Treatment of Idiopathic Scoliosis in Adolescents (Age 10–17) with Cobb Angle Above 20° and Curve Progression
In adolescents aged 10 to 17 with idiopathic scoliosis, a Cobb angle between 20° and 45°, skeletal immaturity (Risser sign 0 to 3), and demonstrated curve progression or elevated risk of worsening, active intervention is warranted to prevent the curve from reaching surgical range.
Clinical scenario: A growing adolescent (Risser 0–3) presenting with idiopathic scoliosis, Cobb angle above 20° but below 45°, and evidence of deformity progression — a combination that calls for a structured conservative treatment approach.
Treatment approach: The protocol involves a corrective orthotic intervention worn for an extended daily period throughout the remaining growth phase, combined with physiotherapeutic scoliosis-specific exercises. The complete regimen — including the wearing schedule, the exercise programme, and the step-down strategy — is specified in the structured protocol.
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.
- Bracing is recommended to treat adolescent idiopathic scoliosis.
- It is recommended that braces are worn until the end of vertebral bone growth and then the wearing time is gradually reduced, unless otherwise justified in the opinion of a clinician specialized in conservative treatment of spinal deformities.
- It is recommended that physiotherapeutic scoliosis-specific exercises are performed during brace treatment.