1.The basic composition of the crestal column? A: The 24 vertebrae, one sacrum and one coccyx are interconnected to form our crest, which is commonly referred to as the cervical, thoracic and lumbar spine. The vertebrae are linked together by intervertebral discs to form a bony spinal canal that protects and accommodates important nerves. 2.What is scoliosis of the crest? A: Crestal scoliosis is a three-dimensional plane deformity. The normal human crest is straight from the front (front or back), and from the side, the normal crest shows a certain physiological curvature to maintain the balance of the crest. Scoliosis of the crest refers to the frontal view of the crest deviating from the midline and bending to the side, and the increase or decrease of the physiological curvature in the lateral position. The appearance is manifested by the protrusion of one scapula, unequal height of both shoulders, and pelvic tilt. The severity of crestal curvature is usually measured by the cobb angle, and the normal crestal cobb angle should be 0 degrees, but medical science usually only defines the crestal curvature with a cobb angle of more than 10 degrees as crestal scoliosis. 3, the causes of scoliosis? A: The causes of scoliosis are many, according to the different causes, scoliosis can be divided into idiopathic scoliosis, congenital scoliosis, neuromuscular scoliosis, degenerative scoliosis, etc.. Among them, idiopathic scoliosis is the most common, accounting for 79% to 85%. Idiopathic scoliosis can be divided into infant type (0-3 years old), child type (3-10 years old), adolescent type (10-17 years old) and adult type according to the age of onset, of which the onset of adolescence is the most common. 4.What are the dangers of scoliosis? A: Light scoliosis and the early stage of scoliosis will not affect the flexibility, stability, weight-bearing function and protection of the crestal medulla. However, if left untreated, some scoliosis patients will develop and worsen, and the cobb angle can reach more than 90 degrees in severe cases. At this time, it not only leads to obvious deformity in appearance, but also causes muscle fatigue and pain due to the imbalance of the trunk, stiffness and pain due to the inflammation and degeneration of the crestal joints and intervertebral discs, abnormal cardiopulmonary function due to the collapse of the trunk, and pain, numbness and weakness of both lower limbs due to the compression of the nerves, which can lead to paralysis in severe cases. Therefore, early diagnosis and early treatment should be emphasized. 5.What are the risk factors for the progression of scoliosis? A: Some patients with idiopathic scoliosis can maintain a stable scoliosis angle for a long time, while others will rapidly progress and worsen, the cause of which, like its etiology, is always a mystery. However, a number of high-risk factors can be observed that predict rapid progression of scoliosis: (1) Gender: The incidence and severity of scoliosis progression is higher in girls than in boys, with the former having a progression rate 10 times higher than the latter. (2) Age: The younger the age of onset, the greater the likelihood of progression. (3) Degree of curvature: The greater the degree of curvature at the time of onset, the greater the risk of progression. (4) The shape and location of the bend: the risk of progression is greater for a double bend than for a single bend, and the risk of progression is greater for thoracic scoliosis than for lumbar scoliosis. 6.How to diagnose scoliosis early? A: The earlier idiopathic scoliosis is diagnosed, the greater the chance of treatment through non-surgical methods. Early detection of scoliosis and proper treatment can prevent the emergence of serious secondary symptoms. However, early mild scoliosis is often covered by clothing, and the most common scenario at the first visit is when the scoliosis has progressed to about 40 degrees and is discovered by parents, classmates, or by accident. At this point, the opportunity for non-surgical treatment is often lost. Therefore, screening for scoliosis in school-aged children is highly recommended. Although screening at school age does not reduce the incidence of scoliosis, it can reduce the number of patients with severe scoliosis through early detection and treatment. This measure has been implemented in developed countries in Europe and the United States, where the severity of scoliosis and the number of patients requiring surgical intervention have decreased very significantly in recent years. Domestic efforts in this area are lacking. For every parent of a school-aged child, whether or not the school conducts screening for scoliosis, it is important to pay more attention to your child and not wait for the school or doctor to detect the signs of scoliosis. Observing for some degree of asymmetry is the key to diagnosing scoliosis. You should take the opportunity to observe your child from the front and back of the body when he or she is naked, such as in the shower, and be alert to the presence of scoliosis if you notice the following signs: (1) one hip is higher than the other and the waist is asymmetrical; (2) one shoulder is significantly higher or “enlarged” than the other (2) one shoulder is significantly higher or “enlarged” than the other, usually the right shoulder is more common; (3) uneven neckline, one shoulder is higher than the other; (4) uneven development of both breasts in girls, the left breast is often larger. Although the presence of the above asymmetries does not necessarily mean scoliosis of the crest, if any of the above asymmetries are found, you should visit the orthopedic department of the hospital and have further investigations (such as x-ray, etc.) if necessary. It is important to note that idiopathic scoliosis has family heredity and aggregation, so if there are patients with scoliosis in the family, parents should be highly alert to the possibility of their children suffering from scoliosis. 7.How is scoliosis treated? A: The occurrence of scoliosis does not necessarily mean surgery, in fact, a large proportion of patients do not need treatment because the scoliosis angle is small and stable, and some patients can avoid surgery or delay surgery through non-surgical treatment such as braces. Treatment for scoliosis can be broadly divided into surgical and non-surgical treatments. The only non-surgical treatment that is recognized as effective is bracing. Other non-surgical treatments such as crestal massage therapy, electrical stimulation therapy, and hydrotherapy are inaccurate. Gymnastic exercises cannot stop the progression of scoliosis, but they are more valuable in treating muscle fatigue and secondary pain. The treatment plan depends on many factors, but it is generally accepted that: (1) scoliosis less than 20 degrees, no significant progress, usually no treatment. Children with growth potential should be followed up regularly. Adult patients with a scoliosis angle of 40-50 degrees or less do not need treatment if they have no accompanying symptoms, and should be followed up regularly according to the size of the angle and the degree of skeletal maturity. (2) Children with a scoliosis angle between 20 degrees and 40 degrees and with growth potential should be treated with bracing. (3) Patients with a scoliosis angle of 40 degrees or more, whose scoliosis progression cannot be controlled by brace treatment, whose appearance deformity is obvious, and whose trunk is out of balance, should undergo surgery in a timely manner. Typical case He, female, 20 years old. Low back deformity was found for 5 years. Bending test (+); the right shoulder was 1 cm higher than the left shoulder in the standing position; the thoracic segment of the crest was bent to the right in the posterior view, and the lumbar segment was bent to the left.