Biomechanical aspects of idiopathic scoliosis evolution

Background In patients with idiopathic scoliosis, the interaction between biological and mechanical factors plays a central role in the evolution of deformities. According to the “vicious cycle model” of scoliosis evolution, the asymmetric load on the spine is the main factor driving the onset and development of deformities by altering the vertebral growth dynamics. Hence, once a critical asymmetric load has established, the progression of deformity is unavoidable, unless a compensatory force is applied to offset the biomechanical effects of growth [1,2]. Here, we present a case series of adolescents with idiopathic scoliosis, in whom a normal vertebral morphology was achieved before the end of growth, who withdrew from the orthotic treatment during the growing age and maintained the correction over a 5-year follow-up.