In order to establish an effective treatment, it is necessary to be able to predict possible periods of progression (worsening) of scoliotic curvature. The greatest possibility for the occurrence or progression of an existing deformity is with rapid growth and development. The period of the fastest growth and development occurs in the first 5 years of life and during the adolescent period. The most common type of idiopathic scoliosis occurs in adolescence. We recognize pubertal growth and development by the first signs of breast development and pubic hair in girls, which can be accompanied by menarche (first menstrual cycle). In boys, a change (mutation) in the voice is noticed during this period.
During growth and development, in many cases, idiopathic scoliosis tends to progress. Factors influencing the progression of scoliosis include the location and size of the scoliotic curve at the Cobb angle, the rotation of the apical vertebra, and bone maturity. Bone maturity is determined by age, menarche, and Risser sign. Risser sign (ossification of the iliac pineal gland) is associated with the maturation of the vertebral body, which is why it is considered as very useful for assessing the growth rate of the spine. This sign is not helpful for children who are in the infantile or juvenile period. It is marked with grades from "0" (period from birth to the beginning of pubertal rapid growth) to "5" (end of pubertal growth and development). In girls who are in the pre-menarche period, the Riser sign is mostly "0", after which the Riser sign gradually progresses after menarche in girls, ie voice mutations in boys. As puberty varies, so can Risser sign vary from individual to individual. Another factor that is also correlated with the progression of scoliosis is the type of curvature. It has been proven that thoracic (thoracic) curves worsen more than lumbar ones.
It has been proven that as many as 52% of scoliosis that are in the period of growth and development (Risser 0-2) and which are NOT TREATED, and whose size is between 20 ° - 40 °, progress above the values for which surgery is recommended (> 50 °).
The progression of scoliotic curvature can be reduced or completely prevented by applying an adequate conservative approach. It has been proven that the use of Schroth conservative exercises and the application of 3D brace significantly reduces the risk of scoliosis progression. In order to achieve the most effective results in stopping the progression of scoliotic curvature, with Schroth treatment should be started as soon as possible.