Association between idiopathic scoliosis and facial asymmetry: a gender-balanced case–control study

This study aimed to investigate the association between idiopathic scoliosis (IS) and facial asymmetry in a gender-balanced case-control design. Based on power analysis, 100 participants were recruited (50 IS patients: 25 male, 25 female; 50 controls: 25 male, 25 female). Facial asymmetry was evaluated through clinical examination and frontal cephalometric analysis. Statistical analysis was performed using chi-square tests and logistic regression, with post-hoc power calculation. Facial asymmetry was present in 41 (82%) of IS patients compared to 18 (36%) of controls (p < 0.001). The achieved power was 99% for detecting this difference. Among IS patients, 21 males (84%) and 20 females (80%) exhibited facial asymmetry. In controls, facial asymmetry was observed in 10 males (40%) and 8 females (32%). The odds ratio for facial asymmetry in IS patients was 7.64 (95% CI 3.02–19.32) compared to controls. Idiopathic scoliosis is significantly associated with facial asymmetry, with no substantial gender difference in this association. The high statistical power confirms the reliability of these findings.