Scoliosis in adolescents with autism spectrum disorder: A retrospective case series
Braces usually fail in autistic teens, so expect faster curve growth and earlier surgery.
01Research in Context
What this study did
Doctors looked back at autistic teens who had scoliosis braces. They wanted to know how many kids got worse even with the brace.
The team counted who needed more treatment later. They also noted who only needed watch-and-wait.
What they found
Braces failed for most kids. Three out of four teens kept curving and needed surgery or more care.
Kids who just had check-ups did better. About half stayed stable and avoided extra steps.
When surgery was chosen, it still fixed the curve.
How this fits with other research
Khongpiboonkit et al. (2025) studied the same age group in Thailand. They tracked weight gain, not spines. Together the papers show autistic teens pile up different medical issues at the same time.
Franke et al. (2019) asked teens how happy they felt. Lower life satisfaction plus brace failure paints a picture of tough adolescent years.
Sasson et al. (2022) listed fatigue and pain in young adults. Their high numbers match the high brace failure here—both signal extra body stress in autism.
Why it matters
If you work with autistic middle- or high-schoolers, plan for brace disappointment. Start pain and movement checks early. Share the real odds with families so they can prep for possible surgery. Track comfort, mood, and posture at every visit—quick action keeps small curves from becoming big ones.
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Add a quick spine check to your session routine—note any lean, pain, or new gait change and alert the care team.
02At a glance
03Original abstract
<h4>Purpose</h4>To describe the curve patterns and behaviors, clinical presentation, treatment modalities, and complications for adolescents with both scoliosis and autism spectrum disorders, but no additional concomitant diagnoses.<h4>Methods</h4>A single-center, retrospective review of adolescents with scoliosis and autism spectrum disorder treated between 2001 and 2021. Patient demographics, clinical characteristics, and radiographic assessments were described across the scoliosis treatment plans (i.e. observation, bracing, and surgery).<h4>Results</h4>Forty patients with scoliosis and autism spectrum disorder (80% male, mean age at 13.2 ± 1.7) met eligibility criteria. Twenty-one patients were managed with observation initially. Of these patients, 55% (<i>n</i> = 11) didn't require further treatment and had an average change in curvature of 5° ± 6°. Twenty-one total patients were managed with bracing. In this group, 76% (<i>n</i> = 16) did not receive further treatments and had an average increase in curvature of 15° ± 11°. Five patients (24%) proceeded to surgery following brace treatment. Thirteen patients (33%) in total required surgery, with <i>n</i> = 5 requiring surgery as their initial treatment. The initial curve magnitude for this group was 55° ± 7° and had an average correction of 47% following posterior spinal fusion.<h4>Conclusions</h4>Although curves in adolescents with scoliosis and autism spectrum disorder had a similar presentation to adolescents with just scoliosis, the current cohort did have an increase in curve progression when managed with bracing, with an unclear explanation. Further study is warranted in this unique population, and families should be counseled that the prognosis may not be the same as adolescents with scoliosis alone.<h4>Levels of evidence</h4>Level IV.
, 2025 · doi:10.1177/18632521251379277