Comparative effects of conservative treatment strategies on quality of life and cervical sagittal parameters in adolescent idiopathic scoliosis: A retrospective study

Background Cervical sagittal imbalance is frequently observed in adolescents with idiopathic scoliosis (AIS) and may contribute to neck pain and reduced health related quality of life (HRQOL). The effects of different conservative treatments on cervical sagittal parameters remain unclear.Objective To compare the effects of Schroth therapy, bracing, and combined treatment on cervical sagittal alignment and HRQOL in adolescents with AIS.Methods Eighty patients with AIS treated for ≥6 months were retrospectively analyzed: Schroth therapy (n = 20), bracing (n = 21), and combined Schroth plus bracing (n = 39). Cervical sagittal parameters were measured using standing radiographs. HRQOL was assessed using the SRS-22 questionnaire and neck pain visual analogue scale (VAS). Within-group and between-group comparisons were performed.Results All treatment strategies were associated with improvements in neck pain and HRQOL. In the Schroth-only group, SRS-22 self-image and total scores improved significantly (both p < .01). However, reductions in C7 slope (15.60 ± 9.39° to 8.65 ± 8.62°, p < .01) and C2–7 Cobb angle (2.70 ± 12.36° to −7.20 ± 12.90°, p < .05) were observed during follow-up. No significant cervical sagittal changes were identified in the brace-only or combined-treatment groups. Compared with Schroth therapy alone, combined treatment demonstrated a smaller reduction in C2–7 Cobb angle (Δ −3.56° vs Δ − 9.90°, p < .05). Mental health scores improved significantly in the combined-treatment group (p < .05).Conclusion While Schroth therapy provides significant improvements in pain and psychosocial outcomes, a trend toward reduced cervical lordosis was observed in the Schroth-only group during follow-up. The addition of bracing appears to mitigate this trend while maintaining HRQOL benefits.