Does Weight Status Affect Idiopathic Early-Onset Scoliosis Progression and Initial Curve Severity? A Retrospective Multicenter Study

Background Young patients with scoliosis tend to have weight abnormalities, which were previously shown to be correlated with bigger curves in adolescent idiopathic scoliosis, but their associations with early-onset scoliosis curves remain unknown. The present study aimed to investigate the effect of weight status on initial curve magnitude and progression in idiopathic early-onset scoliosis patients. Methods A retrospective review of patient records was conducted at 3 centers. Idiopathic early-onset scoliosis patients, with regular follow-up intervals and no major medical comorbidities, were included. Collected variables were date of birth, sex, primary diagnosis, outpatient visit dates with measured height/weight/Cobb angle, and length of follow-up. Patients were assigned the categories underweight, normal, or overweight/obese based on their weight/height pattern over time. Fisher’s exact test was used for categorical variables, while the Mann-Whitney test was carried out for continuous variables. A P value of 0.05 was considered statistically significant. Results A total of 110 patients, 39 males and 71 females, were included from all centers. The average follow-up duration was 8.5 years. A significant association of both underweight (RR = 5.2, 95% CI = 2.2–11.7, P = 0.0006) and overweight/obesity (RR = 4.4, 95% CI = 1.9–10.0, P = 0.0008) categories with early progression was found. Initial curve magnitudes of underweight patients (P = 0.0473) and overweight/obese patients (P = 0.0051) were significantly greater than normal weight patients. Conclusions Idiopathic early-onset scoliosis patients who are underweight or overweight/obese are at a higher risk of early scoliosis curve progression, and they initially present with higher curve magnitudes compared to patients with a normal weight status. Clinical Relevance Spine surgeons can have more insight into the association between weight and scoliosis curve magnitude and progression risk, allowing more robust risk stratification and better counseling for patients and caregivers. Level of Evidence 3.