In an afternoon of intense and busy clinic, in addition to patients coming in for cervical and lumbar discomfort, two little girls with scoliosis caught my attention. The incidence of this disease is about 1% during the growth and development of our adolescents, which is still relatively common, so let’s talk about scoliosis today. The first girl was 11 years old when her mother discovered by chance that her daughter’s lumbar spine was not straight, and out of concern for her daughter’s development and growth, she began to seek medical help. The second girl, aged 14, was also found to have a curvature of the lumbar spine by chance, but the angle of curvature measured by X-ray was smaller. Most of the scoliosis we see today can be idiopathic, congenital, or acquired. The cause of idiopathic pathogenesis is unknown and accounts for 75-85% of the total, with more common in underage girls. Congenital scoliosis can be divided into three categories: vertebral body formation disorders, vertebral body segmentation disorders, and mixed types. Acquired scoliosis can be caused by ankylosing spondylitis, spinal trauma, and spinal tuberculosis. Early detection and treatment can prevent the development of severe deformities. Scoliosis can manifest as unequal shoulders, deviation of the spine from the midline, wrinkled skin pattern on one side of the waist, or asymmetry of the back in small-angle lumbar scoliosis only in forward bending. We can detect scoliosis by simple examination: note whether the shoulders are symmetrical, bend forward with the skin of the back exposed, and carefully observe whether their backs are symmetrical from the front, back and sides. The diagnosis can be made more clearly through professional imaging. Scoliosis examination diagram Scoliosis X-ray So, the question arises, what should we do if we find scoliosis? Severe or progressive scoliosis usually requires surgery, and the decision to operate and how to operate depends on the patient’s age, the type and location of the deformity, the type of curvature, the natural history of the deformity, and whether it is combined with other systemic congenital deformities. The 11-year-old girl we mentioned earlier with small-angle idiopathic lumbar scoliosis and who has not yet reached developmental maturity may be treated with bracing as an option, and we can expect to avoid surgery or even correct the scoliosis by delaying the progression of the scoliosis through the brace during growth and development. However, congenital scoliosis is a rigid deformity and bracing is mostly ineffective. In the case of a 14-year-old girl with a smaller scoliosis like the one we mentioned earlier, we focus on observing the progression of the scoliosis, usually with follow-up every 3 months. In fact, the key to scoliosis is early detection and early treatment so that the condition does not progress and the chances of surgery are reduced, especially for the development and growth of the child is more important ah!