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Background The tendency is to start conservative treatment at a lesser Cobb angle, but this can be warranted only if the scoliosis is progressing. Duval-Beaupere [1,2] (1971, 1984) concluded that an “evolutive scoliosis” is progressing in a linear way during two periods: one from birth until the onset of puberty, and the second one during puberty until maturation. Changes in the progression occur suddenly between these two phases (P point) as the first minor signs of puberty occur. Each patient has their own evolution rate; therefore, using clinical signs to determine the exact maturation state of a scoliotic patient and the risk of progression can be difficult.

Correlation between maturation, growth spurt, and the progression of adolescent idiopathic scoliosis