In order to set up an effective treatment plan and program, it is necessary to be able to predict possible periods of progression (worsening) of the scoliotic curve. The greatest possibility for the emergence or worsening of an existing deformity is during rapid growth and development. The period of 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 the adolescent period. Puberty growth and development can be recognized with the first signs of breast development in girls, which can also be followed by menarche (the first menstrual cycle). In boys, a change of the voice is observed during this period.

During growth and development, in many cases, idiopathic scoliosis tends to worsen. Factors influencing the progression of scoliosis include the location and magnitude of the scoliotic curve by Cobb angle, apical vertebral rotation, and bone maturity. Bone maturity is determined by age, menarche, by determining Risser’s sign. Risser’s sign (ossification of the iliac epiphyses) is associated with the maturation of the vertebral bodies, which is why it is considered very useful for assessing the growth rate of the vertebral column. This sign is not helpful to us in children who are in the infantile or juvenile period. It is marked with grades from “0” (the period from birth to the beginning of the pubertal growth spurt) to “5” (the end of pubertal growth and development). In girls who are in the pre-menarche period, the Risser sign is usually “0”, after which the Risser sign gradually progresses after menarche in girls and voice change in boys. Just as puberty varies, Risser’s sign can also be different from individual to individual. Another factor that is also correlated with the progression of scoliosis is the type of curve. It has been proven that thoracic (upper back) curves deteriorate more than lumbar curves.

It has been proven that as many as 52% of scoliosis that is in the period of growth and development (Risser 0-2) and that is NOT TREATED, and whose magnitude is between 20°-40°, progresses above the values for which surgery is recommended (>50°).

The progression of the scoliotic curve 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 braces significantly reduces the risk of scoliosis progression. In order to achieve the most effective results in stopping the progression of the scoliotic curve, it is necessary to start the Schroth treatment as soon as possible.