Risk factors, lifestyle and prevention among adolescents with spinal curvature abnormality: a cross-sectional study in twenty-four primary and secondary schools in Hangzhou, Zhejiang Province, China.

BACKGROUND

Spinal Curvature Abnormality (SCA) is a general term for abnormal curvature of the spine that can have long-term negative consequences in adolescents. Research into its aetiology is important for identifying high-risk populations and formulating tailored prevention strategies. This study aimed to evaluate the association between school-related factors and daily lifestyle habits and SCA.

METHODS

In this population-based cross-sectional study, 5652 primary and secondary school students were recruited in Hangzhou, eastern China. All selected students underwent spinal health screenings, as well as height and weight assessments. The influencing factors were gathered through self-report questionnaires completed by the students themselves. We used logistic regression models to estimate the relative risk of SCA prevalence for each variable in the analysis.

RESULTS

The overall prevalence of SCA was found to be 2.23% (126/5652), with the SCA rates observed among students in primary school, junior high school, and senior high school, at 0.06%, 1.88%, and 4.61%, respectively. After adjustment for potential confounders, multivariable logistic regression models showed that live on campus was significantly increased the risk of SCA in children and adolescents (OR = 2.68, 95% CI:183 - 3.92; P < 0.001). However, attending a suburban school (OR = 0.18, 95% CI:0.11-0.31; P < 0.001), spending ≥ 2 h per day outdoors (OR = 0.56, 95% CI:0.34-0.93; P = 0.026), being overweight (OR = 0.54, 95% CI:0.31-0.95; P = 0.032) and maintaining correct sitting and standing postures (OR = 0.60, 95% CI:0.37-0.97; P = 0.036) were protective factors for SCA in children and adolescents.

CONCLUSIONS

In conclusion, academic-related factors, outdoor activity time, weight status and daily lifestyle habits were significantly associated with SCA in Chinese children and adolescents. It is recommended that schools, families, hospitals and society should jointly take measures to encourage adolescent students to cultivate good academic-related behaviours and healthy lifestyles to maintain and promote spinal health.