Adolescent idiopathic scoliosis (AIS) is defined by the Scoliosis Research Society (SRS) as a spinal deformity in which the spine curves laterally by more than 10 degrees during immature skeletal development over the age of 10 years. It is one of the most common spinal deformities in adolescents. At present, it is widely recognized that orthopedic braces can change the natural course of AIS and effectively control the progression of mild to moderate (less than 45 degrees of scoliosis) AIS. Some scholars have summarized the relevant studies conducted by their counterparts in different countries during the 2004 International Spine Week (SPINE WEEK), and pointed out that the answer to the question of the long-term results of orthopaedic bracing in the treatment of AIS needs to be found by evaluating the patients’ dysfunctional conditions and health-related quality of life. Wearing a brace is important, but the time of brace treatment is also an important issue to be considered in the whole treatment process. Wearing a brace for a long time, every day, for a long period of time, although it will help to ensure the therapeutic effect, however, it will bring a greater impact on the patient’s quality of life and mental health; getting rid of the brace too early can reduce the adverse effects of the brace treatment on the patient, but it is difficult to ensure the therapeutic effect. Therefore, how to remove the brace in a safe, reasonable and timely manner is of great significance to ensure the therapeutic effect and improve the quality of life of patients. Many scholars believe that during the immaturity of skeletal development, due to the active growth centers of the spine and the rapid increase in trunk length, the risk of further aggravation of deformity is higher for those with greater than 30 degrees of scoliosis or those with less than 20 degrees of scoliosis, but the scoliosis is aggravated by 5-10 degrees within six months.Rowe et al. conducted a meta-analysis of 1,910 patients with AIS who had been treated with a brace in 20 studies, and found that among female patients aged 10 to 12 years old, there was a significant difference in the number of patients with AIS treated with a brace. ~Karol retrospectively analyzed 112 male idiopathic scoliosis patients aged 10 years or older who were treated with braces and recorded measurements at the initial visit, after initial bracing, immediately after removal of the brace, and at the final follow-up visit. Cobb’s angle and Risser’s grade were measured and recorded at the initial visit, immediately after removal of the brace, and at the final follow-up visit to observe the progression of the deformity, which was defined as an increase in the curvature of the scoliosis of at least 6 degrees compared with that prior to brace treatment. The effect of the brace treatment and the parameters related to the progression of the scoliosis were analyzed after the patients had been followed up for at least 1.2 years after the removal of the brace. It was found that younger patients with immature skeletal development and an initial scoliosis angle of 30 degrees or more had a higher risk of further aggravation of the deformity. Therefore, there is a great need to accurately evaluate the degree of maturity of spinal skeletal growth and development in order to guide the treatment of patients with mild to moderate AIS with bracing to prevent aggravation of the deformity. Since Risser first proposed the appearance of ossification of the iliac crest as an index for evaluating the degree of spinal bone growth and development in 1936, Risser’s sign has been commonly used to determine the degree of spinal developmental maturity, but many scholars have found that in some patients with AIS of Risser’s grade 4, the length of the torso is still increased, and the curvature of the scoliosis is still aggravated. Therefore, the accuracy of Risser’s sign in predicting the degree of spinal skeletal maturity and the trend of deformity with growth has been questioned and a lot of research has been done on this. Noordeen et al. conducted a prospective study on 34 patients with idiopathic scoliosis who underwent anterior surgery. By obtaining the upper and lower endplates of the vertebral body at the time of anterior orthopaedic surgery and performing histologic studies to detect the residual growth force of the vertebral plate, the vertebral endplates were classified into four grades according to the histology based on whether or not there was an accretion of cartilage bands on the longitudinal section of the vertebral endplates, as well as the extent of the cartilage bands: there were no accretion of the cartilage bands and no growth The absence of a proliferating cartilaginous zone with no growth activity was classified as histologic grade 0; the presence of a proliferating cartilaginous zone without growth activity was classified as histologic grade 1; the presence of a proliferating cartilaginous zone with inactive growth