What does the US public think of scoliosis: a comprehensive crowd-sourced study of perceptions about adult spinal deformity.

purposeThe United States (US) adult population's baseline knowledge and perceptions of adult spinal deformity (ASD) are unknown. This study employs crowdsourcing to evaluate public perceptions regarding ASD.

methodsThis is a survey-based study comprising a representative sample. A multiple-choice survey was administered through the CloudResearch platform and participants were matched for age, sex, and other demographics to reflect the current US census.

results1000 participants were included with a mean age of 45.3 ± 16.1 years. Respondents ≥ 65 years old were significantly more likely to never have been screened for scoliosis compared to the 18-64 cohort (62% vs. 38%; p < 0.05). The majority of respondents (54%) correctly responded that X-ray is the typical diagnostic tool. Primary treatment modalities thought most useful by participants were physical therapy (80%) followed by spinal braces (66%). In terms of surgical treatment, 61% stated that fusion surgery was the typical treatment whereas 51% felt that motion-preserving surgery with disc replacement was a viable treatment option. Participants were most likely to identify orthopedic surgeons (81%) as most likely to treat ASD, followed by physical therapists (75%). The majority (80%) believed that surgery was effective treatment and only 4% believed that surgery was ineffective. Respondents ≥ 65 years old were significantly more likely to rely on primary-care referral (95% vs. 89%; p < 0.05) for selecting a surgeon and less likely to rely on health insurance, hospital name, and social media. The majority of respondents (73%) expected to return to baseline after surgery with only some minor limitations. Only 2% of respondents thought that the rate of any complication or likelihood of reoperation was ≥ 50%.

conclusionThis study is the first of its kind to utilize an online crowd-sourced survey to comprehensively investigate perceptions of ASD and demonstrates a trend toward significantly lower scoliosis screening rates in respondents > 65 years old. While awareness was relatively high in domains, such as symptoms, diagnosis, and treatment, common misconceptions persisted regarding disease pathophysiology, expected recovery, complications, and pain; areas where perceptions underestimated risks compared with published outcomes. These findings highlight important knowledge gaps that may influence care-seeking behavior, referral patterns, and expectation management, demonstrating the need for targeted educational initiatives.