Objective To understand the epidemiological characteristics of scoliosis in primary and secondary school students in Zhejiang province, identify related influencing factors and provide evidence for the prevention and control of scoliosis.

Methods A stratified random cluster sampling method was used to select 176 primary and secondary schools from 11 prefectures in Zhejiang from September to November 2021. A questionnaire survey was conducted in 31308 primary and secondary school students aged 9–17 years. The dtection of scoliosis was carried out in accordance with the “Guideline for Screening of Abnormal Spinal Curvature in Children and Adolescents” (GB/T 16133－2014). Statistical analysis was conducted by using software SPSS 17.0. The incidence of scoliosis was compared with χ² test, and the influencing factors were identified by logistic regression analysis.

Results Scoliosis was detected in 1084 primary and secondary school students in Zhejiang, the detection rate was 3.46%. The detection rate in girls was 4.24%, higher than that in boys (2.75%) (χ²=52.33, P<0.001). The detection rate in urban area was 4.49%, higher than that in suburban area (2.10%) (χ²=131.35, P<0.001). The detection rate of scoliosis increased with the increase of school grade, with the highest detection rate in senior high school students (5.51%), followed by that in junior high school students (4.12%) and primary school students (1.40%) (χ²=269.31, P<0.001). Multivariate Logistic regression analysis showed that being girl odds ratio (OR)= 1.54, 95% confidence interval (CI ): 1.36–1.74), living in suburban (OR=0.47, 95%CI : 0.41–0.54), being junior high school student (OR= 2.87, 95%CI: 2.39–3.45), being senior high school student (OR=2.87, 95%CI: 2.39–3.45), moderate economy status (OR=1.68, 95%CI: 1.45–1.94), Underdevelopment (OR=1.29, 95%CI: 1.09–1.52), ＞2 hours home work time (OR=1.18, 95%CI: 1.01–1.38), >3 hours (OR=1.29, 95%CI: 1.08–1.53), interval of 0.5 hours between home work (OR=1.20, 95%CI: 1.04–1.38), >2 hours (OR=1.25, 95%CI: 1.02–1.53) were the factors influencing the prevalence of scoliosis in primary and secondary school students in Zhejiang (All P<0.05).

Conclusion There were gender, area and school grade specific differences in the detection rate of scoliosis in primary and secondary school students in Zhejiang. It is necessary to pay close attention to girl students, urban students and secondary school students, actively control the influencing factors for scoliosis, and carry out targeted interventions to reduce the incidence of scoliosis in primary and secondary school students.