was classified as grade 2; and the entire cross-section was covered with proliferating cartilaginous zones was classified as grade 3. If the histology was 0 or 1, it was assumed that the vertebral endplate would have no significant growth potential. The relationship between vertebral endplate growth force and Risser grading, actual age, and pubertal status was thus analyzed, and it was found that the growth of the vertebral endplates ceased in patients with scoliosis with only Risser grade 5, whereas 10 of the 14 patients with Risser 4 still had significant growth force, but when combined with the actual age of the patient and the time since the first menstrual period in female patients, the The reliability of Risser4 in determining vertebral endplate growth force would increase. Therefore, it is believed that the vertebral endplates still have significant growth vigor even in patients who are already at the Risser4 level. This suggests that we should not assume that the spinal skeleton is mature on the basis of Risser4 alone.Hoppenfeld et al. followed 101 patients with AIS treated with a brace for at least 2 years after removal of the brace. Each patient’s height was measured consecutively and the closure of the iliac epiphysis, proximal humeral epiphysis, and rib epiphysis was evaluated. The mean age at the time of Risser 4 was found to be 14.9 years for girls and 16.0 years for boys, with a mean increase in height of 1.75 cm for girls and 2.45 cm for boys by the end of the follow-up period, whereas no increase in height was found after closure of the iliac crest epiphysis, rib epiphysis, and proximal humeral epiphysis. It was concluded that the Risser 4 cannot be used as a final indicator of cessation of spinal skeletal growth and development, and it was suggested that it should be used in conjunction with continuous height measurements, and evaluation of other bone growth centers to determine a treatment plan for patients with scoliosis.Little et al. compared 120 female patients with AIS with normal female adolescents, and found that the height growth rates of both groups went through a peak and a rapid When the height growth rate reaches the peak, if the angle of scoliosis is greater than 30 degrees, there is an 83% chance that the scoliosis will worsen to more than 45 degrees; while if the scoliosis is less than 30 degrees, there is only a 4% chance that the deformity will worsen to more than 45 degrees. Moreover, it was found that the height growth rate had a shorter time lag and was more accurately predicted than the patient’s age, time of menarche and Risser’s sign. It suggests that our height growth velocity can effectively predict the degree of skeletal development and provide useful information for predicting deformity exacerbation. Wever et al. photographed anteroposterior upright radiographs of 60 patients with AIS, and obtained new spinal imaging by using computers and related software to process the images of consecutively photographed longitudinal radiographs, and measured the length of the spine from the upper endplate of T1 to the lower vertebral plate of L4, and classified the follow-up time into three phases according to the rate of change of spinal length in female scoliosis patients: the spinal length growth rate of more than 20 mm per year was the The rapid growth stage was defined as an increase in spinal length of more than 20 mm per year; the stable growth stage was defined as an increase in spinal length of 10-20 mm per year; and the slow growth stage was defined as an increase in spinal length of less than 10 mm per year. The relationship between the rate of change in spine length and the aggravation of scoliosis was studied. It was found that the risk of scoliosis exacerbation was greater in patients with faster spinal length growth (>10mm/year), while the risk of scoliosis exacerbation was small in patients with slower or no length growth (<10mm/year). Therefore, it is believed that the rate of spinal length growth is a good indicator of the maturity of spinal skeletal growth and development and can be used as a good predictor of the risk of scoliosis exacerbation. However, this method of measuring spinal length is less practical because of the complexity of the procedure. In addition, it is also commonly used to predict the residual growth potential of the spine based on physiologic signs such as breast and pubic hair development, the time of menarche, and the closure of the annular epiphysis of the vertebral body. In conclusion, although scholars have conducted a lot of research on how to evaluate the degree of spinal bone development, a more practical and reliable evaluation index than Risser's sign has not yet appeared in clinical practice. Correct evaluation of the maturity of spinal bone growth and development is the key to decide whether or not the brace should be removed, which is closely related to the improvement of patients' quality of life, so more in-depth research on this aspect is needed.