This protocol addresses patients aged 10 to 17 years with idiopathic scoliosis and a Cobb angle between 45° and 60°. At this curve range, conservative intervention is recommended with the goal of avoiding surgical escalation. Curves exceeding 50° carry a well-established risk of ongoing progression into adulthood and associated reduction in quality of life.
Management at this curve magnitude involves very hard rigid bracing or corrective casting, combined with physiotherapeutic scoliosis-specific exercises — the complete regimen, full wearing protocol, and structured combination approach are detailed in the protocol below.
The clinical target is a spinal Cobb angle remaining below 50° at the end of treatment, with curve improvement or stabilization as the primary measure of success.
DOI: 10.1186/s13013-017-0145-8
Very hard rigid bracing (casting) is recommended to treat patients with curve between 45° and 60° to try avoiding surgery.
Over 50°, there is a consensus that it is almost certain that scoliosis is going to progress in adulthood and cause health problems and reduction of quality of life.
Full Time Rigid Bracing (20–24 h per day) or cast (FTRB): wearing a rigid brace all the time (at school, at home, in bed, etc.).
Recently, a new brace has been developed that has been claimed to achieve same results as casting.
It is recommended that physiotherapeutic scoliosis-specific exercises are performed during brace treatment.
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