Laubach Logan, Sharma Viraj, Alsumait Abdulaziz, Chiang Benjamin, Kuester Victoria
Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, USA.
General Surgery, Riverside University Health System Medical Center, Riverside, USA.
Cureus. 2023 Feb 14;15(2):e34993. doi: 10.7759/cureus.34993. eCollection 2023 Feb.
Race and socioeconomic status correlate with disease outcomes and treatment in patients with idiopathic scoliosis (IS) to varying degrees, although there is no clear association with Cobb angle and curve type. The purpose of this study was to assess socioeconomic factors and their association with Cobb angles in patients with IS.
A retrospective chart review was completed with the radiographic analysis of 89 patients diagnosed with IS and spinal curves >10° between the ages of six and 18. Associations between the Cobb angles and socioeconomic categorical variables were analyzed using a nonparametric Kruskal-Wallis test and continuous variables using a Spearman Rank correlation. Results: There were no significant associations between proximal thoracic, main thoracic, or thoracolumbar/lumbar Cobb angles and sex, insurance type, race, access to healthy food, financial difficulty, or income. BMI and proximal thoracic Cobb angle (ρ = 0.2375, p=0.0268) had a significant positive correlation, and BMI and income (ρ = -0.2468, p=0.0228) shared a significant negative correlation.
The severity of IS proximal thoracic Cobb angles was positively associated with BMI and income. Other socioeconomic factors such as age, race, sex, access to food, insurance, and financial difficulties related to scoliosis treatment were not correlated with Cobb angle severity. The data presented suggest that patients with IS have varying degrees of curve type and severity that overall do not correlate with various socioeconomic factors. Validating which factors are predictive of curve severity could lead to early intervention preventing further morbidity of IS.
种族和社会经济地位在不同程度上与特发性脊柱侧凸（IS）患者的疾病预后及治疗相关，尽管与Cobb角和侧弯类型并无明确关联。本研究旨在评估社会经济因素及其与IS患者Cobb角的关联。
对89例年龄在6至18岁、诊断为IS且脊柱侧弯>10°的患者进行了回顾性病历审查及影像学分析。使用非参数Kruskal-Wallis检验分析Cobb角与社会经济分类变量之间的关联，使用Spearman秩相关分析连续变量。结果：胸近端、胸主段或胸腰段/腰段Cobb角与性别、保险类型、种族、获得健康食品的机会、经济困难或收入之间无显著关联。BMI与胸近端Cobb角（ρ = 0.2375，p = 0.0268）呈显著正相关，BMI与收入（ρ = -0.2468，p = 0.0228）呈显著负相关。
IS胸近端Cobb角的严重程度与BMI和收入呈正相关。其他社会经济因素，如年龄、种族、性别、获得食物的机会、保险以及与脊柱侧弯治疗相关的经济困难，与Cobb角严重程度无关。所呈现的数据表明，IS患者的侧弯类型和严重程度各不相同，总体上与各种社会经济因素无关。验证哪些因素可预测侧弯严重程度可能会带来早期干预，预防IS的进一步发病。
