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Clinical Advances of Adolescent Idiopathic Scoliosis: Current Status and Prospects

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Dear Colleagues,

Adolescent idiopathic scoliosis (AIS) is a significant clinical concern, with its management requiring ongoing research and innovation. This spinal deformity poses challenges not only due to its impact on quality of life but also due to the complexities in treatment and long-term care. The continued advancement of clinical practices and research efforts is important to improving outcomes for those affected by AIS.

The Special Issue titled “Clinical Advances of Adolescent Idiopathic Scoliosis: Current Status and Prospects” aims to collect the latest advancement in the diagnosis, treatment, and overall management of AIS. Recent years have seen a surge in innovative approaches, from enhanced bracing techniques and surgical advancements to the incorporation of digital health technologies, such as 3D imaging, neurophysiology, and motion analysis, which are helping to refine treatment precision and patient monitoring. This issue will deepen key areas of clinical progress, including non-invasive therapies, surgical strategies, and the evolving role of rehabilitation in AIS care. Additionally, research advances exploring long-term outcomes, treatment optimization, and the integration of innovative approaches will be highlighted to offer a comprehensive view of the current landscape and future directions.

We invite contributions from experts in AIS research and clinical practice to share their findings.

Dr. Maria Chiara Maccarone
Prof. Dr. Stefano Masiero
Guest Editors

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13 pages, 601 KiB

Open AccessArticle

Hidden Asymmetries: Leg Length Discrepancy and Breast Asymmetry in Adolescent Scoliosis and Postural Disorders—A Cross-Sectional Study

by Nicola Manocchio, Roberta Marini, Concetta Ljoka, Laura Giordani, Isabella Iovene, Giulia Vita and Calogero Foti

J. Clin. Med. 2025, 14(11), 3793; https://doi.org/10.3390/jcm14113793 - 28 May 2025

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Abstract

Background/Objectives: Morphological spinal alterations in adolescents, including idiopathic scoliosis (IS) and postural scoliotic attitudes (paramorphisms), may be associated with leg length discrepancy (LLD) and breast asymmetry (BA). This study aimed to assess the prevalence and characteristics of LLD and BA in adolescents with spinal paramorphisms and dysmorphisms (IS), and to explore associations between these asymmetries and spinal curve features. Methods: A cross-sectional observational study was conducted. Adolescents aged 10–18 years were included. LLD was measured clinically via direct tape measurement and, when necessary, ultrasound. BA was assessed via visual inspection. Spinal deformities were characterized via clinical and radiological examination. Results: Among the 44 participants, 26 (60%) had IS and 18 (40%) had postural scoliotic attitudes. LLD was present in 79.5% (mean 0.7 ± 0.6 cm; all mild). BA was observed in 14% of the sample. LLD was more frequent in IS (87%) than in postural scoliotic attitudes (72%). In lumbar postural curves, the shorter limb was consistently ipsilateral to the curve convexity. In IS, no consistent association was found between LLD and curve characteristics. BA was slightly more prevalent in IS (19%) than postural scoliotic attitudes (17%), with no consistent pattern relative to curve convexity. Conclusions: Mild LLD is common in adolescents with spinal asymmetries and reflects general population norms. While LLD may influence compensatory postural curves, it does not appear to affect IS curve patterns or severity. BA is more frequent in IS, but shows variable association with curve features. Considering LLD and BA prevalence in adolescents with spinal asymmetries routine assessment is warranted, though their impact on IS progression is limited. Full article

(This article belongs to the Special Issue Clinical Advances of Adolescent Idiopathic Scoliosis: Current Status and Prospects)

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7 pages, 450 KiB

Open AccessCommunication

Training for Radiographic Assessment of Scoliosis: A Pilot Educational Study

by Mirko Filippetti, Sofia Tomasello, Rita Di Censo, Angela Modenese, Dalila Scaturro, Giulia Letizia Mauro, Valentina Varalta, Nicola Smania and Alessandro Picelli

J. Clin. Med. 2025, 14(3), 911; https://doi.org/10.3390/jcm14030911 - 30 Jan 2025

Viewed by 746

Abstract

Background: Given the prevalence of scoliosis, it is essential for residents in Physical and Rehabilitation Medicine to develop proficiency in evaluating spinal radiographs, particularly in measuring the Cobb angle. This education and training study aimed to define the minimum educational requirements for residents to achieve competency in Cobb angle measurement with acceptable inter- and intra-operator variability, as reported in the literature. Methods: In this ethics-approved study, Physical and Rehabilitation Medicine residents measured Cobb angles and the Risser index using specialized software on 30 different spinal X-rays, with oversight to ensure consistency and eliminate bias. Results: The data revealed that 44.4% of residents achieved the target accuracy for primary Cobb angles (<3.6°), but only 11.1% did so for secondary curves. For intra-operator error, 88.9% of residents met the target for primary curves, but only 11.1% achieved the target for secondary curves. The Risser index showed minimal deviation across all participants. Conclusions: These findings highlight that mastering Cobb angle measurement is challenging and generally requires more than 20 different measurements for inter-operator reliability and over 30 repetitions for intra-operator reliability, particularly when secondary curves are included. Full article

(This article belongs to the Special Issue Clinical Advances of Adolescent Idiopathic Scoliosis: Current Status and Prospects)

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