No description available.

Current methods for treating and diagnosing spinal deformities caused by scoliosis are both surgically intensive and rarely allow for complete correction. This is mainly due to the fact that the diagnostic techniques used are rough estimates made by angles defined by observations of 2-D radiographs. By utilizing the latest software, our research is based on designing a tool that creates a 3-D representation of the spine. When creating a three-dimensional spinal model, it becomes possible to determine local curvature and local torsion values at each specific vertebrae. By manipulating these values at discrete locations on the spine, one can generate "virtual" spines in a three-dimensional environment. The Scoliosis Learning Tool includes algorithmic steps that determine the Lenke Classification of the "virtual" spines. The Lenke Classification is the most commonly accepted method for diagnosing spinal deformities. This patient building program will produce a group of spines with random values for curvature, torsion and initial spinal orientation. An algorithm within the software determines the Lenke Classification of each, and discards any curves that appear unnatural. By defining a metric that places an emphasis on certain geometric similarities, the software is able to define diameters of classification groups and separations between different classification groups. In turn it is possible to determine minor to major differences between spines within the same classification. In doing so, the opportunity exists to possibly find an undiscovered deformity that had previously fallen under another classification category. / Master of Science

Objective: Research on the role of acute post-surgical pain in children is extremely important in order to have a positive influence on pre-surgical preparation and post-surgical care and to prevent pain from becoming chronic, which can extend decades into adulthood. This project aims to identify predictors of acute post-surgical pain in adolescents with idiopathic scoliosis undergoing spinal fusion by utilizing sensory thresholds obtained through quantitative sensory testing (QST). Methods: Eligible candidates were Adolescent Idiopathic Scoliosis (AIS) patients ages 10-17 who have been recommended to receive elected spinal fusion surgery at Boston Children's Hospital (BCH). 9 successfully recruited and enrolled participants underwent a full series of QST tests on their palmar thenar eminence (non-surgical site), and their lower back (surgical site). Patients' Light Touch Detection Threshold (LTDT) and Pain Detection Threshold (PDT) scores were determined using Von Frey Hairs. Patients' Pressure-Pain Sensation Threshold (PPST) scores were determined using a pressure algometer. Patients' Warm/Cool and Hot/Cold Pain Detection Thresholds were detected using a calibrated thermode strapped to the skin. Following the full-series of QST tests, and after the patient was discharged from the hospital, a retrospective chart review was conducted to determine the patients': Age at Surgery, Gender, Number of Vertebrae Fused (Fusion Length), Length of Surgery, Pre-Operative Self-Identified Pain Level (NRS 0-10), Average Post-Operative Acute-Phase Self-Identified Pain Level (NRS 0-10), and daily Pain Medication Doses (Opiate Vs. Non-Opiate Vs. Total). Correlation calculations were done between each variable, including those determined through QST as well as retrospective chart review. For every QST test, each patient's individual score was compared to the cohort's median score, which helped determine whether the patient was either hyper- or hyposensitive for that particular test. For each QST test, these hyper- and hyposensitive groups were then compared to see if there were any significant differences in post-operative pain experienced. Results: Due to the low number of participants (N = 9), the results should be considered preliminary. Correlation studies demonstrate that pre-operative pain was significantly positively correlated with post-operative pain (r = 0.81, p <0.05), indicating that patients who are pre-operatively already in pain, will consequently experience the most pain post-operatively. Additionally, fusion length had a strong positive correlation to acute post-operative opiate pain medication administration (r = 0.71, P < 0.05), indicating that patients who had more vertebrae fused were given more opiates. Through the use of QST, we discovered that patients hypersensitive in the LTDT-Spine QST test experienced significantly less pain post-operatively (3.22 NRS 0-10) than that experienced by hyposensitive patients (5.52 NRS 0-10) from the same test. Identical results were discovered in patients determined hyper- and hyposensitive using the PPST-Spine test, respectively. Retrospective chart review data show that these hyposensitive patients were experiencing greater pain pre-operatively (0.75 NRS 0-10) than that experienced by the hypersensitive patients (0 NRS 0-10), which may have contributed to the hyposensitive cohort's greater post-operative pain. Although insignificant, patients hypersensitive in the Hot Pain - Spine QST test experienced greater post-operative pain (4.72 NRS 0-10) than that experienced by hyposensitive patients in the same test (4.06 NRS 0-10). Conclusions: The goal of this study was to determine a substantiated hypothesis to test in the future, using larger pediatric cohorts. Even though it initially appears that the hyposensitive patients, as determined by the LTDT-Spine and PPST-Spine QST tests, experienced greater post-operative pain, one must consider the fact that this hyposensitive group experienced a significantly greater amount of pre-operative pain. Not only has pre-operative pain been proven to have a strong correlation to post-operative pain in this study, it has also been proven in other larger studies as well. Other studies have identified a test similar to the Hot Pain - Spine QST test as a potential predictor of post-operative pain. The present study's results, although insignificant, share the same conclusion that hypersensitive patients determined through Hot Pain - Spine QST test experience greater post-operative pain. Therefore, the hypothesis to test in the future in pediatric cohorts should read: AIS patients with no pre-operative pain who demonstrate increased sensitivity to hot pain on their surgical site via thermal stimulation (QST) will experience greater post-operative pain in the acute-recovery phase.

