Background and objectives: Idiopathic scoliosis is a three-dimensional spinal deformity characterized by a lateral curvature exceeding 10 degrees in the frontal plane accompanied by vertebral rotation in the transverse plane. Despite extensive research on genetic and neurological factors, its etiology is uncertain. This prospective observational study aims to investigate the relation between the primitive reflexes, specifically, the asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and spinal Galant reflex (SGR), which play key roles in early motor development and postural control and the severity of idiopathic scoliosis (measured via the Cobb angle and the Nash–Moe rotational quota. Additionally, the study evaluated whether the retention of primitive reflexes correlates with increased progression risk over 12 months of conservative treatment. Materials and Methods: Our study cohort included 162 patients, aged 7–19 years, diagnosed with idiopathic scoliosis, who underwent clinical examination and assessment of retained primitive reflexes using standardized grading systems. Results: A total of 162 patients (95 girls, 67 boys; mean age: 12.73 ± 2.74 years) met the inclusion criteria. In 73.5% of the cases, scoliosis was detected, with the majority occurring in the dorsal region (40.1%). The mean initial Cobb angle was 13.49° ± 7.14°, with no significant change after 12 months of conservative treatment (p = 0.584). Nash–Moe rotation scores were 1 in 52.5% and 2 in 22% of the cases. Retention of the following primitive reflexes were identified at baseline: Moro (19.1%), ATNR (38.3%), STNR (44.4%), and GSR (27.8%). GSR retention significantly correlated with the Cobb angle (p = 0.011; R = 0.233). All the reflex scores decreased significantly after 12 months, but no correlation existed between the retained reflexes and scoliosis progression. Patients with a history of quadrupedal locomotion had significantly lower ATNR (p = 0.002), STNR (p < 0.001), and GSR (p = 0.017) retention. Conclusions: These findings suggest that primitive reflex testing could serve as an early screening tool in scoliosis risk stratification, being a cost-effective, non-invasive instrument for identifying at-risk children before clinically significant deformity develops.

Background and Objectives: Idiopathic scoliosis (IS) has been conceptualized as a structural spinal deformity; emerging evidence suggests that postural control and vestibular mechanisms may contribute to curve development and functional severity. This study investigated the relationship between radiological parameters, postural stability, and vestibular dysfunction in adolescents with IS. Materials and Methods: A retrospective cohort of 177 patients aged 8–22 years was analyzed between 2022 and 2024. Standard radiography was performed on 135 participants to evaluate the major curve as established by the Cobb method, Nash–Moe classification, and Risser stage. Peripheral vestibular syndrome (PVS) was investigated using the Fukuda (FST), video-nystagmography (VNG), and instrumental Romberg tests on a stable and unstable platform. Associations between vestibular variables and radiographic parameters were explored using Mann–Whitney U and Kruskal–Wallis tests, supported by non-parametric correlations. Results: Female participants (63%) exhibited significantly higher initial major curve angle value compared with males (median 14° vs. 10.5°, p = 0.004). Positive FTS findings and the presence of peripheral vestibular syndrome were strongly associated with higher baseline and final major curve angles (both p < 0.001). Romberg performance showed significant correlations with major curve angle across stable and unstable conditions (r = 0.298–0.396, all p < 0.001). VNG identified multi-canal vestibular involvement, particularly anterior–horizontal combinations on the right ear, as being associated with substantially greater curve magnitude; left-ear impairment demonstrated similar non-significant trends. Curve localization did not differ by vestibular involvement. Conclusions: Patients with idiopathic scoliosis (IS) display consistent associations between vestibular dysfunction, impaired postural control, and greater curve severity. These findings support the clinical relevance of vestibular assessment in scoliosis evaluation and suggest a potential role for sensorimotor rehabilitation strategies. Integrating vestibular screening into standard care may enhance risk stratification and inform the clinician on individualized conservative management.

Background and Objectives: Musculoskeletal ultrasound (MSUS) is increasingly used to assess structural changes in knee osteoarthritis (KOA), although measurement reproducibility may vary with examination protocol and operator experience. This pilot study aimed to evaluate intra- and inter-observer reliability for assessing cartilage thickness, osteophyte dimensions and meniscal displacement in supine and weight-bearing conditions in patients with KOA. Material and Methods: This prospective reliability study included patients with KOA stages 2–3 on the Kellgren–Lawrence (K-L) scale. Ultrasound (US) evaluation of cartilage thickness and osteophytes was performed in the supine position, while medial and lateral meniscal extrusion was additionally assessed in bipedal and single-leg conditions using a standardized protocol. Intra- and inter-reproducibility were evaluated through the intraclass correlation coefficient (ICC), agreement analysis and kappa statistics. The analysis was performed using Microsoft Excel (version 2019) and IBM SPSS version 26 software. Results: Both inter-reliability and intra-reliability were evaluated, with intra-rater agreement being constantly higher than inter-rater agreement. From the inter-rater reliability, ICC values ranged from 0.48 to 0.88 for quantitative ultrasound measurements, whereas osteophyte assessment showed Cohen’s k values ranging from 0.71 to 0.86, indicating substantial to almost perfect agreement. Both evaluators identified a higher number of knees with medial meniscal extrusion > 3 mm under weight-bearing conditions than in the supine position. Conclusions: Standardized US evaluation demonstrated at least good reproducibility for structural abnormalities in KOA. Medial and lateral meniscal displacement increased under loading conditions, highlighting the added value of dynamic weight-bearing assessment. However, the clinical significance of load-dependent meniscal extrusion requires further investigation.