Contemporary Advances in Adolescent Idiopathic Scoliosis: Precision Assessment, Individualized Nonoperative Care, and Evolving Surgical Strategies

Dr. Nishant

Abstract: Purpose: Adolescent idiopathic scoliosis (AIS) management is moving from threshold-based algorithms toward individualized estimation of progression risk, treatment response, and patient priorities. This narrative state-of-the-art review critically summarizes recent developments in assessment, bracing, physiotherapeutic scoliosis-specific exercises (PSSE), radiation-sparing surveillance, artificial intelligence (AI), vertebral body tethering (VBT), and posterior spinal fusion (PSF). Methods: PubMed/MEDLINE and major society and regulatory sources were narratively reviewed, emphasizing randomized trials, prospective multicenter studies, systematic reviews, and guidance published from 2019 through August 2026. Seminal earlier studies were retained when necessary to define current standards. Because this was a narrative review of published literature, institutional review board approval was not required. Results: Full-time thoracolumbosacral orthosis remains the reference nonoperative treatment for skeletally immature patients at meaningful risk of progression, but nighttime hypercorrective bracing is supported as a pragmatic alternative for selected flexible curves or patients who reject full-time treatment. Objective wear monitoring and early in-brace correction increasingly guide brace optimization. PSSE produces small improvements in deformity and quality-of-life measures and is best considered an adherence-dependent adjunct; digitally supervised programs may improve delivery. Growth assessment increasingly combines Sanders or distal radius-ulna staging with curve magnitude and growth velocity. AI can automate radiographic measurements and prediction tasks, but limited external validation precludes autonomous clinical use. VBT preserves motion and can achieve satisfactory correction in carefully selected immature patients, although tether failure and unplanned reoperation remain important limitations. PSF remains the most predictable operation for progressive surgical-range AIS; current innovation focuses on three-dimensional alignment, selective fusion, navigation, patient-specific rods, blood conservation, and enhanced recovery. Conclusions: The most mature advances in AIS care are not wholesale replacements for established treatment, but tools that improve patient selection, adherence, surveillance, and perioperative recovery. Shared decision-making should explicitly distinguish proven benefits from promising technologies whose long-term comparative effectiveness remains uncertain.

Keywords: adolescent idiopathic scoliosis; bracing; scoliosis-specific exercise; vertebral body tethering; posterior spinal fusion; artificial intelligence

How to Cite?: Dr. Nishant, "Contemporary Advances in Adolescent Idiopathic Scoliosis: Precision Assessment, Individualized Nonoperative Care, and Evolving Surgical Strategies", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 2025-2029, https://www.ijsr.net/getabstract.php?paperid=SR26829095745, DOI: https://dx.doi.org/10.21275/SR26829095745

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