Yim, Po Yee Annie. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 166-219). / Abstracts in English and Chinese. / Acknowledgements --- p.ii / Abstract --- p.iv / Abbreviations --- p.xi / Table of Content --- p.xiii / List of Figures --- p.xviii / List of Tables --- p.xxi / Major Conference Presentations --- p.xxiii / Publication in Preparation --- p.xxvi / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- General Overview of Adolescent Idiopathic Scoliosis (AIS) --- p.2 / Chapter 1.2 --- Natural History --- p.3 / Chapter 1.3 --- Current Treatments --- p.5 / Chapter 1.3.1 --- Non-operative Treatments --- p.5 / Chapter 1.3.2 --- Surgical Treatments --- p.6 / Chapter 1.4 --- Current Hypothesis on the Etiology of AIS --- p.8 / Chapter 1.4.1 --- Genetic Factors --- p.8 / Chapter 1.4.2 --- Neuromuscular Impairment --- p.10 / Chapter 1.4.3 --- Abnormalities in Skeletal Development --- p.11 / Chapter 1.4.4 --- Metabolic Dysfunction --- p.12 / Chapter 1.4.4.1 --- Lower Bone Mineral Density --- p.12 / Chapter 1.4.4.2 --- Delayed Sexual Maturity --- p.14 / Chapter 1.4.4.3 --- Hormonal Dysfunction --- p.14 / Chapter 1.5 --- Skeletal arid Spinal Growth in AIS --- p.16 / Chapter 1.5.1 --- Abnormal Growth during Puberty --- p.16 / Chapter 1.5.2 --- Growth Pattern --- p.17 / Chapter 1.5.3 --- Disproportional Growth in AIS --- p.18 / Chapter 1.5.4 --- Asymmetric Growth --- p.20 / Chapter 1.6 --- Melatonin and its Receptor --- p.22 / Chapter 1.6.1 --- Introduction --- p.22 / Chapter 1.6.2 --- Melatonin Receptor --- p.24 / Chapter 1.6.3 --- Melatonin's Role in t h e Skeletal System --- p.25 / Chapter 1.6.4 --- Melatonin-Deficient Scoliotic Animal Model --- p.27 / Chapter 1.6.5 --- Melatonin and AIS --- p.29 / Chapter 1.6.5.1 --- Melatonin Level in AIS --- p.30 / Chapter 1.6.5.2 --- Melatonin Receptor in AIS --- p.30 / Chapter Chapter 2 --- Hypothesis and Objectives --- p.39 / Chapter 2.1 --- Study Hypothesis --- p.40 / Chapter 2.2 --- Objectives --- p.41 / Chapter Chapter 3 --- Abnormal skeletal growth patterns in adolescent idiopathic scoliosis - A longitudinal study till skeletal maturity --- p.42 / Chapter 3.1 --- Introduction --- p.43 / Chapter 3.2 --- Methodology --- p.44 / Chapter 3.2.1 --- Recruitments of Subjects --- p.44 / Chapter 3.2.1.1 --- Patients with AIS --- p.44 / Chapter 3.2.1.2 --- Normal Controls --- p.44 / Chapter 3.2.1.3 --- Patients Consents --- p.45 / Chapter 3.2.2 --- Anthropometric Measurements --- p.45 / Chapter 3.2.3 --- Data Analysis --- p.46 / Chapter 3.2.3.1 --- Cross-sectional Study --- p.46 / Chapter 3.2.3.2 --- Longitudinal Study --- p.46 / Chapter 3.3 --- Results --- p.47 / Chapter 3.3.1 --- Cross-sectional Study of Anthropometric Measurements --- p.47 / Chapter 3.3.2 --- Longitudinal Study of Anthropometric Measurements --- p.48 / Chapter 3.3.2.1 --- Comparison Adjusted for Chronological Age --- p.49 / Chapter 3.3.2.2 --- Comparison Along Year Since Menarche (YSM) --- p.49 / Chapter 3.4 --- Discussion --- p.51 / Chapter Chapter 4 --- Establishment of a Melatonin-Deficierit Induced Scoliotic Model with Locally Bred Chicken --- p.63 / Chapter 4.1 --- Introduction --- p.64 / Chapter 4.2 --- Methodology --- p.67 / Chapter 4.2.1 --- Animals --- p.67 / Chapter 4.2.2 --- Materials and Reagents --- p.67 / Chapter 4.2.3 --- Pinealectomy --- p.68 / Chapter 4.2.4 --- Confirmation of Pineal Gland Removal --- p.69 / Chapter 4.2.5 --- Development of Scoliosis --- p.69 / Chapter 4.2.6 --- Measurement of Long Bone Growth --- p.70 / Chapter 4.2.7 --- Measurement of Weight --- p.71 / Chapter 4.2.8 --- Measurement of Bone Mineral Density (BMD) --- p.71 / Chapter 4.2.8.1 --- Micro Computed Tomography (MicroCT) --- p.71 / Chapter 4.2.8.2 --- Image Processing and Evaluation of BMD --- p.71 / Chapter 4.2.9 --- Data Analysis --- p.72 / Chapter 4.2.9.1 --- Measurements of Long Bone Growth and Weight --- p.72 / Chapter 4.2.9.2 --- Bone Mineral Density --- p.72 / Chapter 4.3 --- Results --- p.73 / Chapter 4.3.1 --- Confirmation of Pineal Gland Removal --- p.73 / Chapter 4.3.2 --- Occurrence of Scoliosis --- p.73 / Chapter 4.3.3 --- Measurements of Long Bone and Weight --- p.74 / Chapter 4.3.4 --- Measurement of Bone Mineral Density --- p.75 / Chapter 4.4 --- Discussion --- p.76 / Chapter Chapter 5 --- Expression of Melatonin Receptor in AIS and Control --- p.102 / Chapter 5.1 --- Introduction --- p.103 / Chapter 5.2 --- Methodology --- p.105 / Chapter 5.2.1 --- Subjects Recruitments --- p.105 / Chapter 5.2.2 --- Cell Isolation --- p.106 / Chapter 5.2.2.1 --- Bone Biopsies for Osteoblasts Isolation --- p.106 / Chapter 5.2.2.2 --- Materials and Reagents --- p.106 / Chapter 5.2.2.3 --- Isolation of Osteoblasts from Bone Biopsies --- p.107 / Chapter 5.2.3 --- Expression Level and Pattern of Melatonin Receptors 1A and IB --- p.108 / Chapter 5.2.3.1 --- Materials and Reagents --- p.108 / Chapter 5.2.3.2 --- Validation of Specificities of Antibodies by Co-immunoprecipitation --- p.113 / Chapter 5.2.3.3 --- Quantification of Protein Expression of Melatonin Receptors in Osteoblasts --- p.115 / Chapter 5.2.3.4 --- Quantification of mRNA Expression of Melatonin Receptor in Osteoblast --- p.117 / Chapter 5.2.3.5 --- Localization of Melatonin Receptor 1A and IB by Immunofluorescence Staining --- p.119 / Chapter 5.2.4 --- Evaluation and Correlation of Clinical Phenotypes with Melatonin Receptor Expression --- p.120 / Chapter 5.2.5 --- Data Analysis --- p.120 / Chapter 5.3 --- Results --- p.121 / Chapter 5.3.1 --- Protein Expression of Melatonin Receptor 1A and IB --- p.121 / Chapter 5.3.2 --- mRNA Expression of Melatonin Receptor 1A and IB --- p.121 / Chapter 5.3.3 --- Localization of Melatonin Receptors 1A and IB --- p.122 / Chapter 5.3.4 --- Evaluation and Correlation of Clinical Phenotypes with Melatonin Receptor Expression --- p.123 / Chapter 5.4 --- Discussion --- p.124 / Chapter Chapter 6 --- Summary and Overall Discussion --- p.152 / Chapter 6.1 --- Study Flowchart --- p.153 / Chapter 6.2 --- Summary and Discussion --- p.159 / Chapter 6.3 --- Limitations and Further Studies --- p.163 / Bibliography --- p.166

Man, Chi Wai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 141-184). / Abstract also in Chinese. / Acknowledgements --- p.ii / Abstract --- p.iv / Abbreviations --- p.xi / List of Tables --- p.xviii / List of Figures --- p.xx / Major Conference Presentations --- p.xxii / Publications in Preparation --- p.xxiv / Study Flowchart --- p.xxv / Chapter Chapter 1 --- Study Background --- p.1 / Chapter 1. --- Introduction --- p.2 / Chapter 1.1. --- General Overview of Adolescent Idiopathic Scoliosis (AIS) --- p.2 / Chapter 1.2. --- Natural History --- p.3 / Chapter 1.3. --- Current Treatments --- p.5 / Chapter 1.4. --- Additional Phenotypes Abnormalities --- p.9 / Chapter 1.5. --- Bone Modeling and Remodeling in Adolescents --- p.14 / Chapter 1.6. --- Bone Development --- p.15 / Chapter 1.7. --- Bone (re)modeling by osteoclasts and osteoblasts --- p.17 / Chapter 1.8. --- Factors Affecting Osteoblasts Regulation --- p.19 / Chapter 1.9. --- Current Hypothesis on the Etiology of AIS --- p.21 / Chapter 1.10. --- Melatonin --- p.26 / Chapter Chapter 2 --- Hypothesis and Objectives --- p.47 / Chapter 2. --- Hypothesis and Objectives --- p.48 / Chapter 2.1. --- Study Hypothesis --- p.48 / Chapter 2.2. --- Objectives --- p.48 / Chapter Chapter 3 --- Study on the Anthropometric Parameters and Bone