SOSORT

SOSORT was founded in 2004 by a group of physicians from Europe and Asia who were focused on improving conservative (non-operative) scoliosis care. Its mission is to advance evidence-based, non-operative treatment for scoliosis and other structural spinal changes. sosort.org

Founding Background of SOSORT

While the organization does not publicly list each individual founding member by name, the available records show:

• A group of physicians from Europe and Asia founded SOSORT in January 2004 to study and improve conservative scoliosis treatment.
• Dr. Manuel Rigo served as the first president, indicating his central role in the early formation of the Scoliosis Rehab society. 
• Dr. Lamantia was one of nearly 100 clinicians who met in Barcelona in 2004 to establish shared standards for non-operative scoliosis care, laying the groundwork for the society’s formal launch.

SOSORT Mission

SOSORT’s mission centers on advancing high-quality, evidence-based conservative care for scoliosis:

Advance evidence-based non-operative care for scoliosis and structural spinal changes.

• Promote the most appropriate care for individuals with scoliosis, emphasizing non-surgical management.
• Foster research on early detection, prevention, treatment, and outcomes in spinal deformities.
• Provide education and knowledge exchange among clinicians, researchers, and patients.
• Support a multidisciplinary community including physicians, therapists, orthotists, and rehabilitation specialists.

The SOSORT treatment guidelines outline evidence-based, non-surgical management for idiopathic scoliosis, focusing on bracing, physiotherapeutic scoliosis-specific exercises (PSSE), assessment, and age-specific decision pathways. They are the most widely referenced global standards for conservative scoliosis care, updated most recently in the 2016 guideline set.

Overview of SOSORT Treatment Guidelines

(International Society on Scoliosis Orthopaedic and Rehabilitation Treatment)

Core Goals

• Provide evidence-based recommendations for non-operative scoliosis care
• Standardize assessment, bracing, and exercise-based treatment
• Guide clinicians on when to observe, brace, or escalate care
• Support growing patients with idiopathic scoliosis (primary target group)

Major Components of the 2016 SOSORT Guidelines

1. Assessment Recommendations

• Comprehensive clinical evaluation including posture, asymmetry, and functional tests
• Radiographic assessment with Cobb angle measurement
• Growth and maturity evaluation (Risser sign, menarche, growth velocity)
• Risk-of-progression analysis to guide treatment decisions

2. Bracing Recommendations

Bracing has the strongest evidence base in the guidelines.

• Full-time rigid bracing recommended for moderate curves with high progression risk
• Part-time or half-time bracing for lower-risk cases
• Soft bracing may be considered in select mild cases
• Brace wear monitoring (compliance) is emphasized
• Brace treatment during growth is central to preventing curve progression

Two bracing recommendations reached Level I evidence and Grade A strength.

3. Physiotherapeutic Scoliosis-Specific Exercises (PSSE)

Exercises are structured, scoliosis-specific, and evidence-supported.

• PSSE to prevent progression during growth (12 recommendations)
• PSSE combined with bracing improves outcomes
• PSSE during surgical therapy phases for conditioning and recovery
• Respiratory exercises for thoracic curves
• General sports participation is encouraged

One PSSE recommendation reached Level I evidence.

4. Other Conservative Treatments

• Manual therapy and electrical stimulation have limited evidence
• Inpatient rehabilitation programs may be used in select cases

5. Age- and Severity-Based Treatment Flowcharts

The guidelines include detailed flowcharts for:

• Infantile scoliosis
• Juvenile scoliosis
• Adolescent scoliosis by Risser stage
• Adults with or without pain
• Elderly patients

Example from the published chart:

• Infantile: Minimum — Observe every 3 months  |  Maximum — Total-time rigid bracing
• Juvenile: Minimum — Observe every 3 months  |  Maximum — Surgery
• Adolescent Risser 0–4: Minimum — Observation or soft brace  |  Maximum — Full-time rigid brace or surgery
• Adults: Minimum — Nothing or PSSE  |  Maximum — Bracing or surgery
• Elderly: Minimum — Observation  |  Maximum — Bracing or surgery

Evidence Summary

The 2016 guidelines include 68 total recommendations:

• 25 bracing
• 12 PSSE (growth)
• 6 PSSE (brace/surgery)
• 2 other conservative treatments
• 3 respiratory
• 6 sports
• 14 assessment