Prevalence of Spinal Deformities among School Age Children in Iran: A Systematic Review and Meta-Analysis

Background: Postural disorders and spinal deformities are one of the common conditions in children and adolescents. The aim of this systematic review and meta-analysis was to study the prevalence of spinal deformities among school age children in Iran. Methods: The search strategy was developed using keywords relating to kyphosis, lordosis, scoliosis, child and Iran in the databases of Medline, Scopus, CINAHL, Psycinfo as well as Persian local databases up to January 2020. Articles were appraised by two reviewers using the checklist of Joanna Briggs Institute (JBI) and data was extracted in the designed tables and analyzed using R software with a random effects model. The heterogeneity and dispersion of data was presented in Forest plots. Results: Eighteen studies were included in the meta-analysis. The total population included 84195 students consisting of 39202 boys and 45947 girls. The mean age of the participants was 12.71±1.18 years. The total prevalence of kyphosis was 13.06% [95% CI 0.07; 0.22], the total prevalence of scoliosis was 2.61% [95% CI 0.014; 0.045] and the total prevalence of lordosis was 32.59% [95% CI 0.23; 0.43]. The prevalence of deformities was higher in girls. Kyphosis and scoliosis was more frequent in elementary school children but lordosis was more frequent in middle school students. Confirmation of diagnosis with radiology as well as clinical examination yielded a lower prevalence compared to diagnosis only made by clinical examination. Conclusion: The prevalence of spinal deformities in school age children in Iran is on the average level compared to the other countries and lordosis is more common in girls. Designing further studies to evaluate etiology and risk factors of this condition is recommended.