Geometry of Girls with Severe AIS --- p.49 / Chapter 3.1. --- Introduction --- p.50 / Chapter 3.2. --- Methodology --- p.51 / Chapter 3.2.1. --- Recruitment of Subjects --- p.51 / Chapter 3.2.2. --- Evaluation of Curve Severity of Scoliosis --- p.52 / Chapter 3.2.3. --- Anthropometric Measurements --- p.53 / Chapter 3.2.4. --- Measurements of BMD --- p.53 / Chapter 3.2.5. --- Data Analysis --- p.54 / Chapter 3.3. --- Results --- p.55 / Chapter 3.3.1. --- Anthropometry --- p.55 / Chapter 3.3.2. --- BMD of Femoral Neck and Midshaft of Radius --- p.56 / Chapter 3.4. --- Discussion --- p.57 / Chapter Chapter 4 --- Response of Osteoblasts to Melatonin in AIS Girls In vitro Study --- p.69 / Chapter 4.1. --- Introduction --- p.70 / Chapter 4.2. --- Methodology --- p.72 / Chapter 4.2.1. --- Subjects Recruitments --- p.72 / Chapter 4.2.2. --- Cell Isolation --- p.73 / Chapter 4.2.3. --- Effect of Melatonin on Proliferation and Differentiation of AIS Osteoblasts --- p.76 / Chapter 4.2.4. --- Data Analysis --- p.79 / Chapter 4.3. --- Results --- p.80 / Chapter 4.3.1. --- Isolated Osteoblasts from Normal Human and AIS Patients --- p.80 / Chapter 4.3.2. --- Effect of Melatonin on Osteoblasts Proliferation --- p.80 / Chapter 4.3.3. --- Effect of Melatonin on Cell Differentiation --- p.81 / Chapter 4.4. --- Discussion --- p.83 / Chapter Chapter 5 --- Expression of MT1 and MT2 receptors in AIS Osteoblasts --- p.101 / Chapter 5.1. --- Introduction --- p.102 / Chapter 5.2. --- Methodology --- p.104 / Chapter 5.2.1. --- Osteoblast Samples --- p.104 / Chapter 5.2.2. --- Protein Expression of Melatonin Receptors in AIS Osteoblasts. --- p.105 / Chapter 5.2.3. --- Genotyping of MT2 receptors by Restriction Fragment Length Polymorphism (RFLP) --- p.109 / Chapter 5.2.4. --- Clinical Evaluations of the AIS Patients --- p.110 / Chapter 5.2.5. --- Data Analysis --- p.110 / Chapter 5.3. --- Results --- p.111 / Chapter 5.3.1. --- Semi quantification of Melatonin Receptors in AIS Osteoblasts 111 --- p.111 / Chapter 5.3.2. --- RFLP --- p.112 / Chapter 5.3.3. --- Functional Response Between the Different AIS Groups --- p.112 / Chapter 5.3.4. --- Correlation of the Clinical Phenotypes with the Different AIS Subgroups --- p.114 / Chapter 5.4. --- Discussion --- p.115 / Chapter Chapter 6 --- Summary and Conclusion --- p.132 / Chapter 6.1. --- Summary and Discussion --- p.133 / Chapter 6.2. --- Limitations and Further Studies --- p.136 / Chapter 6.3. --- Conclusion --- p.138 / Bibliography --- p.141 / Appendix I --- p.185 / Appendix II --- p.186 / Appeddix III --- p.187 / Appendix IV --- p.188 / Appendix V --- p.189 / Appendix VI --- p.190

Robotic exoskeletons are important tools in medicine for characterizing certain aspects of diseases, enabling physical therapy treatments, or providing assistance to those with impairments. One area in particular where these devices can make an impact is the study and treatment of scoliosis. First, I adapt a design of a robotic torso exoskeleton to serve the population most susceptible to scoliosis, female adolescents. I used the device to compare the torso stiffness of members of this group with and without scoliosis, and found an interaction effect of degree of freedom (DOF) and torso segment on translational stiffness, and an interaction effect of DOF and group on rotational stiffness. These results can inform the models used to create rigid orthoses for conservative treatment or to simulate the effects of surgical procedures. Second, I explore the effects of different types of augmented sensory feedback commonly used in scoliosis physical therapy. I compare visual and force feedback provided by the exoskeleton on one’s ability to replicate static