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Idiopathic Scoliosis

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About Idiopathic Scoliosis

Scoliosis is commonly recognized as a lateral curvature of the spine, although the deformity is three-dimensional and typically involves coronal curvature, vertebral rotation, and changes in sagittal alignment. Curves may occur at any spinal level and vary in magnitude and clinical significance.

Scoliosis may result from identifiable structural, neuromuscular, or syndromic causes, or it may occur without a clearly identifiable underlying mechanism. Idiopathic scoliosis, diagnosed by exclusion, accounts for approximately 80% of cases and most commonly presents during adolescence, particularly during periods of rapid growth.

Clinical impact is variable. Many individuals remain asymptomatic or experience minimal functional limitation, while others may develop pain, cosmetic concerns, respiratory compromise, or progressive functional impairment. Larger curves, particularly those exceeding approximately 30–50 degrees after skeletal maturity, are associated with an increased risk of reduced quality of life and long-term functional limitations.

The natural history and management of idiopathic scoliosis are influenced by age at presentation, growth potential, curve magnitude, and curve pattern. As a result, management strategies differ across the lifespan, and evidence from skeletally immature populations is not always generalizable to adults.

About CCG Care Pathways

Purpose

CCG is a knowledge translation resource of the Canadian Chiropractic Association. Its care pathways help chiropractors and other clinicians organize conservative care for musculoskeletal conditions. Each pathway outlines the main steps of the clinical encounter and supports decisions about assessment, care, monitoring, referral, co-management, and discharge. The pathways provide a structured approach to care, not a fixed prescription.

Development

Pathways draw on relevant clinical practice guidelines, systematic reviews, peer-reviewed literature, and safety or professional sources. These sources inform, but do not determine, pathway content. Their findings reflect the questions, populations, outcomes, methods, and judgments used and may not apply to every person. Condition-specific sources are identified by author or organization and year, with full citations in one reference list at the end of the pathway.

Principles of Care

Musculoskeletal conditions are shaped by physical, psychological, social, cultural, and environmental factors, so no single approach fits everyone. Good care is ethical, evidence-informed, person-centred, culturally responsive, and tailored to the patient’s goals, preferences, circumstances, and response. Shared decision-making and informed consent guide care. Education, active rehabilitation, and self-management support recovery, functioning, participation, and long-term health. Regular reassessment shows whether the plan is helping and when to continue, adapt, stop, refer, co-manage, or discharge.populations.

Pathway Flow at a Glance

The pathway follows a recurring clinical cycle: understand the person and their goals; screen for safety and referral needs; develop a working clinical profile; agree on a plan and relevant outcomes; provide care; reassess response and safety; and continue, adapt, stop, refer, co-manage, or discharge as appropriate.

Disclaimer

CCG care pathways support professional clinical judgment; they do not replace it or the advice of a qualified provider. They are not prescriptive, authoritative, or regulatory and are not intended for diagnosis or billing. Clinicians remain responsible for practicing within their competence and scope, meeting applicable legal and regulatory requirements, obtaining informed consent, recognizing emergencies, and arranging referral or co-management when needed.

Idiopathic Scoliosis Care Pathway

1. Record Keeping

Accurate, timely, and sufficiently detailed documentation supports safe, high-quality care. The record should reflect clinically relevant patient interactions, clinical reasoning, decisions, care provided, and progress over time. Documentation should meet the legal, regulatory, privacy, retention, and organizational requirements that apply where the clinician practices. A structured format, such as SOAP, may support consistency, clarity, and continuity and can be adapted to the encounter and practice setting.

Subjective: Record the patient’s concerns, symptoms, functioning and participation, goals, preferences, relevant history and context, and response or adverse effects from previous care.

Objective: Record relevant examination findings, outcome measures, diagnostic test results when available, and clinically important changes.

Assessment: Record the clinical interpretation of findings, working diagnosis or clinical profile, differential and safety considerations, relevant risk factors or modifiers, and the patient’s progress or response.

Plan: Record care provided or proposed, education and self-management, consent and patient decisions, changes to the plan, agreed outcomes and reassessment point, referrals or co-management, follow-up, and discharge planning.

Document at the time of the encounter or as soon as practicable. Corrections and additions should preserve the integrity of the record. Clear records support patient safety, shared decision-making, communication, continuity, and accountability.

