteotomies","volume":"11","author":"Kandwal","year":"2017","journal-title":"Asian Spine J."},{"key":"B7","doi-asserted-by":"publisher","first-page":"379","DOI":"10.5694\/j.1326-5377.1986.tb112390.x","article-title":"The case for scoliosis screening in Australian adolescents","volume":"145","author":"Chan","year":"1986","journal-title":"Med J Aust."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.2106\/00004623-199710000-00006","article-title":"School-screening for scoliosis. 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