Radiological and cosmetic improvement 2 years after brace weaning--a case report

In the early international literature, up to now only very few cases are reported with adolescent idiopathic scoliosis (AIS) and a significant improvement of Cobb angle after conservative management. In the recent literature the possibility of an improvement of Cobb angle at skeletal maturity after brace treatment is mentioned no more. The application of physiotherapy and braces is widely rejected while the standards of conservative measures differ greatly worldwide. So it seems necessary more than ever to present the possibility of successful conservative measures nowadays. More detailed case reports with long-term follow-up using defined protocols are needed to provide appropriate standards for replication by others. The purpose of this presentation is to demonstrate the possibility of significant improvement of curvature angle and cosmesis after the application of long-term physiotherapy and brace treatment in a girl with a curve of more than 50 degrees where spontaneous resolving is not usual. A pre-menarchial girl (although being Risser 2) with a Cobb angle of 53 degrees was treated by exercises and curve-specific bracing for more than 3 years. Two years after the start of the weaning period, the Cobb angle was 36 degrees with a marked and stable cosmetic improvement at the age of 18 years. This case report shows that conservative treatment can improve both cosmesis and curvature in immature patients with AIS. The results of such treatment is appreciated by the patients because of the significant reduction of the truncal deformity as documented by surface topography.