Idiopathic Scoliosis in Infants (Age 0–2 Years) with Cobb Angle 10° or Higher

This protocol addresses idiopathic scoliosis presenting within the first two years of life where the spinal curve has reached or exceeded a Cobb angle of 10°. This age group carries a distinct prognosis from later-onset scoliosis and warrants its own dedicated management pathway.

Clinical Scenario

Age 0–2 years • Idiopathic scoliosis • Cobb angle ≥10°

The Scoliosis Research Society confirms diagnosis when the Cobb angle is 10° or higher and axial rotation is recognizable. Infantile scoliosis — while sometimes grouped with juvenile forms under "early onset scoliosis" — has a different natural history and prognosis, and is treated accordingly.

Treatment Approach

Management in this age group centres on a corrective casting approach applied serially over time; the complete protocol — including sequencing, transition criteria, and subsequent steps — is detailed in the full regimen.

Clinical Targets

The goals of treatment are resolution of the spinal curve to a Cobb angle below 10°, or stabilization at an acceptable Cobb angle while maintaining normal pulmonary function.

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References

DOI: 10.1186/s13013-017-0145-8

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.
Casting (or rigid bracing) is recommended to treat infantile idiopathic scoliosis to try stabilizing the curve.
Casts are used by some schools as the first stage to achieve correction to be maintained afterwards with rigid brace; a cast is considered a standard approach in infantile scoliosis.

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