The aim of this report is to evaluate the segmental rib index (RI) from T1-T12 spinal level in mild and moderate idiopathic scoliosis (IS) curves of thoracic, thoracolumbar and lumbar type by gender. The relationship of segmental RI to the frontal plane radiological deformity presented as the Cobb angle and to the posterior truncal surface deformity presented as the scoliometric readings of Angle of Trunk Rotation (ATR) in these patients is also assessed. Any statistical significant rela-tionship of these parameters would be very important for biomechanical relations of the rib cage (RC) deformity presented as the rib hump deformity (RHD) and the deformity in the spine and it would thus provide valuable information about scoliogeny. The segmental rib index (RI) is presented in 83 boys and girls with mild and moderate IS. The measurements include the scoliometric readings for truncal asymmetry (TA), the Cobb angle assessment and the segmental RI from T1-T12. The statistical package SPSS 23 was used for statistical analysis. The TA is documented and the Cobb angle is presented by gender and curve type. The segmental RI of thoracic, thoracolumbar and lumbar curves are presented for the first time. The correlations of the segmental RI to surface deformity presented as the rib hump deformity (RHD) in all IS patients and particularly in thoracic curves, to Cobb angle by gender and age and the comparison of the segmental RI index of asymmetric but not scoliotic children to the scoliotic peers by curve (in thoracic, thoracolumbar, lumbar curves) in boys and girls are presented. The findings emphasize the significant protagonistic role of the thoracic asymmetry in relation to the spinal deformity mainly in girls for the thoracic and in boys for the thoracolumbar curves. The cut-off point of age of the examined scoliotics is 14 years, that is when the RI shows stronger correlation with the spinal deformity, namely when the thoracic deformity is decisively effective to the developing thoracic spinal deformity, in terms of Cobb angle. In summary, the results of this study provide aetiological implications for IS, as far as the role of thorax is con-cerned.

Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that requires effective conservative management to prevent progression and reduce surgical risk. Although bracing is effective, predictors of long-term outcomes and the prognostic value of short-term results remain insufficiently defined. Objective: This study aimed to identify clinical and radiological determinants of final treatment success in AIS patients treated with the Chêneau modified brace (CMB), with special emphasis on short-term predictors. Methods: A prospective longitudinal cohort study was conducted at the Institute for Physical Medicine, Rehabilitation, and Orthopaedic Surgery “Dr. Miroslav Zotović”, Banja Luka (2018–2024). Fifty AIS patients (mean age 13.5 ± 1.4 years; 80% female) with Cobb angles between 20 and 45° and Risser sign 0–3 were analyzed. Cobb angles were measured at four timepoints: baseline, 4 weeks (in-brace), 6 months (out-of-brace), and final follow-up (48.3 ± 9.4 months). Statistical analyses included repeated-measures ANOVA, Pearson correlation, and multivariate regression. Results: The mean Cobb angle improved significantly from 28.7° ± 7.1° to 22.1° ± 10.5° (p < 0.001). The six-month out-of-brace Cobb angle was the strongest predictor of treatment success (OR = 0.726, p = 0.001), surpassing initial in-brace correction. Lumbar curves demonstrated the most stable correction (28.1° → 20.5°, p < 0.001), while thoracic curves showed partial loss of improvement (30.5° → 26.9°, p = 0.373). Single-curve and non-compensatory deformities achieved greater correction than complex or double curves (p = 0.014). Conclusions: The six-month out-of-brace radiograph represents a key prognostic milestone in AIS management. Incorporating this dynamic assessment into routine follow-up may enhance individualized treatment planning and long-term outcomes.

This retrospective study, utilising prospectively collected data, investigates the use of spine ultrasound as an alternative method for assessing scoliosis, with the aim of reducing radiation exposure. We included 92 patients aged 10 to 16 years with suspected idiopathic scoliosis. Exclusion criteria were weight over 150 kg, metal implants, pre-existing conditions, secondary deformities, and cognitive impairments. Each patient underwent clinical assessment and full spine radiographs, followed by spine ultrasound using the Scolioscan® system. Unprocessed B-mode ultrasound images were analysed using automatic measurements. The correlation between Ultrasound Coronal Angle (UCA) and Radiographic Cobb Angle (RCA) was evaluated at initial and follow-up visits. Strong correlations were found between UCA and RCA, with correlation coefficients ranging from 0.786 to 0.903 (p < 0.001). The regression formula showed good predictive accuracy for curve progression on follow-up radiographs. The best results were observed in females and in primary thoracic curves (r = 0.936, p < 0.001). Although only four patients exhibited true progression (≥5° increase in Cobb angle), changes in scoliotic angles were effectively detected using ultrasound. This study confirms the feasibility of unprocessed spine ultrasound for scoliosis monitoring in clinical settings. Automatic measurements without 3D reconstruction make ultrasound a practical tool for tracking progression. The regression model shows potential for predicting curve progression, although further validation is needed. These findings suggest spine ultrasound could reduce the need for radiographs, benefiting patients by minimising radiation exposure while providing reliable monitoring of scoliosis progression and treatment outcomes.

Introduction: The relationship between vertebral rotation (VR), curve magnitude, and age in adolescent idiopathic scoliosis (AIS) is not yet fully understood. Although VR represents a defining feature of scoliotic deformity, it remains unclear whether rotational progression is age-related or curve magnitude-related. It has been suggested that in early scoliosis the intervertebral disc is initially deformed or wedged, driving the formation of the Cobb angle, with secondary vertebral and rotational deformity.The present study aimed to analyze the associations between age, Cobb angle, and VR in an AIS cohort, and to determine the independent predictors of axial rotation. Methods: This retrospective study included 255 AIS patients (183 females, 72 males, age 10–18 years) at first presentation. Radiographic measurements included Cobb angle of the primary curve and apical vertebral rotation (AVR - Raimondi method). Univariate linear regression models evaluated associations between age and AVR, and age and Cobb angle. A multivariable linear regression model was constructed with AVR as the dependent variable, incorporating age, Cobb angle, primary curve location, number of curves, and gender as independent variables. Results: The mean age was 14.0 ± 1.6 years, with a mean primary Cobb angle was 26.5 ± 11.2°(10-78) and mean AVR 17.3 ± 6.6°(2-40) In univariate analysis, age showed a modest but statistically significant association with VR (B=0.664, p=0.009), whereas no significant association was observed between age and Cobb angle (B=0.360, p=0.406). In multivariable regression analysis (Table 1), Cobb angle emerged as the strongest independent predictor of VR (B=0.286, p<0.001). Age retained a smaller but significant independent effect (B=0.566, p=0.011). Curve location, number of curves, and gender were not significant predictors of VR. Discussion and conclusion: Although VR showed a modest increase with age in univariate analysis, curve magnitude emerged as the primary independent determinant. The absence of a significant age-related increase in Cobb angle suggests that rotational progression is not simply an age-dependent phenomenon. These findings support the concept that axial deformity in AIS is predominantly magnitude-driven, with age contributing only modestly. In the context of existing biomechanical evidence, the results are consistent with the hypothesis that early scoliotic deformity may originate at the intervertebral disc level, with VR developing secondary to curve progression rather than aging itself. Further studies in larger stratified cohorts by curve severity and skeletal maturity are warranted to better clarify the temporal relationship between disc deformation and VR in AIS.