Is there a link between scoliosis and headache disorders-related symptoms?

BackgroundScoliosis is a complex deformity of the spine in all three planes. Its multifactorial etiology is not fully clear: it results from genetic, endocrine and muscular factors connected with biomechanical causes. The most common form is adolescent idiopathic scoliosis (AIS), usually detected during the pubertal growth spurt. It affects 2-3% of adolescents with some restrictions to their daily life, being a risk factor for different impairments to health-related quality of life (HRQoL). With advances in this field of study, more attention has been given to the perception of deformity and the correlated symptoms of some comorbidities. Among different aspects, several studies are focusing on the potential of scoliosis to cause postural control impairments. To date, in literature, a plausible relationship between scoliosis and headache disorders is sparsely studied not only in adult patients but also in adolescents. The diagnosis of the different types of headaches remains a challenge even because they are similar, having several symptoms that can be considered the same. ObjectivesThe aim of this scoping review is to provide an analysis of the current state of the art on scoliosis and the possible correlation with headache-related symptoms. MethodsResearch was conducted through all publications written in English about this topic in accordance with the PRISMA extensions for Scoping Reviews (PRISMA-ScR). Studies were included if they had met the following inclusion criteria: population affected by primary scoliosis, no limits of age and gender. No study design, publication type and data restrictions were applied. Medline (PubMed), gray literature databases were searched up to May 2023. Two reviewers managed to screen independently all titles, abstracts and free full-text studies for inclusion. A data collection form was developed in order to extract the characteristics of the studies included. ResultsIn recent years, greater attention has been given to the perception of the deformity and to the correlated symptoms of different comorbidities. A few studies focus on the potential of scoliosis for causing postural control impairments that can pave the way to headache. A plausible relationship between scoliosis and headache disorders is sparsely studied not only in adult patients but also in adolescents. Data on percentage of headache as a comorbidity are present in 7 studies, which met the elegibility criteria for the review. Heterogeneity of outcome measures and participants in the studies caused the impossibility to pool together the results in a statistical form. Therefore, it was decided to report them in narrative form. ConclusionThe data included seem not sufficient to guarantee a reasonable quality of analysis. Specifically, there is a lack of systematic research with a focus on the presence of a possible correlation between scoliosis and headache. The significant heterogeneity of symptomatic dimensions and sometimes their overlap occur in the cephalalgic patient and it complicates the interpretation of the data. It seems necessary to continue research in order to investigate through a questionnaire -Midas adapted-that can be submitted to scoliotic patients and offer a good methodological perspective. Moreover, in case of the presence of headache, a detailed analysis could also be significant through their symptom diary.