Exploring the Visual Profile in Pediatric Scoliosis: Insights from a Controlled Comparative Study.

BACKGROUND: Idiopathic scoliosis is a complex spinal deformity that often emerges during growth and has a multifactorial etiology. Recent evidence suggests that visual disturbances may affect postural alignment and potentially influence spinal curvature patterns. However, the relationship between visual impairments and scoliosis, especially S-shaped curves, remains insufficiently understood. The aim was to investigate the association between visual disturbances and spinal curvature characteristics in pediatric patients with double major idiopathic scoliosis, and to explore the correlation between visual status and selected metabolic biomarkers. MATERIALS AND METHODS: This retrospective controlled study included 73 pediatric patients under the age of 16, diagnosed with double major idiopathic scoliosis between January 2020 and 2025. Patients were divided into two groups: 38 with visual disturbances (myopia, hypermetropia, astigmatism, strabismus, or partial blindness) and 35 without visual impairments (control group). Radiographic parameters, clinical characteristics, and biochemical markers were analyzed using univariate and multivariate statistical methods. RESULTS: Patients with visual disturbances exhibited a significantly more cranial thoracic apical vertebra level (T6 vs. T8, p < 0.01), greater thoracic Cobb angles, and lower mean serum calcium and magnesium levels compared with the control group (p < 0.05). Multinomial logistic regression showed that hypomagnesemia and earlier thoracic apical vertebra level were independently associated with visual disturbances. DISCUSSION: The present study provides preliminary evidence that visual disturbances may be associated with specific spinal and metabolic characteristics in children with idiopathic double-curve scoliosis. Although causal relationships cannot be established, these findings support further investigation of visual assessment as a potential component of multidisciplinary scoliosis evaluation and early screening strategies. CONCLUSIONS: Visual impairments in pediatric patients with double major idiopathic scoliosis are associated with altered spinal morphology and lower calcium-magnesium levels. These findings support the potential role of visual and metabolic screening in the comprehensive assessment and management of scoliosis.