Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis in children between the ages of 10 and 16. Nevertheless, risk factors for AIS, especially adjustable ones, are still poorly understood. This study seeks to examine the associations of lifestyle and social environment factors with AIS in Syrian schoolchildren. This matched case-control study uses survey data from a school-based scoliosis screening approach. We utilized logistic regression models to estimate the relative risk of AIS prevalence for each variable in the analysis. A multivariate logistic regression was performed to investigate the independent influence of each component on AIS development, with odds ratios (ORs) adjusted for the important factors. Overall, 1102 participants from 22 schools were included in this study, comprising 551 AIS cases and 551 controls. Mean age of the study population was 13.5 years ± 1.08. Six hundred and twenty (56.3%) of the study subjects were girls. After adjusting for other significant factors, age between 13 and 15 years (OR = 2.45; 95% CI, 1.37–6.17), inappropriate desk heights, either too low (OR = 1.53, 95% CI 1.12–1.85) or too high (OR = 1.46, 95% CI 1.13–1.87), standing with anterior pelvic tilt (OR = 1.97, 95% CI 1.46–3.43), and sleeping on the right side (OR = 1.92, 95% CI 1.54–2.23), remained associated with elevated AIS risks. In contrast, sitting normally and classroom sitting positions change regularly were associated with lower odds of AIS. The adjusted ORs were 0.73 (95% CI 0.43–0.94) for sitting normally, and 0.63 (95% CI 0.31–0.97) for sitting positions change. This study investigated the correlation between desk heights and AIS and revealed that incorrect desk heights were associated with more AIS risk. To prevent schoolchildren from developing AIS, stakeholders should consider installing height-adjustable desks in the classroom, changing students’ sitting positions on an ongoing basis, and establishing training courses that assist students in keeping proper sitting postures.
