Idiopathic scoliosis arising in the first two years of life is a distinct clinical entity with its own prognosis and management pathway. When the Cobb angle meets or exceeds the diagnostic threshold, a structured active protocol is indicated from the outset.
This protocol applies to infants and toddlers aged 0 to 2 years with a confirmed diagnosis of idiopathic scoliosis where the Cobb angle is 10° or higher and axial rotation is recognisable — the diagnostic criteria established by the Scoliosis Research Society (SRS).
Infantile scoliosis carries a meaningfully different prognosis from juvenile-onset forms. Although the broader label "early onset scoliosis" is sometimes applied to both, the infantile classification is maintained here given the distinct natural history of this age group.
Management in this age group begins with a structured observational approach — the first step of active clinical engagement — consisting of scheduled evaluations at defined intervals with specific physical examination components.
The full protocol — including the specific evaluation components, follow-up timing, and criteria for escalation — is available via the link below.
Today, the general term "Early onset scoliosis" is sometimes used to classify together Infantile and Juvenile scoliosis, but we prefer the James classification, due to the fact that infantile scoliosis has a different prognosis.
The Scoliosis Research Society (SRS) suggests that the diagnosis is confirmed when the Cobb angle is 10° or higher and axial rotation can be recognized.
Observation: It is the first step of an active approach to idiopathic scoliosis, and it consists of regular clinical evaluation with a specific follow-up period.
Timing of this follow-up can range from 2 to 3 to 36–60 months according to the specific clinical situation.
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