2. Informed Consent
  • Definition: A continuing process in which a capable patient, or an authorized substitute decision-maker when required, voluntarily agrees to a proposed examination or intervention after receiving and understanding the information needed to make an informed choice.
  • Key Aspects:
    • Prior to interaction: Obtain consent before beginning an examination, procedure, or treatment, except where applicable law permits otherwise. Explain what is proposed and why. Revisit consent when the plan or material information changes.
    • Voluntarily and specific: must be voluntary and specific to the proposed care. Consider the patient’s capacity for the decision at the time it is required and follow applicable requirements for substitute decision-making when the patient lacks capacity. The patient may ask questions, refuse, place limits on, or withdraw consent.
    • Transparent process: Use honest, plain, and accessible communication. Offer interpretation or other communication support when needed and consider language, culture, health literacy, disability, and prior trauma. Written or digital information may support but does not replace discussion.
    • Patient understanding and agreement:
      • Diagnosis/prognosis: Explain relevant findings, the clinical impression or working diagnosis, important uncertainty, and the expected course in understandable language.
      • Treatment plan: Discuss the nature and purpose of proposed care, expected benefits, material risks and side effects, burdens, reasonable alternatives, the option of no intervention, and the likely consequences of accepting or declining.
      • Questions: Invite questions, explore goals and preferences, allow appropriate time for a decision, and confirm understanding, for example using teach-back.
    • Documentation: Record the consent discussion and decision, including material information provided, questions, capacity or substitute decision-maker where relevant, consent, refusal, limits or withdrawal, and any need to revisit consent. Follow documentation requirements applicable to the jurisdiction and practice setting.
3. Health History
  • Apply cultural awareness and trauma-informed care principles.
  • Sociodemographic: Age (noting periods of rapid growth and skeletal maturity), gender, sex (progression more frequent in females), race/ethnicity.
  • Main concern: When and by whom the spinal asymmetry was first noticed; location and perceived rate of change; presence and characteristics of pain (location, intensity, frequency, radiation, aggravating or relieving factors); associated functional or cosmetic concerns.
  • Body systems: Maturation/growth (e.g., menarche in females, voice change in males, recent growth spurt); neurologic; cardiovascular; respiratory; genitourinary; gastrointestinal; muscles and joints; eyes/ears/nose/throat; skin; mental health; reproductive.
  • Health, lifestyle, family, social, and occupational history: Family history of scoliosis or neurologic or musculoskeletal disorders; relevant medical conditions; medications; prior injuries, hospitalizations, or surgeries; physical activity, sleep habits, and general health behaviours; family and caregiver supports; school or work environment.
  • Social determinants of health: Employment, education, childcare responsibilities, housing stability, nutrition, access to care, social supports, discrimination, isolation, and safety concerns including domestic violence or child maltreatment.
  • Previous treatments and responses: Prior screening, imaging, or treatment for scoliosis and response, including any adverse effects.
  • Beliefs and expectations: Understanding of scoliosis, expectations regarding monitoring or treatment, and individual or family goals.
  • Red, yellow, and orange flags: Screen for factors requiring urgent referral or further medical evaluation, as outlined in subsequent sections.

​​Outcomes Assessments:

  • Pain: Pain scales (e.g., NRS), pain diagram.
  • Function and Participation: Impact of scoliosis on daily activities (e.g., PSFS, WHODAS).
  • Quality of Life: Scoliosis-specific and generic measures as appropriate (e.g., SRS-22r, SF-12).
  • Individual Goals: SMART goal setting (Specific, Measurable, Achievable, Relevant, Timely).
  • Patient Feedback: Experience and satisfaction with care.
4. Red Flags : Differential Diagnosis Requiring Medical Referral

ACTION: Refer immediately to emergency care:

  • Suspected spinal infection
    Immunosuppression, recent infection or surgery, history of tuberculosis, unexplained fever or chills, intravenous drug use, or poor living conditions.
  • Acute traumatic spinal injury
    History of significant trauma with concern for spinal fracture or instability.

