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Predicting pediatric spinal deformity (PSD) from X-ray images collected on the patient’s initial visit is a challenging task. This work builds on our previous method and provides a novel bio-informed framework based on a mechanistic machine learning technique with dynamic patient-specific parameters to predict PSD. We provide a geometry-based bone growth model that can be utilized in a range of applications to enhance the bio-informed mechanistic machine learning framework. The proposed technique is utilized to examine and predict spine curvature in PSD cases such as adolescent idiopathic scoliosis. The best fit of a segmented 3D volumetric geometry of the human spine acquired from 2D X-ray images is employed. Using an active contour model based on gradient vector flow snakes, the anteroposterior and lateral views of the X-ray images are segmented to derive the 2D contours surrounding each …