Risk of scoliosis following hip disease: a 10-year nationwide cohort study in South Korea.
TL;DR
Dgenerative and inflammatory/infectious hip disorders are associated with an increased long-term risk of scoliosis, which underscores the need for early spinal evaluation and preventive strategies in patients with hip pathology.
Abstract
Background
The biomechanical linkage between the hip and spine suggests that hip disorders may contribute to secondary spinal deformities such as scoliosis, but longitudinal population-based evidence is limited. This study examined the long-term risk of adult scoliosis following different types of hip disorders using a nationwide South Korean cohort.
Methods
This retrospective matched cohort study used Korean National Health Insurance Service data (2002-2013). Patients with degenerative (n = 5208), inflammatory/infectious (n = 11,215), or traumatic (n = 2765) hip disorders were matched 1:2 to individuals without hip disorders. Incident scoliosis was identified using ICD-10 codes. Adjusted hazard ratios (aHRs) were estimated with multivariable Cox proportional hazards models, with subgroup analyses by age and sex.
Findings
Over a 10-year follow-up, scoliosis incidence was higher among patients with hip disorders than among controls. The risk was significantly increased in degenerative hip disorders (aHR 2.12, 95% CI 1.61-2.78) and inflammatory/infectious hip disorders (aHR 1.68, 95% CI 1.34-2.11). Traumatic hip disorders showed a non-significant association (aHR 1.49, 95% CI 0.99-2.24). Higher relative risks were generally observed in younger patients and males, particularly in the degenerative hip disorder group.
Interpretation
Degenerative and inflammatory/infectious hip disorders are associated with an increased long-term risk of scoliosis. These findings underscore the need for early spinal evaluation and preventive strategies in patients with hip pathology.