Idiopathic scoliosis is a disorder of the growing spine ( 1). Keywords: Idiopathic scoliosis puberty growth spurt anticipation bone age Treating these curves earlier than the surgical threshold before increased stiffness would lead to a better outcome. In these patients, anticipation may be the key for effective treatment strategy. Progression risk assessment of idiopathic scoliosis showed that a 30° curve at the beginning of puberty together with 20° to 30° curves with more than 10° of annual curve progression has a 100% risk of progression towards the 45° surgical threshold. Bone age during this phase is evaluated by hand X-rays and the Risser sign. Growth acceleration is followed by a deceleration phase of three years where menarche occurs. Lateral olecranon radiograph is effective for estimating bone age during this phase. The first two years following puberty are the turning point in the natural history of this disease since 90% of growth occurs during this period. Puberty is the turning point in the natural history of this disease.
Remaining growth can be estimated by repeated biometric measurements, tanner sign and bone age estimation. Risk of progression and aggravation of disease are mainly dictated by the remaining growth and curve magnitude. Abstract: Idiopathic scoliosis is a disease of the growing spine.