Treatment of Idiopathic Scoliosis in Adolescents (Ages 10–17) with Cobb Angle Above 20° and Demonstrated Curve Progression
Clinical Scenario
This protocol addresses idiopathic scoliosis in patients aged 10 to 17 years, with a Cobb angle between 20° and 45°, skeletal immaturity (Risser sign 0–3), and either demonstrated curve progression or an elevated risk of worsening.
Why This Situation Requires Structured Management
In skeletally immature adolescents, curves in this range with active growth potential carry a meaningful risk of continued deformity. Structured, timely intervention is indicated to reduce that risk before skeletal maturity is reached.
Treatment Approach — Partial Overview
The first-line intervention centres on physiotherapeutic scoliosis-specific exercises. The full protocol specifies the exact components, structure, and clinical decision pathway that guide management in this population.
Treatment goal: spinal Cobb angle stabilization, with curve progression of 5° or less.
References
DOI: 10.1186/s13013-017-0145-8
- Bracing is recommended to treat patients with curves above 20° ± 5° Cobb, still growing (Risser 0 to 3), and with demonstrated progression of deformity or elevated risk of worsening, unless otherwise justified in the opinion of a clinician specialized in conservative treatment of spinal deformities.
- The use of brace is recommended in patients with evolutive idiopathic scoliosis above 25° during growth; in these cases, PSSE alone (without bracing) should not be performed unless prescribed by physicians expert in scoliosis.
- Physiotherapeutic scoliosis-specific exercises are recommended as the first step to treat idiopathic scoliosis to prevent/limit progression of the deformity and bracing.
- It is recommended that physiotherapeutic scoliosis-specific exercises follow SOSORT Consensus and are based on auto-correction in 3D, training in ADL, stabilizing the corrected posture, and patient education.
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