Adolescent idiopathic scoliosis and the Cobb angle

What it is

Idiopathic scoliosis is a curve of the spine. The Cobb angle is based on spine radiology that quantifies the magnitude of the scoliosis curve, so it is the measured number that decides what happens next.

What decides whether the curve will progress

There are three major risk factors for curve progression of idiopathic scoliosis:

• The magnitude of the curve at presentation
• The potential for future growth
• Female sex

Of these factors, curve progression has the most impact on the need for referral versus observation.

The same page then puts age, sex, menstrual status, pubertal status and growth potential among the less important factors. So female sex and growth potential stand on both lists at once, and the page says no more about it.

The number that carries the referral

If the Cobb angle is 20° or more there is a high risk that the curve will progress and that the patient may need treatment. That is what indicates a need for referral to a specialist - not the pain, not the sex, not the weight, and not the premenarchal status.