ACTION: Refer to appropriate medical provider:

  • Non-idiopathic scoliosis
    Features suggestive of congenital scoliosis (e.g., early onset, atypical curve patterns, rigid curves), neuromuscular disorders, or syndromic conditions.
  • Atypical curve patterns
    Left thoracic convexity, which is more commonly associated with underlying pathology (e.g., spinal cord tumors, Chiari malformation, syringomyelia).
  • Significant or atypical pain
    Pain that is severe, progressive, or disproportionate, as idiopathic scoliosis rarely presents with marked pain.
  • Neurological or cutaneous findings
    Neurologic deficits, abnormal reflexes, midline cutaneous lesions (e.g., hairy patches), café-au-lait spots.
  • Suspected malignancy or fracture
    Progressive pain, history of cancer, systemic symptoms (e.g., weight loss, fever), osteoporosis, corticosteroid use, or prior fracture.
5. Orange Flags: Symptoms of Psychiatric Disorders Requiring Referral

Orange Flags are signs that a mental health or substance use concern may require emergency or timely assessment or shared care, and may change whether and how MSK care proceeds. They are not diagnoses. Ask directly and respectfully when concern arises, considering immediate safety, severity, change from usual, daily functioning and context. Psychosocial factors that may affect recovery but do not require separate mental health or medical assessment are addressed under Yellow Flags.

ACTION: Arrange emergency assessment now when there is immediate danger or an urgent medical need:

  • Suicide, self-harm or harm to others: current intent or plan, a recent attempt, inability to stay safe, or behaviour suggesting an immediate risk of serious harm.
  • Severe change in mental state: extreme agitation, confusion, disorganization, possible psychosis or mania with impaired judgment or unsafe behaviour, or inability to meet basic needs when this creates immediate danger.
  • Substance-related or medical emergency: suspected overdose, severe intoxication, dangerous withdrawal, delirium or another sudden change requiring urgent medical care.

When immediate safety is uncertain, do not leave the person alone while help is arranged. Follow local emergency procedures and call 9-1-1 for immediate danger or urgent medical need. If the person is thinking about suicide, call or text 9-8-8: Suicide Crisis Helpline with them or support them to do so.

If violence, abuse or exploitation is disclosed or suspected, support immediate safety and follow applicable safety and reporting requirements.

ACTION: Arrange prompt medical or mental health assessment when there is:

  • Suicide or self-harm thoughts: thoughts without immediate danger.
  • Substantial symptoms or effects: severe, persistent or worsening symptoms of depression, anxiety, trauma, possible psychosis or mania, eating problems or substance use that substantially affect daily life, decision-making or safe participation in care.
  • Other reasons for assessment: a marked change from usual behaviour or functioning; concern about medication or substance effects; a presentation outside the clinician’s competence; or a request for help.

Agree with the patient on who will be contacted, how soon and what to do if the situation worsens. Confirm that the person has connected with the service when clinically important.

ACTION: Adapt and coordinate MSK care:

  • Safe care: care may continue when it is safe and acceptable and does not delay needed assessment. Adapt communication, examination and care; obtain ongoing consent; and coordinate with other providers with the patient’s permission.
  • Continue the MSK assessment: do not assume that a mental health or substance use concern explains the MSK presentation. Continue to consider physical causes and the patient’s account.
  • Questionnaires: they may support conversation and monitoring, but do not establish a diagnosis or replace direct questions, clinical judgment or action.
  • Acceptable support: ask what type of help is acceptable and whether language, cultural, family, community or other supports are important to the patient.

ACTION: Document and follow up:

Record the concern; relevant questions and the patient’s responses; the safety decision and reasons; actions, advice and referrals; communication and consent; follow-up; and any unresolved concern. Follow applicable privacy, safety and reporting requirements.

For provincial, territorial and national services, see Mental health support: Get help (Public Health Agency of Canada 2026).

6. Yellow Flags: Factors that May Affect Recovery or Participation

Yellow Flags are personal, social, work, school, healthcare, environmental or structural factors that may influence symptoms, functioning, participation or response to care. They are contextual, not diagnoses or certain predictions, and do not mean that symptoms are psychological. They guide how care is tailored and do not by themselves require urgent referral. Explore them through conversation and ongoing outcome review, with attention to the patient’s priorities, strengths and circumstances. A separate Yellow Flag score is not required. New or worsening signs of serious physical illness follow the Red Flag process. Mental health or substance use concerns that need separate assessment, or any immediate safety concern, follow the Orange Flag process and applicable emergency or safeguarding procedures.

