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Background <p>Brace treatment can contribute to the progression of adolescent idiopathic scoliosis (AIS) along with skeletal maturity and curve severity. However, other contributing factors remain unclear. We aimed to identify factors associated with the progression of AIS, focusing on skeletal muscle mass.</p> Methods <p>The inclusion criteria were as follows: (1) female patients, (2) Risser grade 0–2 at the initial examination and ≤ 2 years postmenarche, (3) major Cobb angle of 10°–39° at baseline, (4) Risser grade ≥ 4 and ≥ 2 years postmenarche at final evaluation, and (5) follow-up of ≥ 2 years. In total, 149 patients with AIS were included. The assessed variables included major curve Cobb angle, age, height, age at menarche, extracurricular sports involvement, family history of scoliosis, curve type, Risser grade, body mass index, appendicular skeletal muscle mass index (ASMI), trunk skeletal muscle mass index (TSMI), and brace compliance. Skeletal muscle mass was measured by bioelectrical impedance analysis of skeletal maturity. Patients were classified into the progression (≥ 10° Cobb increase; <i>n</i> = 61) and nonprogression (<i>n</i> = 88) groups for comparison.</p> Results <p>Significant differences (<i>p</i> &lt; 0.05) were observed between the nonprogression and progression groups in height increase (6.9&#xa0;cm vs. 10.8&#xa0;cm), age at menarche (11.6 years vs. 12.2 years), curve type (major thoracic scoliosis: 67% vs. 92%), Risser grade (grade 0: 33% vs. 57%), ASMI (6.13&#xa0;kg/m² vs. 5.92&#xa0;kg/m²), TSMI (7.27&#xa0;kg/m² vs. 6.97&#xa0;kg/m²), and major Cobb angle at final examination (30.0° vs. 44.4°). Multivariate analysis identified major thoracic scoliosis (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.535–15.175), height increase (OR 1.2, 95% CI 1.031–1.360), and TSMI (OR 0.3, 95% CI 0.101–0.914) as factors associated with curve progression.</p> Conclusions <p>Although skeletal maturity largely determines AIS progression, trunk muscle mass may also play a role during growth. Future studies should explore targeted interventions to improve muscle condition for better scoliosis management.</p>

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Multifactorial analysis of adolescent idiopathic scoliosis progression: the potential role of trunk skeletal muscle mass

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Kei Watanabe,
  • Masayuki Ohashi,
  • Hideki Tashi,
  • Yohei Shibuya,
  • Keitaro Minato,
  • Toru Hirano,
  • Kazuhiro Hasegawa

摘要

Background

Brace treatment can contribute to the progression of adolescent idiopathic scoliosis (AIS) along with skeletal maturity and curve severity. However, other contributing factors remain unclear. We aimed to identify factors associated with the progression of AIS, focusing on skeletal muscle mass.

Methods

The inclusion criteria were as follows: (1) female patients, (2) Risser grade 0–2 at the initial examination and ≤ 2 years postmenarche, (3) major Cobb angle of 10°–39° at baseline, (4) Risser grade ≥ 4 and ≥ 2 years postmenarche at final evaluation, and (5) follow-up of ≥ 2 years. In total, 149 patients with AIS were included. The assessed variables included major curve Cobb angle, age, height, age at menarche, extracurricular sports involvement, family history of scoliosis, curve type, Risser grade, body mass index, appendicular skeletal muscle mass index (ASMI), trunk skeletal muscle mass index (TSMI), and brace compliance. Skeletal muscle mass was measured by bioelectrical impedance analysis of skeletal maturity. Patients were classified into the progression (≥ 10° Cobb increase; n = 61) and nonprogression (n = 88) groups for comparison.

Results

Significant differences (p < 0.05) were observed between the nonprogression and progression groups in height increase (6.9 cm vs. 10.8 cm), age at menarche (11.6 years vs. 12.2 years), curve type (major thoracic scoliosis: 67% vs. 92%), Risser grade (grade 0: 33% vs. 57%), ASMI (6.13 kg/m² vs. 5.92 kg/m²), TSMI (7.27 kg/m² vs. 6.97 kg/m²), and major Cobb angle at final examination (30.0° vs. 44.4°). Multivariate analysis identified major thoracic scoliosis (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.535–15.175), height increase (OR 1.2, 95% CI 1.031–1.360), and TSMI (OR 0.3, 95% CI 0.101–0.914) as factors associated with curve progression.

Conclusions

Although skeletal maturity largely determines AIS progression, trunk muscle mass may also play a role during growth. Future studies should explore targeted interventions to improve muscle condition for better scoliosis management.