Comprehensive systematic review and evidence synthesis on the morphological, epidemiological, diagnostic, biomechanical, psychosocial, and therapeutic dimensions of scoliosis

Background: Scoliosis is a complex three-dimensional spinal deformity with multifactorial etiology, encompassing genetic, biomechanical, and environmental factors. Over the last decade (2015-2025), scientific advances have provided new insights into its morphological, epidemiological, diagnostic, biomechanical, psychosocial, and therapeutic aspects. Objective: To systematically review, synthesize, and critically evaluate the most recent scientific evidence on morphological characteristics, epidemiological patterns, diagnostic methodologies, biomechanical and functional alterations, psychosocial impacts, and conservative and surgical treatment strategies for scoliosis. Methods: This systematic review followed the PRISMA 2020 guidelines and the Whittemore and Knafl integrative method. A structured search was conducted in PubMed, Scopus, Science Direct, Springer Link, and Web of Science databases for studies published between 2015 and 2025. The selection process included independent screening, eligibility assessment, data extraction, and methodological quality appraisal using the Joanna Briggs Institute tools. Results: Thirty-two studies were included. The evidence indicates significant morphological changes in vertebral structure, alterations in epidemiological prevalence rates, advancements in AI-based diagnostic techniques, detailed biomechanical models of stress distribution, functional respiratory and postural impairments, psychosocial distress in adolescents, and the efficacy of both conservative and surgical treatment modalities. Emerging technologies, especially artificial intelligence, are reshaping diagnostic precision and treatment planning. Conclusion: This review offers a comprehensive synthesis of the multidimensional aspects of scoliosis, highlighting the importance of early diagnosis, individualized treatment planning, multidisciplinary management, and the integration of new technologies to optimize patient outcomes.