Multifactorial analysis of adolescent idiopathic scoliosis progression: the potential role of trunk skeletal muscle mass
- 1Niigata Spine Surgery Center, Kameda Daiichi Hospital, 2-5-22 Nishi-machi, Konan-ku, Niigata, 950-0165 Japan
- 2Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- 3Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma, Japan
Abstract
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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12891-026-10177-5.
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BibTeX
@article{watanabe2026multifactorial,
title = {{Multifactorial analysis of adolescent idiopathic scoliosis progression: the potential role of trunk skeletal muscle mass}},
author = {Kei Watanabe and Masayuki Ohashi and Hideki Tashi and Yohei Shibuya and Keitaro Minato and Toru Hirano and Kazuhiro Hasegawa},
journal = {BMC Musculoskeletal Disorders},
year = {2026},
month = jul,
doi = {10.1186/s12891-026-10177-5},
url = {https://doi.org/10.1186/s12891-026-10177-5},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Multifactorial analysis of adolescent idiopathic scoliosis progression: the potential role of trunk skeletal muscle mass
AU - Kei Watanabe
AU - Masayuki Ohashi
AU - Hideki Tashi
AU - Yohei Shibuya
AU - Keitaro Minato
AU - Toru Hirano
AU - Kazuhiro Hasegawa
PY - 2026
DA - 2026/07/29
JO - BMC Musculoskeletal Disorders
DO - 10.1186/s12891-026-10177-5
UR - https://doi.org/10.1186/s12891-026-10177-5
AB - 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12891-026-10177-5.
SN - 1471-2474
ER -