Response to: Evidence-Based of Nonoperative Treatment in Adolescent Idiopathic Scoliosis

1. The Risser sign is used as a standard criterion in the treatment of scoliosis because it represents the velocity of height growth. Gender plays a role in the Risser stages. For example, female adolescents in Risser stage 1 have already passed the peak high velocity (PHV); therefore for female adolescents at Risser stage 1 or 2 with 20 degrees Cobb's angle, I recommend only regular follow-ups without the brace treatment. Male adolescent at Risser stage 1 have a lot of potential for growth and for male adolescents at Risser stage 1 or 2 with 20 degrees Cobb's angle, I recommend the brace treatment.

2. There are lots of debates about the results of Charleston and Providence braces treatment with Janicki et al. [1], insisting that the brace treatment is effective, while Wiemann et al. [2], insist that it is not effective. Although I do not have academic evidence yet, I personally think that applying the Providence brace treatment at night and the Charlstone brace treatment during the day might be a way of increasing patient compliance.

3. The Lenke classification [3] is well sorted and effective in fusion level decision, but is too complex. The King classification [4] is simple to use, but the inter-observer variance is large. The Peking Union Medical College (PUMC) classification [5] is simple and useful, but it is not commonly used worldwide. As each of the classifications has its strengths and weaknesses, I personally prefer the King classification. Most of the studies cited in this paper used the King classification or some classification similar to the King classification.