What is each care option for?
Choose a topic to explore its goal, how it works and a question to ask. These approaches can complement one another: they are not four compulsory stages.
Monitoring
Identifying change at the right time.
Appointments compare growth, the shape of the back, symptoms and imaging when needed. Their frequency is adapted to the situation.
Monitoring is an active form of care. It does not mean that the back is being ignored or that surgery will be needed later.
Bracing
Limiting progression during growth.
A brace applies pressure tailored to the shape of the back. Its benefit depends in particular on remaining growth, its fit and the actual time spent wearing it.
The type of brace and wearing schedule are prescribed individually. This diagram cannot be used to select a brace or calculate how long to wear it.
Exercises
Learning better control of the trunk.
Specific exercises include self-correction and postural control; some methods incorporate breathing techniques. They are adapted with a trained professional.
The benefits for the curve remain less certain than those of bracing when a brace is indicated. Exercises can complement care but do not replace a prescribed brace.
Surgery
Correcting and stabilising selected severe deformities.
Spinal fusion combines implants with bone fusion along part of the spine. It is used in selected situations after specialist discussion.
Surgery is not decided on a single measurement. Goals, risks, mobility and recovery are discussed with the young person and their family.
Simplified diagrams. Decisions take into account the type of scoliosis, its progression and remaining growth. This tool explores care options; it does not prescribe treatment.
05Monitoring to act at the right time
Some scoliosis curves can initially be monitored. Appointments assess growth, the shape of the back, symptoms and, when useful, changes on X-rays. Their frequency is adapted to the risk of progression; appointments may be closer together during periods of rapid growth.
Monitoring helps identify changes that could alter the care plan. Mild, stable scoliosis can be compatible with an active life. Follow-up after growth depends in particular on the remaining curve and symptoms, and is planned with the care team.
06What a brace is for
The main aim of a brace is to limit progression during growth. It is made and fitted to the shape of the child’s back. In a landmark trial, bracing increased the chance of reaching skeletal maturity without developing a large curve. Its effectiveness depends in particular on its fit and actual wearing time.
The type of brace, wearing schedule and overall treatment duration are prescribed individually. Some braces are worn mainly at night; others for much of the day. Pressure points, pain or difficulties at school should be discussed so that support can be adapted. Stopping brace treatment is planned with the specialist.
07Staying active and understanding the role of exercises
Idiopathic scoliosis does not mean that sport must stop. Physical activity supports fitness and well-being. Scoliosis alone does not justify blanket restrictions on asymmetric sports or weight-bearing activities; any adjustments depend on individual circumstances.
Scoliosis-specific exercises, such as those used in the Schroth method, teach trunk self-correction and postural control. They can complement care, but the quality of the evidence remains limited. They cannot guarantee that scoliosis will disappear and do not replace a brace when one is needed.
08When surgery may be discussed
Surgery may be considered when a deformity becomes severe or continues to progress. The specialist considers the curve pattern, growth, treatments already tried and their impact on the young person’s life. The decision is made together with the adolescent and their family.
Spinal fusion corrects and stabilises part of the spine using implants followed by bone fusion. Techniques that preserve more movement, such as vertebral body tethering, are available for selected situations, but have their own limitations and risks of further surgery. Choosing an approach requires a detailed discussion of expected benefits and constraints.
09Before the age of ten: a different care pathway
Scoliosis that appears before the age of ten is classified as early-onset scoliosis. It requires specialist assessment because its causes and progression may differ from adolescent scoliosis. The assessment looks for a malformation or an associated condition when these are suspected.
Treatment must take account of the growth of the chest and lungs. Depending on the situation, the team may recommend serial casting, a brace or surgical techniques that accommodate growth. Findings from studies in adolescents cannot automatically be applied to these younger children.
Prepare my questions about bracing, sport and follow-up
Frequently asked questions
Why are some scoliosis curves only monitored?
For some curves, monitoring progression is the appropriate form of care. Appointment frequency is individualised, particularly according to remaining growth. A change may prompt a review of the care plan.
How many hours a day should a brace be worn?
There is no single wearing time that applies to every brace and every scoliosis curve. Follow the care team’s prescription and discuss any difficulties so that solutions can be found. Some protocols involve night-time wear, while others cover much of the day.
Can physiotherapy replace a brace?
Specific exercises can complement care. The available evidence does not support presenting them as a replacement for a prescribed brace or as a guarantee that scoliosis will disappear.
Is surgery automatic above a certain angle?
The decision requires an individual specialist assessment. The size of the deformity matters, alongside its progression, growth and previous treatment. The young person and their family discuss expected benefits and risks with the care team.
Sources and medical references
- F02. HAS — Physician’s guide, ALD 26: Progressive structural scoliosis (in French) — February 2008 · §2.4, pp.5–6; §3.4, pp.8–9; §4.3–4.5, pp.10–11 (printed page numbers).
- F07. Assurance Maladie — Scoliosis treatment (in French) — 11 September 2025 · Bracing; surgical treatment.
- F08. Assurance Maladie — Scoliosis: medical follow-up and daily life (in French) — 2 December 2025 · Follow-up; daily life; wearing a brace.
- F04. HAS — Focus: Physical activity, health conditions and diseases in children (in French) — Validated on 16 October 2025 · §6.3.3 Scoliosis, pp.25–26, particularly p.26.
- F05b. PNDS: Early spinal deformities — Summary for the primary care physician (in French) — September 2022 · p.2; reference centre document, hosted but not validated by HAS.
- E01. Weinstein SL et al. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med. 2013;369:1512–1521..
- E02. Charalampidis A et al. Nighttime Bracing or Exercise in Moderate-Grade Adolescent Idiopathic Scoliosis. JAMA Netw Open. 2024;7:e2352492..
- E03. Cheung PWH et al. Immediate vs Gradual Brace Weaning Protocols in Adolescent Idiopathic Scoliosis. JAMA Pediatr. 2024;178:657–668..
- E04. Monticone M et al. Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life… Eur Spine J. 2014;23:1204–1214..
- E05. Schreiber S et al. Schroth Physiotherapeutic Scoliosis-Specific Exercises Added to the Standard of Care Lead to Better Cobb Angle Outcomes… PLoS One. 2016;11:e0168746..
- E06. Romano M et al. Therapeutic exercises for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev. 2024;CD007837..
- E07. Weinstein SL et al. Health and Function of Patients With Untreated Idiopathic Scoliosis. JAMA. 2003;289:559–567..
- E12. Lenke LG et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83:1169–1181..
- E13. Newton PO et al. Anterior Vertebral Body Tethering Compared with Posterior Spinal Fusion for Major Thoracic Curves. J Bone Joint Surg Am. 2022;104:2170–2177..
- E14. Mehta MH. Growth as a corrective force in the early treatment of progressive infantile scoliosis. J Bone Joint Surg Br. 2005;87:1237–1247..
- E15. Saarinen AJ et al. Traditional versus magnetically controlled growing rods for idiopathic early-onset scoliosis: outcomes at 5-year follow-up. Spine J. 2026;26:173–179..
- I01. Scoliosis Research Society — Surgery — Page accessed on 11 October 2026 · International patient information on surgery; this is not a French recommendation.