Correlation between facial asymmetry, shoulder imbalance, and adolescent idiopathic scoliosis

We conducted a prospective cross-sectional study to examine the correlation between facial asymmetry, shoulder imbalance, and adolescent idiopathic scoliosis. Sixty-nine adolescent idiopathic scoliosis patients and 29 healthy volunteers were enrolled in this study. All patients underwent whole-spine standing anteroposterior radiographs and frontal cephalograms. Patients were divided into mild, moderate, and severe groups depending on Cobb angle (10°-25°, 25°-40°, and >40°, respectively). Facial measurements included maxilla height difference, ramus length difference, and anterior nasal spine-menton angle. Shoulder measurements included coracoid height difference, clavicular angle, clavicle-rib intersection difference, and radiographic shoulder height. The anterior nasal spine-menton angle in the severe group (>40°) was higher than in the other groups (P<.05), as was the clavicle-rib intersection difference (P<.05). In addition, the magnitude of the curve showed a possible correlation with the anterior nasal spine-menton angle and clavicle-rib intersection difference in scoliosis patients (r=0.433 and r=0.511, respectively). According to different curve patterns, the anterior nasal spine-menton angle and clavicle-rib intersection difference were significantly higher in the double thoracic group than in the other groups (P<.05). In the correlation analysis, the ramus length difference and anterior nasal spine-menton angle had a possible correlation with the coracoid height difference, clavicular angle, radiographic shoulder height, and clavicle-rib intersection difference (P<.05).