Lau Kenney Ki Lee, Law Karlen Ka Pui, Kam Owen O Man, Cheung Jason Pui Yin, Cheung Prudence Wing Hang
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pok Fu Lam, Hong Kong.
DOS Dental Limited, Tai Po, Hong Kong.
Spine Deform. 2025 Apr 9. doi: 10.1007/s43390-025-01085-0.
Although the etiology of adolescent idiopathic scoliosis (AIS) remains largely elusive, it is widely recognized as a multifactorial condition shaped by both genetic predispositions and environmental influences. This review seeks to explore the intricate relationships between idiopathic scoliosis and its associated comorbidities, with the goal of advancing our understanding of this multifaceted disorder.
Primary studies involving human subjects diagnosed with idiopathic scoliosis and presenting comorbid conditions were included. Six online databases (AMED, CENTRAL, CINAHL, EMBASE, MEDLINE, and WOS) were systematically searched. Two reviewers independently screened citations and extracted data. Studies were categorized based on commonly examined diagnoses, and outcome measures were descriptively reported.
Our search yielded 1185 citations, with 9 studies meeting the eligibility after screening. These studies examined comorbidities involving conditions like malocclusion, central precocious puberty (CPP), gingival diseases, malignant hematopoietic neoplasms (MHN), temporomandibular joint disorders (TMD), and functional gastrointestinal disorders (FGD). Significant associations were found between AIS and these multifactorial disorders, including dental anomalies (i.e., asymmetrical canine, midline deviations, crossbites, overbite, multiple malocclusion, gingivitis, distocclusion, asymmetric molar occlusion, maxillary overjet, crowding, and reverse chewing cycles), digestive issues (i.e., FGD), endocrine disruptions (i.e., CPP), musculoskeletal imbalances (i.e., reduced masseter muscle volume, higher Fonseca Anamnestic Index score, and greater Helkimo Clinical Dysfunction Index score), and oncological conditions (i.e., MHN).
We have presented the multifactorial and potential systemic nature of AIS by revealing its associations with comorbid conditions. These relationships may indicate shared genetic, hormonal, neuromuscular, and immunological pathways.
尽管青少年特发性脊柱侧凸（AIS）的病因在很大程度上仍不明确，但它被广泛认为是一种由遗传易感性和环境影响共同塑造的多因素疾病。本综述旨在探讨特发性脊柱侧凸与其相关合并症之间的复杂关系，以增进我们对这一复杂疾病的理解。
纳入涉及诊断为特发性脊柱侧凸并伴有合并症的人类受试者的原始研究。系统检索了六个在线数据库（AMED、CENTRAL、CINAHL、EMBASE、MEDLINE和WOS）。两名评审员独立筛选文献并提取数据。研究根据常见的检查诊断进行分类，并对结果指标进行描述性报告。
我们的检索产生了1185条引文，筛选后有9项研究符合纳入标准。这些研究调查了合并症，包括错牙合畸形、中枢性性早熟（CPP）、牙龈疾病、恶性造血系统肿瘤（MHN）、颞下颌关节紊乱（TMD）和功能性胃肠疾病（FGD）。发现AIS与这些多因素疾病之间存在显著关联，包括牙齿异常（即不对称犬齿、中线偏差、反牙合、深覆牙合、多种错牙合畸形、牙龈炎、远中错牙合、不对称磨牙咬合、上颌前突、牙列拥挤和反向咀嚼周期）、消化系统问题（即FGD）、内分泌紊乱（即CPP）、肌肉骨骼失衡（即咬肌体积减小、较高的丰塞卡记忆指数评分和较高的赫尔基莫临床功能障碍指数评分）和肿瘤疾病（即MHN）。
通过揭示AIS与合并症之间的关联，我们展示了其多因素和潜在的系统性本质。这些关系可能表明存在共同的遗传、激素、神经肌肉和免疫途径。
