I. Definition of scoliosis Scoliosis is a deformity of the spine in which one or several segments of the spine deviate from the midline of the body in the coronal plane and bend to the side, forming a spinal deformity with a curvature. As shown in the figure below, the right side is the normal spine, while the left side is the deformed spine where scoliosis occurs. Scoliosis is usually accompanied by rotation of the spine and an increase or decrease in the posterior or anterior protrusion in the sagittal plane, as well as a rotational tilt deformity of the ribs and pelvis and abnormalities of the paravertebral ligaments and muscles, as shown in the figure below. Third, scoliosis is only a symptom Scoliosis is a symptom or x-ray sign that can be caused by a variety of diseases. The most common form is idiopathic scoliosis of unknown origin (about 80% of all scoliosis), which occurs in adolescents, especially in females, and often develops in early adolescence. Because the cause of most scoliosis is unknown, other types of scoliosis may be associated with other abnormalities. Therefore, we cannot simply assume that scoliosis is simply a deviated curvature of the spine. The cause of scoliosis 1, adolescent idiopathic scoliosis: adolescent idiopathic scoliosis scoliosis is about 80% of cases of idiopathic scoliosis, that is, a type of scoliosis for which no cause can be found, almost all occurring in adolescence, so called adolescent idiopathic scoliosis. It occurs in adolescents, especially in women, often in prepubertal development, progresses rapidly throughout adolescence until the end of adolescence, and eases in adulthood, and sometimes stops progressing. 2, congenital scoliosis: congenital scoliosis is due to abnormal embryonic development of the spine, the onset of early, most of which is found in infancy, the pathogenesis of structural abnormalities of the spine and spinal growth imbalance, the diagnosis is not difficult, X-ray film can be found in the spine has structural deformities, such as conventional X-ray film is difficult to identify, available three-dimensional CT reconstruction. 3, neuromuscular scoliosis: neuromuscular scoliosis: can be divided into neurogenic and myogenic, the former includes upper motor neuron lesions such as cerebral palsy, spinal cord cavity and lower motor neuron lesions such as poliomyelitis. The latter includes myotonic dystrophy, myelopathic muscular atrophy, etc. The pathogenesis of this type of scoliosis is due to the loss of control and regulation of the spinal trunk balance by the nervous system and muscles, and its etiology often requires careful clinical examination to detect, and sometimes requires neuromuscular electrophysiology or even neuromuscular biopsy to make a clear diagnosis. 4, mesenchymal lesions complicating scoliosis: mesenchymal lesions complicating scoliosis: sometimes Marfan syndrome, Ehlers-Danlos syndrome, etc. can be first diagnosed with scoliosis, and a detailed physical examination can reveal other clinical symptoms of these diseases, such as ligamentous laxity, corpus cavernosum or funnel chest, spider hand deformity, etc. 5. “Functional” or “non-structural” scoliosis: “Functional” or “non-structural” scoliosis: this type of Scoliosis can be caused by improper posture, nerve root irritation, and unequal length of the lower limbs. If the original cause is removed early, the scoliosis can be eliminated on its own. However, it should be noted that a small number of adolescents with idiopathic scoliosis may be mistaken for “postural malformation” in the early stages because of their small size, so the so-called “functional” scoliosis before puberty should be closely followed up. 6, other rare causes of scoliosis: osteochondral dystrophy complicating scoliosis, such as many types of dwarfism, spinal epiphyseal dysplasia; metabolic disorders with scoliosis, such as various types of mucopolysaccharidosis, homocystinuria, etc.; other causes of scoliosis, such as radiotherapy, extensive laminectomy, infection, tumors can cause scoliosis.