Explore relevant factors:

  • Understanding, expectations and healthcare experiences: concerns about injury or damage, uncertainty, recovery expectations, confidence, conflicting advice, previous dismissal or harm, and trust in care.
  • Responses to symptoms and activity: worry, fear, avoidance, cycles of doing too much and then needing prolonged rest, difficulty pacing, coping, sleep, confidence in self-management, and return to meaningful activities.
  • Emotional and life context: distress, low mood, anxiety, grief, trauma, caregiving, relationship change, job loss or other major events. Ask permission before sensitive questions and limit discussion to what is relevant and acceptable to the patient.
  • Relationships, culture and strengths: supportive relationships, isolation, family and community roles, cultural or spiritual practices, identity, preferences, language and other sources of resilience.
  • Work, school and administrative context: physical and psychosocial demands, control, satisfaction, job security, accommodations, return concerns, and compensation, insurance or legal processes. Explore these neutrally and in context.
  • Social and structural conditions: consider social and structural determinants of health (Public Health Agency of Canada 2026), including income, housing, food security, transportation, childcare, access and cost of care, discrimination, racism, colonialism, neighbourhood and workplace conditions, and physical or digital accessibility.

ACTION: Respond with the patient:

  • Ask, do not assume: use open questions to understand what helps, what gets in the way, what matters and what feels feasible. Ask about strengths and protective factors, not only difficulties. Do not treat a person’s circumstances, culture or choices as a deficit.
  • Plan together: integrate relevant findings into shared goals, education, self-management, physical activity or exercise, and participation in meaningful activities. Adapt communication, setting, pace, cost and access where possible.
  • Connect and coordinate: with the patient’s consent, consider appropriate clinical, social, workplace, school, community, Indigenous or culturally specific supports. Clarify who will do what and follow up when the connection is important to the plan.
  • Review response to care: reassess the patient’s account and the pathway’s selected outcomes at clinically relevant points. If progress differs from expected, review the clinical impression, care plan, access and other barriers; do not automatically attribute the outcome to Yellow Flags.
  • Document: record relevant factors and strengths, the patient’s priorities and preferences, agreed actions, consent, referrals or coordination, follow-up, and any change requiring the Orange Flag process.
7. Physical Examination

General considerations
Conduct the examination with attention to comfort and privacy. Compare findings over time where prior assessments are available.

Observation

  • Posture and alignment in coronal and sagittal planes
  • Shoulder and pelvic height asymmetry, waist creases, trunk shift
  • Adam’s Forward-Bending Test for rib or lumbar prominence
  • Balance, gait, and movement patterns
  • Cutaneous findings (e.g., café-au-lait spots, midline hairy patches, hemangiomas)
  • Overall morphology suggestive of syndromic or connective tissue conditions (e.g., limb length discrepancy, joint contractures, hyperlaxity)

Range of motion

  • Active cervical and thoracolumbar spine range of motion (flexion, extension, lateral flexion, rotation)
  • Note asymmetry, restriction, or symptom reproduction

Hypermobility

  • Assess for regional or generalized joint laxity (e.g., Beighton score) when clinically indicated

Palpation

  • Spinous processes, paraspinal musculature, and rib cage for asymmetry, tenderness, step-offs, muscle tone changes, or soft-tissue abnormalities

Neurological examination

  • Motor strength: Upper and lower extremities as indicated, noting asymmetry or weakness
  • Sensory testing: Dermatomal or regional deficits
  • Reflexes: Symmetry and appropriateness
  • Upper motor neuron signs: Hyperreflexia, clonus, pathological reflexes
  • Lower motor neuron signs: Atrophy, fasciculations, reduced tone

Special tests

  • Scoliometer measurement of angle of trunk rotation during forward bending
  • Clinical surface assessment or 2D photography for aesthetic documentation, where appropriate
  • Additional tests as indicated to evaluate non-idiopathic causes or associated conditions

Imaging considerations

  • Routine radiography is not recommended indiscriminately, particularly in children, due to radiation exposure
  • Imaging may be considered at initial evaluation when trunk rotation is clinically significant (5⁰ or 10⁰) and for monitoring progression when indicated (every 6–12 months)
  • Curve magnitude should be assessed using Cobb angle, recognizing expected inter- and intra-observer variability in interpretation

Assessment frequency and monitoring during growth should align with jurisdictional guidance and individual risk of progression.