poses and dynamic movements. I find that while force feedback leads to faster initial improvement, visual feedback may enable the user to learn finer details of the movement. Third, I design a torso exoskeleton for people with neuromotor impairments. People who are not able to sit up independently are at a high risk of developing neuromuscular scoliosis, and must balance the benefits of treatment with rigid orthoses, with the limits that these devices place on functional movements. The device allows users four degrees of freedom, to support functional movements such as reaching and pressure relief maneuvers, but prevents lateral translation and axial rotation, which can contribute to neuromuscular scoliosis. Together, these results demonstrate the potential for robotic exoskeletons in torso study, training, and assistance.

published_or_final_version / Nursing Studies / Doctoral / Doctor of Philosophy

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Adolescent Idiopathic Scoliosis (AIS) is typically treated surgically by Posterior Spinal Fusion (PSF) surgery. Intravenous analgesics and oral opioids are commonly used for pain management. Several adjunct therapies are used in addition to the standard treatments. One of these therapies is the use of dexmedetomidine (dex). Though dex has been found to be an effective sedative for post‐operative patients, there are also several adverse effects that are associated with its use. The purpose of this study was to investigate the effectiveness and overall benefit of using dex for pain control for patients undergoing PSF for AIS. IRB approval was obtained. A group of 43 patients with AIS undergoing PSF and using Dex for adjunctive pain control were matched with 43 patients who did not use Dex. The groups were matched based on gender, age, height, weight, and level of spinal fusion. During the patients’ post‐operative hospital stay, the total opioid use and clinical pain scores were compared between the two groups using t‐tests, with significance set at p<0.05. Total opiate use was 239.6 morphine equivalent doses in the non‐Dex (control) group and 246.2 in the group that received Dex (p=0.72). The average pain score in the control group was 2.3, and the group that received Dex was 2.6 (p =0.43). There were no differences in the complication rate between the two groups, specifically the oversedation rates and pulmonary complications. Lastly, the average length of stay for the control group was 4.8 days compared to the dex group, which was 5.0 days (p=0.35). Although adjunctive pain modalities may be very useful in the treatment of postoperative pain after PSF in patients with AIS, the use of Dex in this cohort did not improve pain scores, lower opioid use, or lower the LOS. Based on these results, we do not recommend the routine use of dexmedetomidine as an adjunctive pain control modality. Adjunctive modalities are important in pain control in patients with AIS undergoing PSF, but the use of dexmedotomidine was not effective in improving pain control.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Surgical correction of Adolescent Idiopathic Scoliosis (AIS) carries a substantial risk of complication. The literature supports improved perioperative outcomes through the two surgeon strategy in other complex orthopedic procedures. Does the presence of 2 versus 1 attending surgeons affect the perioperative morbidity of posterior spinal fusion (PSF) in patients with AIS curves greater than 70°? We reviewed the database from a large regional children’s hospital of all patients with AIS curves greater than 70° who underwent PSF from 2009‐2014 and divided the cohort into single versus 2‐surgeon groups (28 vs. 