Scoliosis can have many causes, and the mechanism of its formation has only two factors, one is its own factors, and the other is external factors. There are two aspects of the self factor, one is congenital and the other is acquired. Since the thorax and spine are one and the same, congenital scoliosis is often combined with a thoracic deformity. In patients with acquired scoliosis, there is no thoracic deformity prior to the onset of the disease, so unless the lesion is very severe, there will not be a very severe scoliosis, much less a thoracic deformity. In contrast, among external factors causing scoliosis, thoracic factors are the most common ones. Such patients may be completely normal at birth or have only symmetrical thoracic deformities. With age, most symmetrical thoracic deformities develop into asymmetrical deformities. Sooner or later, the asymmetry of the thorax will cause scoliosis of the spine. It can be seen that in patients with scoliosis secondary to other factors, the deformity of the thorax is often the true cause of the disease. Such an understanding has long been recognized by orthopedic surgeons and spine surgeons, but very unfortunately it has not been passed on to thoracic surgeons such that all previous scoliosis patients have gone to orthopedics and spine surgery but not to thoracic surgery. This inevitably affects the treatment of patients. Patients with scoliosis whose onset is indeed caused by a thoracic deformity will certainly not be very satisfied with the results of scoliosis treatment alone. Even if the spine does become erect, the deformed thorax is unlikely to improve. From a thoracic perspective, if the thoracic deformity is corrected, the scoliosis is likely to gradually return to normal. Thus, some advice must be given to scoliosis patients. In patients with a thoracic deformity, if it is clear that the spinal pathology is secondary to the thoracic deformity, the thoracic deformity should be treated first rather than the spine. Thoracic surgery is simpler, safer, and much less costly than spinal surgery. Why not make such a wise choice? Of course, this requires the ideal correction of the thoracic deformity. The fundamental reason is that most thoracic surgeons do not have the means to treat complex thoracic deformities, which is perhaps the fundamental reason why patients have to rely excessively on orthopedic and spine surgeons. It is gratifying to know that after a long period of clinical practice, we have mastered the surgical skills of complex thoracic deformities. With such technical support, we believe that more and more patients will be treated correctly.