Measuring the Level of Knowledge and Awareness about Scoliosis in Saudi Arabia

Background: Scoliosis is a serious condition occurring in 1% to 4% of the population. This study was conducted and designed to educate society about scoliosis and measure the knowledge and awareness about it. Methods: This was a cross-sectional study conducted on members of the Saudi Society who have consented to participate in this research between the 8th of January and 5th of February 2023. Results: A total of 427 people agreed to participate in the study. The highest percentage of the participants was female 69.1%. About 41% participants out of 427 were in the age group 18-25 years. Most of the participants were from the Middle Region. (71.9%) of participants were unfamiliar with scoliosis, while (72.1%) had no prior knowledge of the condition. Conclusion: This study indicates insufficient awareness and knowledge about scoliosis in Saudi Arabia. Therefore, further studies are needed to raise awareness about scoliosis and help people to learn more about this condition.


Introduction
Scoliosis is defined as a sideways curvature of the spine that occurs in 1% to 4% of the population.It can happen to people of any age but the most diagnosed with it are adolescents, it often affects females more than males [1] [2] [3].
There are many causes of scoliosis but the most common type of scoliosis is an unknown cause which is named "idiopathic scoliosis (IS)" [4].
The other types may be caused by certain neuromuscular conditions, such as cerebral palsy or muscular dystrophy.
Birth defects affect the development of the spine's bones, previous surgery on the chest wall as a baby, wear and tear of the spine with age, injuries to or infections of the spine, and Spinal cord abnormalities [5].
Symptoms and signs of scoliosis include uneven waist or shoulders, one hip higher than the other, visibly curved spine, prominence on one side of the back when bending forward, and some people may have back pain.This symptom is usually common in adult patients [6] [7].
The treatment depends on the type of scoliosis, age, and degree of deviation.
There are three options for treatment including bracing, observation, and surgery [5].
Immature patients with curves less than 25˚ must be monitored and when the curves are between 25˚ and 50˚, then recommended back brace is recommended.
Surgery is usually performed when the degree of curvature is greater than 45˚ in immature patients and greater than 50˚ in mature patients [5].
Scoliosis is a serious condition and early detection is beneficial because it can change the direction of the disease [4].
Therefore, this study aimed to educate society about scoliosis and measure its knowledge and awareness.

Study Design and Setting
This is a randomized, self-administered cross-sectional study conducted on members of the Society who have consented to participate in this research between the 8th of January and to 5th of February 2023.
We included a total of 427 participants who shared their responses during the study period both male and female, and we excluded the Participants below the age of 18 years.
This study utilized a self-administered, online questionnaire that was distributed through social media outlets (e.g., Twitter, WhatsApp) across Saudi Arabia the questionnaire was created, and designed using the Google Forms platform.
The questionnaire was constructed based on research objectives and it was divided into three parts.The first one is the demographic characteristics of respondents such as gender, age, region, and education levels.The second one consists of five questions to measure the participant's level of knowledge regarding scoliosis.
The third one is to see if there is enough awareness about scoliosis in Saudi Arabia and it consists of three questions.

Consent to Participate
We informed all the participants about the aim of this study and we asked if they approve to participate in this study, and we guaranteed complete confidentiality to them.

Results
A total of 427 people agreed to participate in the study and shared their responses.Table 1 shows: the highest percentage of the participants were female (69.1%), (41%) of participants were in the age group 18 -25 years, the majority of the participants were from the middle region (83.1%), in addition, the majority of the participants (55%) have bachelor's degree.The mean of right answers about participant's knowledge and awareness about scoliosis concerning gender and age shows in Table 5 and Table 6.
There are no significant differences between the male and female or the age groups.

Discussion
As far as we know this is the first study in Saudi Arabia to measure the level of Knowledge and Awareness About scoliosis among members of society.
The questionnaire was published on social media, all over the Saudi region but the (83.1%) of our participants were from the middle region, this might not reflect on the whole Saudi society.
Although most of the participants had high educational level (Bachelor's degree) but unfortunately, they have poor knowledge regarding scoliosis.
We asked all the participants if they heard about scoliosis before and (71.9%) answered No, its symptoms (82%) answered No and whether it has a cure or not (60.7%)don't know, this means the majority of our participants don't have any idea about scoliosis.
The last part of the questionnaire was to see if there is enough awareness in their region or if you ever attended any campaign regarding scoliosis and most of the participants answered No. (95.1%) support organizing exhibitions in schools, universities, and public places to raise awareness about scoliosis.
This showed that Health education about scoliosis should be promoted in all regions, and we encourage the government to create national scoliosis screening Advances in Bioscience and Biotechnology

D
. M. Alashgar, N. S. Al-Sowayan DOI: 10.4236/abb.2023.149028420 Advances in Bioscience and Biotechnology it didn't benefit me Do you think there is enough awareness about scoliosis in your region?Yes No I don't know Do you support organizing exhibitions in schools, universities and public places to raise awareness about scoliosis?Yes No

Table 1 .
Demographic characteristics of participants (n = 427).Table 2 demonstrates the questions that are related to Participants' knowledge of scoliosis.The majority of the Participants did not know about scoliosis, its symptoms, or if it has a cure or not.

Table 4 .
Participants' knowledge and awareness about scoliosis right answers and wrong answers (n = 427).

Table 5 .
Comparison between right answers about participant's knowledge and awareness about scoliosis concerning gender.

Table 6 .
Comparison between right answers about participant's knowledge and awareness about scoliosis in relation to age group.