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Background: Adolescent idiopathic scoliosis (AIS) is the most prevalent type of scoliosis affecting children between the ages of 10-16 years. However, risk factors for AIS, particularly the modifiable ones, are still largely unknown. This study aims to investigate the associations of lifestyle and social environment factors with AIS in Chinese schoolchildren., Methods: This is a matched case-control study based on survey data collected from school-based scoliosis screening program. We used conditional logistic regression models to describe the relative risk of AIS incidence for each variable in the analyses. To examine the independent effect of each factor on developing AIS, a multivariate conditional logistic regression was conducted and odds ratios (ORs) were adjusted for age and other significant variables., Results: Overall, 2538 participants from 49 schools were included in this study, comprising 1269 AIS cases and 1269 controls. Mean age of the study population was 13.4 years ± 1.06 (range 10-18). One thousand five hundred and fifty (61.1%) of the study subjects were girls. After adjusting for other significant factors, inappropriate desk heights, either too low (OR = 1.40, 95% CI 1.04-1.90) or too high (OR = 1.61, 95% CI 1.09-2.38), standing with anterior pelvic tilt (OR = 2.73, 95% CI 1.41-5.28), and sleeping on the right side (OR = 1.38, 95% CI 1.00-1.91), remained associated with elevated AIS risks. In contrast, sitting normally and classroom sitting positions change regularly were associated with lower odds of AIS. The adjusted ORs were 0.69 (95% CI 0.50-0.96) for sitting normally, and 0.72 (95% CI 0.53-0.98) for sitting positions change., Conclusions: This is the first study to address the associations between desk heights and AIS and showed inappropriate desk heights were related to increased AIS risks. To protect school children from developing AIS, stakeholders are advised to consider introducing height-adjustable desks in the class, changing students' sitting positions in the classroom on a regular basis, and implementing educational programs to help students maintain correct sitting postures., (© 2022. The Author(s).)

Background: Globally, 20% to 50% older adults have been found to have thoracic hyperkyphosis. Negative effects on physical performance have been reported. However, there has been a lack of research on the prevalence and negative effects of thoracic hyperkyphosis among Chinese community-dwelling elderly., Design: A cross-sectional study., Setting: The communities in Wuhan, China., Participants: Three hundred and ninety-five Chinese community-dwelling older adults with thoracic hyperkyphosis., Measures: Chinese community-dwelling older adults aged 60 or above lived in Wuhan, China from August to December 2018 were recruited for spine and physical performance assessments. The primary outcome was the prevalence of thoracic hyperkyphosis estimated according to the angle of kyphosis which was measured by manual inclinometers. The secondary outcomes were the effects of thoracic hyperkyphosis on physical performance measured by One-leg Standing Test (OLS), Timed Up AND Go Test (TUG), Chest Expansion Test (CE), Six Minutes Walking Test (6MWT), and Farsi Version of Functional Gait Assessment (FGA). The socio-demographic and health-related information were collected by a questionnaire., Results: Among 395 participants, the mean angle of kyphosis was 49.0° ± 10.5°, 75.2% of participants had the angle of kyphosis >40° (i.e., having thoracic kyperkyphosis). Compared with older adults having no thoracic hyperkyphosis, older adults with thoracic hyperkyphosis had increased risks performing impaired in OLS (OR=4.55, 95% CI 2.18-9.53, p<0.001), TUG (OR=6.08, 95% CI 2.57-14.40, p<0.001), CE (OR=3.23, 95% CI 1.63-6.38, p=0.001), 6MWT (OR=4.64, 95% CI 1.98-10.86, p<0.001), and FGA (OR=5.18, 95% CI 2.25-11.89, p<0.001) after controlling socio-demographic and health-related factors., Conclusion: The thoracic hyperkyphosis had high prevalence and associated with impaired performance in balance, gait, and cardiopulmonary function tests among Chinese community-dwelling older adults, which calls for the future intervention., Competing Interests: The authors has no conflicts.

Objective: To investigate the surgical strategy and mid-and long-term outcomes of neurofibromatosis associated cervical kyphotic deformity. Methods: Thirteen patients with neurofibromatosis associated cervical kyphotic deformity operated in Shanghai Changzheng Hospital from January 1998 to December 2015 were analyzed retrospectively. There were 7 males and 6 females in this group, aged from 12 to 61 years, with an average age of (28±15) years. Eight patients were treated with anterior surgery (Group A) and 5 patients were treated with combined anterior and posterior surgery (Group A+P). Cobb angle correction of cervical kyphosis and improvement of clinical symptoms were followed up. Clinical efficacy between the two groups was compared and analyzed. Chi-square test, Fisher exact test and independent sample t test were used for comparative analysis between the two groups. Results: All patients were operated successfully and finished follow up. The follow-up period was from 42 to 128 months ((80±22) months). After the surgery, neurological symptoms and pain were significantly improved in all patients. Compared with preoperative values, Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) score for pain at the last follow-up were significantly improved ( t= 7.63, -5.19, 8.63, -4.75, all P< 0.01). Cervical kyphosis was significantly improved in all patients after surgery. In group A, the Cobb angle was improved from 64°±24° preoperatively to 12°±11° at the last follow-up, and the average correction rate of Cobb angle was 82.6%. In group A+P, the Cobb angle was improved from 55°±10° preoperatively to 7°±9° at the last follow-up, and the average correction rate of Cobb angle was 88.3%. The operation time, intraoperative blood loss and length of stay in group A were all significantly lower than those in group A+P ( t= -6.32, -11.92, -6.52, all P< 0.01). At the last follow-up, there was no significant difference in Cobb angle, JOA score and VAS score between the two groups ( t= 0.89, 0.94, 1.02, all P> 0.05). Conclusions: Mid-and long-term results of anterior and combined anterior and posterior surgery for neurofibromatosis associated severe cervical kyphosis are satisfactory. Moderate correction strategy for cervical kyphosis is safe and effective. The incidence of complications of nerve injury can be reduced.