Through my study in the Department of Chiropractic Surgery at Peking Union Medical College Hospital, I have seen many patients with scoliosis in the past at the grassroots level who had delayed diagnosis and treatment and had caused severe deformities before going to the hospital. There are those who are not properly diagnosed and treated at the grassroots level, and those who have been transferred to multiple hospitals and treated in different ways. The overall feeling is that this is mainly due to a lack of awareness of this uncommon disease, including parents and even medical staff. I would like to use what I have learned through this online platform to put it into practice. Let us understand and treat more correctly this disease that can easily affect the growth and development of adolescents – scoliosis. 1. What is scoliosis? From the back, the spine is a straight line. If you see the spine bending to the left or right from behind, you have “scoliosis”, which is medically known as scoliosis. Scoliosis is a curved spinal deformity in which one or more segments of the spine curve laterally away from the midline in the coronal plane, usually accompanied by rotation of the spine and an increase or decrease in the sagittal plane of physiological forward or backward convexity. Lateral curvature of the spine measured by the Cobb method on standing ortho-x-ray images is considered scoliosis if the angle is greater than 10 degrees. It can be caused by a variety of etiologies and can be idiopathic, congenital and secondary. Among them, idiopathic scoliosis is the most common and the cause is unknown. Idiopathic scoliosis occurs in adolescents and is usually discovered unintentionally by parents or teachers, often before puberty and progresses rapidly to the end of adolescence, with most patients still progressing slowly through adulthood. 2, how to detect scoliosis early? Scoliosis can be manifested as asymmetrical posture when standing, unequal shoulders, asymmetrical back when bending over, and pigmented or abnormal hair on the back skin. If scoliosis is present, the back or waist may be unequal on both sides, commonly known as “razorback deformity”. In severe cases, there may be thoracic rotation deformity, breast asymmetry, upper body tilt, trunk shortening and decreased activity endurance, shortness of breath and palpitations due to decreased chest volume. If parents notice that their child has one or more of these symptoms, they should contact a spine specialist promptly. After taking a detailed medical history, the doctor will give an X-ray or CT or MRI to confirm the scoliosis deformity and the degree of curvature, and then give treatment recommendations. 3, the dangers of scoliosis Scoliosis can seriously endanger the healthy growth of children. Affect the physical appearance of the child Scoliosis is generally difficult to detect early, and many children are only discovered when there is an obvious deformity, a curvature of the spine, and an asymmetrical bulge in the back that appears as a “razorback”. At this point, the child’s physical appearance is significantly affected and self-confidence is often undermined, which is detrimental to mental health. Once scoliosis is present, how can a child with a “curved” back grow taller? We have found clinically that many children with scoliosis have lower heights than their peers. Many people think that skeletal problems do not affect the internal organs, but they do not. Because scoliosis occurs mostly in the thoracolumbar region, severe curvature can lead to thoracic rotation deformity and decreased thoracic volume, affecting the development of the heart and lungs and resulting in symptoms such as decreased activity endurance and shortness of breath. As mentioned above, children with severe scoliosis have a greatly impaired level of health. Health level is greatly impaired, and in the long run, there is a risk of paralysis, the quality of life is significantly reduced, the average life expectancy is shorter than normal. 4, treatment of scoliosis Early treatment of scoliosis is very important. If the treatment is not timely, it often results in catastrophic consequences. Generally speaking, treatment measures include three aspects: close observation, brace treatment and surgery. The general principle is to select specific treatment measures according to the size of the scoliosis and the potential and speed of scoliosis progression. It is generally believed that patients with a scoliosis angle between 10 and 20 degrees can be treated without any treatment, and parents can educate them to pay attention to correct sitting and standing posture and to develop good living habits. But must be closely followed up, every three months or six months to the hospital for spinal examination, such as deformity unchanged or reduced, no treatment; such as deformity aggravated, a year scoliosis angle increased by more than 5 degrees, should be treated immediately. If the scoliosis angle is between 20 and 30 degrees at the time of initial diagnosis, it can be observed or treated with bracing. If it progresses more than 5 degrees per year, it should be treated with bracing immediately; if the angle has reached 30 degrees but not more than 40 degrees at the time of initial diagnosis, it should be treated with bracing immediately. Currently, bracing is recognized as an effective non-surgical treatment method. The brace should be worn for at least 23 hours a day, with one hour reserved for bathing, gymnastics and other activities. If there is no contraindication, the brace should be used until the bone grows and matures.