Contemporary Management of Pediatric Idiopathic Scoliosis: From Scoliosis-Specific Exercise and Bracing to Growth-Modulating Vertebral Body Tethering
Keywords:
adolescent idiopathic scoliosis; bracing; Schroth exercise; vertebral body tethering; spinal fusion; growth modulation; pediatric orthopedicsAbstract
Pediatric idiopathic scoliosis is the most common structural spinal deformity of childhood and adolescence, and its management has shifted substantially over the past decade toward individualized, growth-aware strategies. This review summarizes the contemporary spectrum of care, spanning observation, physiotherapeutic scoliosis-specific exercises, rigid bracing, and surgical correction. We give particular attention to two converging trends: the integration of Schroth-type exercise with reduced brace-wear regimens for mild-to-moderate curves, and the rise of vertebral body tethering as a motion-sparing, fusion-sparing alternative for skeletally immature patients with larger curves. Evidence indicates that bracing reliably reduces progression to surgical thresholds, that combined exercise-and-brace protocols improve curve and quality-of-life outcomes, and that tethering can achieve meaningful correction while preserving spinal mobility, albeit with non-trivial reoperation rates. Patient selection, skeletal maturity, and adherence remain decisive. We propose a maturity-anchored treatment framework and outline priorities for higher-quality comparative research.
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