8. Clinical Presentations for Idiopathic Scoliosis
  • Pattern: Lateral spinal curvature with three-dimensional deformity (coronal curvature with vertebral rotation), most commonly identified during periods of growth.
  • Onset: Often detected incidentally by the individual, family member, school screening, or healthcare provider.
  • Symptoms: Many individuals are asymptomatic; others may report back pain, fatigue, or cosmetic concerns. Marked or progressive pain is uncommon and suggests an alternative diagnosis.
  • Functional impact: Usually minimal in mild curves; functional limitations may occur with larger or progressive curves.
  • Clinical signs: Asymmetry of shoulders, scapulae, or pelvis; trunk shift; rib or lumbar prominence on Adam’s Forward-Bending Test.
  • Diagnostic considerations: Idiopathic scoliosis is a diagnosis of exclusion after non-idiopathic causes (e.g., congenital, neuromuscular, or syndromic scoliosis) have been ruled out.
  • Imaging: Curves with a Cobb angle <10° are considered normal variants and should not be diagnosed as scoliosis. Radiographic assessment using the Cobb method remains the reference standard for confirming scoliosis and assessing curve magnitude.
9. Conservative Treatment Considerations for Idiopathic Scoliosis

Approach to treatment

The treatments outlined below reflect core domains of conservative care identified across high-quality clinical practice guidelines for idiopathic scoliosis. Management should be individualized based on age, skeletal maturity, curve magnitude and pattern, risk of progression, and individual goals and preferences. Not all domains are required in every case or at every stage. This pathway is not prescriptive and does not include all possible interventions; clinicians should consult relevant guidelines for condition-specific protocols and dosing.

This pathway applies to idiopathic scoliosis. Suspected secondary (non-idiopathic) scoliosis requires referral for further medical evaluation.

(Negrini 2018; Romano 2024)

Patient education

  • Education regarding the nature of idiopathic scoliosis, expected course, and factors influencing progression
  • Reassurance regarding participation in daily activities, sport, and school physical education, unless otherwise contraindicated
  • Discussion of expectations, adherence, and shared decision-making related to monitoring or treatment

Bracing

  • Rigid bracing is a standard component of conservative management for skeletally immature adolescents at risk of curve progression
  • Typically considered for individuals with moderate curves during growth, and may be considered in selected adolescents with curves approximately 45–60 degrees who wish to attempt avoiding surgery
  • Bracing is commonly prescribed for most of the day (often up to ~18 hours/day), depending on brace type, curve characteristics, growth status, and individual tolerance
  • Bracing should be delivered within a structured program with monitoring of fit, adherence, and clinical response

Exercise

  • Exercises are typically emphasized when not wearing the brace
  • Generic therapeutic exercises alone have little to no effect on scoliosis progression or cosmetic outcomes, though they may provide modest quality-of-life benefits. When combined with bracing, therapeutic exercises may be associated with reduced curve progression.
  • Therapeutic exercises focused on posture control, stabilization, and activities of daily living are recommended during periods of growth, particularly in individuals at risk of progression.
  • Physiotherapeutic scoliosis-specific exercises (PSSE) may include scoliosis-specific postural correction, asymmetric strengthening and stretching, breathing techniques, and approaches such as Schroth-based exercises.
  • PSSE should be individualized, progressive, and delivered by clinicians trained in scoliosis management, ideally within an integrated treatment team, with attention to adherence and quality of delivery.

Manual therapy

  • Manual therapy techniques (e.g., gentle mobilization or soft-tissue approaches) may be used only as adjuncts to exercise-based stabilization programs.
  • Manual therapy should not be used as a standalone treatment for scoliosis correction or curve progression.
  • The role of manual therapy is limited to supporting comfort and function within a broader conservative care plan.

Sport and physical activity

  • Participation in general sport and physical activity is encouraged for psychological, neuromotor, and overall health benefits.
  • Sport participation is not a treatment for scoliosis and should not be expected to influence curve progression.
  • Individuals should be supported to remain active according to their interests, abilities, and stage of growth, unless specific medical contraindications are present.
10. Risk and Prognostic Factors for Idiopathic Scoliosis

Risk factors for curve progression

  • Growth potential: Younger age at diagnosis and greater remaining skeletal growth
  • Sex: Higher risk of progression in females
  • Curve characteristics: Thoracic-dominant curves
  • Curve magnitude: Larger initial Cobb angle (e.g., >25° in children; >50° thoracic or >30° lumbar in adults)

Prognosis

  • The clinical course of idiopathic scoliosis is highly variable and influenced primarily by growth status and curve characteristics.
  • Curves identified during periods of rapid growth carry a higher risk of progression, while progression risk is substantially lower after skeletal maturity.
  • Many individuals with mild curves remain stable and asymptomatic, whereas others experience progression requiring intervention.

Negative prognostic indicators

  • Family history of scoliosis
  • Joint or skin laxity
  • Thoracic hypokyphosis
  • Periods of rapid growth
  • Angle of trunk rotation >10°

(Negrini, 2018; Weiss, 2006)

11. Ongoing Follow-up

Ongoing follow-up is a shared review of whether the plan remains safe, useful, acceptable and aligned with the patient’s goals. The timing of review should reflect symptoms, risk, the care being tried, goals and access rather than a fixed visit schedule.

