Effect of Bifidobacterium Breve Supplementation on the Onset and Progression of Idiopathic Scoliosis

Inclusion Criteria: * Age 6 to 15 years Diagnosed with idiopathic scoliosis based on clinical evaluation and radiographic examination at the first clinic visit Skeletally immature, defined as Risser sign 0 to 3 Major Cobb angle \< 40 degrees at baseline Written informed consent provided by the participant or legal guardian Able and willing to comply with study procedures Exclusion Criteria: * Plans to relocate within the next 24 months Use of antibiotics, probiotics, hormones, immunosuppressants, or other nutritional supplements known to affect gut microbiota within the past 3 months or during the study period without investigator approval Known allergy, sensitivity, or intolerance to the investigational product or its ingredients Current or prior significant gastrointestinal disease requiring medication, or history of gastrointestinal surgery Severe gastrointestinal symptoms such as persistent heartburn or indigestion Musculoskeletal, neurodevelopmental, syndromic, or other conditions that may account for the spinal deformity History of spine surgery or major spinal injury Spinal tumor or malignant disease involving the spine Leg length discrepancy \> 20 mm Severe chronic diseases that could interfere with study participation or outcome assessment, including but not limited to diabetes, narcolepsy, or poorly controlled asthma Severe obesity, defined as BMI z-score ≥ 3