The prevalence of adult de novo scoliosis: A systematic review and meta-analysis

INTRODUCTION: Primary degenerative scoliosis represents a new scoliosis developing in patients with no prior history of spinal curvature. Researchers sought to determine the prevalence of this type of scoliosis.

METHODS: MEDLINE, Embase, CINAHL, Web of Science and PubMed were searched from inception to 28th March, 2018. Studies that assessed adults from the general population for scoliosis using imaging techniques were included. Studies were included only if the study authors had excluded participants with previously diagnosed scoliosis and/or spinal disorders. Mixed-effects logistic-regression was used to establish an overall prevalence estimate with 95% confidence intervals (primary outcome) and to examine the effect of age and sex (secondary outcomes).

RESULTS: Four cross-sectional studies and one cohort study, involving 4069 participants (66.6% Female), aged between 41 and 94 years, were eligible for inclusion. Reported prevalence figures ranged from 13 to 68%. The pooled prevalence estimate from the mixed-effects logistic regression analysis was 37.6% (95% CI 18.7-61.8). Females were more likely to suffer from scoliosis compared with males (p<0.001), with prevalence figures of 41.2% (95% CI 20.7-65.8) versus 27.5% (95% CI 12.2-51.1), respectively. Individuals aged <60 years had a prevalence of 13% (95% CI 5.2-30.2), whereas the prevalence estimates were substantially higher in the> 60 age group [36% (95% CI 17.4-60.6)].

CONCLUSION: Primary degenerative scoliosis is a highly prevalent condition, especially in females. Further research targeting this type of scoliosis is required to obtain more precise global prevalence estimates and to understand the influence of age and sex.