  • Review symptoms and safety: ask what has changed in symptoms, functioning and daily activities; review adverse effects; and check for new or worsening Red Flags and relevant Orange or Yellow Flag concerns. Arrange earlier or urgent assessment when the findings require it.
  • Review outcomes: repeat the small set chosen at baseline and use the same measures when possible. These may include the Patient-Specific Functional Scale, WHODAS 2.0, quality of life using the patient’s own rating or a measure such as WHOQOL-BREF, symptom impact, participation and the patient’s own assessment of change. Interpret measures with the patient and alongside what has changed in daily life rather than relying on a score alone.
  • Review goals, preferences and consent: ask whether care remains acceptable, feasible and worthwhile; revisit goals and priorities; and confirm consent when the plan or circumstances change.
  • Adapt care: continue what is useful and acceptable, and change, pause or stop what is not. If progress is not sufficient from the patient’s perspective, review the clinical impression, the fit and amount of care, barriers to participation, other health or social factors and whether other expertise is needed.
  • Support self-management and participation: review the strategies the patient is using, including physical activity or exercise, symptom management, pacing and participation in work, school, caregiving, recreation or community life. Ask what is helping and which barriers can be addressed.
  • Referral and co-management: arrange emergency assessment for Red Flags requiring urgent care. Consider referral or co-management when findings or needs are beyond the clinician’s role, the patient’s condition is worsening, progress remains insufficient after the plan has been reviewed, or the patient requests another opinion.
  • Plan the next step: agree whether to continue, change the interval between visits, move toward more self-directed care, or apply the Criteria for Discharge section.
12. Criteria for Discharge

Discharge is a shared decision about ending or transferring a course of care. It does not require complete symptom resolution, a normal outcome score or a fixed number of visits.

  • When discharge may be appropriate: consider discharge when the patient’s goals have been met to a degree they consider satisfactory; the patient feels able to manage with less or no clinician involvement; the patient chooses to end care; continued care is not providing enough benefit to justify its burden, cost or time; or care is being transferred to another provider.
  • Reassess before discharge: review symptoms, functioning, participation, selected outcomes, goals, adverse effects, confidence and preferences. Check for new or worsening Red Flags and any Orange or Yellow Flag concerns that still require action. If the condition is worsening or a safety concern remains, arrange the required assessment or referral rather than routine discharge.
  • When progress has slowed: review the clinical impression, response to care, goals, barriers and access, other health or social factors, and other reasonable options before deciding with the patient whether to continue, change or end care.
  • Plan after discharge: agree on self-management, physical activity or exercise, symptom management, pacing and participation in work, school, caregiving, recreation or community life. Explain which changes should prompt earlier or urgent assessment and when and where to seek care.
  • Future access to care: explain how the patient can return if symptoms recur, functioning declines, or goals or demands change. Any planned future review or supportive care should have an agreed purpose, expected benefit and review point.
  • Referral or transfer: explain the reason, share a relevant summary with the patient’s consent, and clarify who will address outstanding concerns when possible. Avoid an unintended gap in care when safety or ongoing needs remain.
  • If the patient ends care or does not return: respect the patient’s right to stop. Record what is known and unknown about the outcome, advice or referral offered, attempts to communicate when clinically warranted, and any unresolved safety concern. Follow applicable record keeping and communication requirements.
  • Documentation: record the reason care ended, the patient’s status and selected outcomes, goals and preferences, unresolved concerns, advice and self-management plan, referral or transfer details, and how to seek care again if needed.

References

  • Mullender, M., Blom, N., De Kleuver, M. et al. A Dutch guideline for the treatment of scoliosis in neuromuscular disorders. Scoliosis 3, 14 (2008)
  • Negrini, S., Donzelli, S., Aulisa, A.G. et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 13, 3 (2018).
  • Romano M, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Kotwicki T, Maier-Hennes A, Arienti C, Negrini S. Therapeutic exercises for idiopathic scoliosis in adolescents. Cochrane Database of Systematic Reviews 2024, Issue 2. Art. No.: CD007837.
  • Weiss HR, Negrini S, Rigo M, Kotwicki T, Hawes MC, Grivas TB, Maruyama T, Landauer F. Indications for conservative management of scoliosis (guidelines). Scoliosis. May 8;1:5. (2006)