19 cases, respectively). We analyzed cases for length of surgery, estimated blood loss, and length of stay. The groups were identical when comparing age, gender, spinal levels fused, and average ASA score. However, the average Cobb angle in the single surgeon group was significantly less than in the 2 surgeon group at 78.4 vs 84.0 degrees, respectively (p=0.049). Mean operative time for single versus 2 surgeons was 238 (SD 48) vs 212 (SD 46) minutes (p=0.078). Mean percent estimated blood loss was 26% (SD 14.1) for single surgeon vs 31% (SD 14.9) for 2 surgeons (p=0.236), and mean estimated blood loss for single surgeon vs 2 surgeons was 830ml (SD 361) vs 1045ml (SD 346) (p=0.052). Mean length of stay was significantly decreased in the 2 surgeon group at 5.16 days (SD 1.7) versus the single surgeon group at 6.82 days (SD 6.82) (p=0.002). The use of 2 surgeons in AIS deformity correction at an experienced regional children’s hospital did not improve clinical outcomes. The average length of stay was reduced in the two‐surgeon group, but there was no significant impact on blood loss or operative time. However, this study does not rule out the potential for positive impact with a two‐surgeon strategy, and given previous supportive data in the literature, this approach should further evaluated to determine its effect on improving perioperative outcomes.

A escoliose idiopática do adolescente (EIA) é uma deformidade tridimensional da coluna vertebral. Dados epidemiológicos sobre sua prevalência nas regiões do hemisfério sul não são suficientes. Primeiramente, o objetivo deste estudo foi estimar a prevalência da EIA em cidades do interior do estado de São Paulo; secundariamente, identificar fatores demográficos, clínicos e relacionados ao estilo de vida e à postura associados à ocorrência da escoliose e avaliar a validade e capacidade preditiva do escoliômetro®. Foram avaliados 2.562 adolescentes (1.490 meninas e 1.072 meninos), entre 10 e 14 anos. Os adolescentes eram estudantes de escolas públicas estaduais pertencentes à Diretoria Regional de Ensino de Mogi Mirim/SP. O rastreamento para EIA foi feito pela mensuração do ângulo de rotação de tronco (ART) no teste de Adams por meio do escoliômetro® e pelo exame radiográfico. Adolescentes com ART >= 7º foram encaminhados para radiografia e diagnosticou-se a escoliose quando o ângulo de Cobb foi maior ou igual a 10º. A avaliação postural foi realizada por fotografias analisadas no Software de Avaliação Postural (SAPO) dos adolescentes com suspeita (ART >= 7º e Cobb < 10º) e com escoliose (ART >= 7º e Cobb >= 10º). Os resultados mostraram prevalência de 1,5% (IC95%: 1 - 1,9%), sendo maior para o sexo feminino (2,2%; IC95%: 1,4 - 2,9%) do que masculino (0,5%; IC95%: 0,1 - 0,9%). Os fatores associados à ocorrência da escoliose foram o sexo feminino (odds ratio: 4,7; IC95%: 1,8 - 12,2; p=0,001), as idades de 13 e 14 anos (odds ratio: 2,2; IC95%: 1 - 4,8; p=0,035) e o desnivelamento dos ombros (odds ratio: 1,4; IC95%: 1,1 - 1,8; p=0,011). Houve predomínio de curvas duplas (59,4%) e de lateralidade à direita (56,8%), porém de baixa magnitude (75% com ângulo de Cobb até 22º) e fator de progressão (75% com fator de até 1,2). As curvas à direita apresentaram maior magnitude (ângulo de Cobb: 20,8º (7,3º)) do que aquelas à esquerda (13,8º (4,1º)) (p=0,003). O encaminhamento ao exame radiográfico foi de 5%. O escoliômetro® apresentou melhor sensibilidade aos 45º de flexão anterior de tronco (53,8% (IC95%: 43,7 - 64)) e melhores especificidade e valor preditivo positivo aos 60º (75% (IC95%: 66,2 - 83,9%) e 78,4% (IC95%: 70 - 86,8%), respectivamente). Concluiu-se, portanto, que a prevalência da EIA em cidades do estado de São Paulo (1,5%) foi semelhante à descrita na literatura (2%), sendo também mais prevalente no sexo feminino e nas idades mais próximas à puberdade (13 e 14 anos). Considerando que a puberdade ocorre em momentos distintos entre os sexos, sendo mais tardio para o masculino, a recomendação de se realizar programas de rastreamento escolar para escoliose na mesma faixa etária (10-14 anos) para ambos os sexos deve ser repensada. A validade e capacidade preditiva do escoliômetro® foram melhores aos 60º de flexão de tronco. Em relação aos aspectos posturais, o alinhamento horizontal dos acrômios, que avalia o desnivelamento dos ombros, está associado à presença de escoliose idiopática do adolescente e deve ser considerado na rotina de avaliação dos adolescentes seja no ambiente clínico ou escolar / Adolescent idiopathic scoliosis is a common three-dimensional spinal deformity. Epidemiological data about the condition in South Hemisphere are insufficient. First, the objective of this study was to estimate the adolescent idiopathic scoliosis prevalence rate in cities of São Paulo, Brazil. Second to identify demographic, clinical, lifestyle and body posture factors associated with adolescent idiopathic scoliosis, and to assess the Scoliometer accuracy. We assessed 2,562 adolescents (1,490 girls and 1,072 boys), between 10 and 14 years of age. The adolescents studied in public schools belong to Education Regional Board of Mogi Mirim/SP. The screening procedure included the measurement of Angle of Trunk Rotation (ATR) using a Scoliometer in the Adams test and the radiographic examination. The adolescents with ATR >= 7o were referral to radiographic examination and body photographic. A Cobb angle >= 10o on standing radiographs were classified as adolescent idiopathic scoliosis. We used Postural Assessment Software (PAS) to analyze posture and we divided into adolescents with scoliosis suspicion (ATR >= 7o and Cobb angle < 10o) and with scoliosis (ATR >= 7o and Cobb angle >= 10o). The adolescent idiopathic scoliosis prevalence rate was 1.5% (95% CI: 1 - 1.9%), higher to females (2.2%; 95% CI: 1.4 - 2.9%) than males (0.5%; 95% CI: 0.1 - 0.9%). The following factors were associated with adolescent idiopathic scoliosis: female gender (odds ratio, 4.7; 95% CI: 1.8 - 12.2; p=0.001), the 13 and 14-year age group (odds ratio, 2.2; 95% CI: 1 - 4.8; p=0.035) and shoulder imbalance (odds ratio, 1.4; 95% CI: 1.1 - 1.8; p=0.011). The double curves and right laterality were more frequent (59.4% and 56.8%, respectively), but with low magnitude (75% with Cobb angle until 22o) and progression factor (75% with progression factor until 1.2). The right curves (20.8º (7.3º)) showed high magnitude than the left ones (13.8º (4.1º)) (p=0.003). The referral to radiography was 5%. Scoliometer sensitivity was better at 45o forward bending test (53,8% (95% CI: 43,7 - 64)), and the specificity and positive predictive value were better at 60o (75% (95% CI: 66.2 - 83.9%) and 78.4% (95% CI: 70 - 86.8%), respectively). We concluded that the prevalence of adolescent idiopathic scoliosis in cities of São Paulo (1.5%) was similar to the literature (2%) and was also more prevalent in females and in puberty ages (13 and 14 years). Whereas puberty occurs at different times between gender, and later for males, the recommendation to screen the same age group (10-14 years) for both genders must be rethought. Scoliometer accuracy was better at 60o forward bending test. The shoulder imbalance assessed by horizontal alignment of acromion was associated with the presence of adolescent idiopathic scoliosis and should be considered as an assessment routine for adolescents in clinical or school environment