I. What is scoliosis Scoliosis, commonly known as scoliosis, is a three-dimensional deformity of the spine that includes serial abnormalities in the coronal, sagittal and axial positions. In a normal person, the spine should look like a straight line from the back and be symmetrical on both sides of the trunk. Scoliosis should be suspected if the shoulders are unequal in the frontal view or if the back is uneven from the back. A full spine x-ray in the standing position should be taken at this time, and if the frontal x-ray shows a lateral curvature of the spine greater than 10 degrees, scoliosis is diagnosed. In mild scoliosis, there is usually no significant discomfort and no visible trunk deformity on the exterior. In more severe cases, scoliosis can affect the growth and development of infants and adolescents, deforming the body and, in severe cases, affecting cardiopulmonary function and even involving the spinal cord, resulting in paralysis. Mild cases of scoliosis can be observed, while severe cases require surgery. Scoliosis is a common disease that affects adolescents and children, and it is crucial to detect and treat it early. Normal X-rays Scoliosis X-rays Scoliosis profile II. Etiology of scoliosis: According to the etiology, it can be classified as functional or organic. (a) Non-structural scoliosis: 1, postural scoliosis; 2, lumbar and leg pain, such as disc herniation and tumors; 3, caused by unequal length of both lower limbs; 4, caused by hip contracture; 5, inflammatory stimulation (such as appendicitis); 6, hysterical scoliosis. These causes of temporary scoliosis, once the cause is removed, can return to normal, but the long-term presence of the person, can also develop into structural scoliosis. (B) Structural scoliosis: 1. Idiopathic scoliosis: the most common, accounting for 75%-85% of the total, the cause of the onset is not clear, so it is called idiopathic scoliosis. Depending on the age of onset, it can be divided into three categories. (1) Infant type (0 to 3 years old) ① natural healing type; ② progressive type. (2) Juvenile type (4 to 10 years old) (3) Juvenile type (>10 years old to skeletal maturity). Among the above three types, the adolescent type is the most common. 2. Congenital scoliosis: The spine develops in the embryonic period with incomplete segmentation of the spine, a bone bridge on one side or incomplete development of one vertebral body or a mixture of the above two factors, resulting in asymmetric growth on both sides of the spine, thus causing scoliosis. It is often combined with other deformities, including spinal cord deformity, congenital heart disease, congenital urinary tract deformity, etc. The spinal developmental deformity is usually detected on x-ray. Congenital scoliosis deformity diagram 3, other types: including neuromuscular, neurofibromatosis combined with scoliosis, scoliosis due to interstitial lesions, acquired scoliosis (such as ankylosing spondylitis, spinal fractures, tuberculosis of the spine, abscess chest and thoracoplasty and other thoracic surgery-induced scoliosis) and other causes (such as metabolic, nutritional or endocrine causes) scoliosis. Treatment of scoliosis: It can be divided into non-surgical treatment and surgical treatment. (a) Conservative treatment: The most important and reliable conservative method is brace treatment. Generally, idiopathic scoliosis within 20 degrees can be left untreated and closely observed, and if it worsens more than 5 degrees per year, brace treatment should be performed. Adolescent idiopathic scoliosis with a first diagnosis of 30 degrees to 40 degrees should be treated immediately with bracing because more than 60% of this group of patients will develop and worsen. (ii) Surgical treatment: The goals of scoliosis surgery are: to prevent progression of the deformity; to restore spinal balance; to correct the deformity as much as possible; to preserve as many mobile segments of the spine as possible; and to prevent nerve damage. Juvenile idiopathic scoliosis requires surgical treatment in the following cases: (1) those with thoracic curvature greater than 40 degrees and thoracolumbar curvature/lumbar curvature greater than 35 degrees; (2) those with rapid progression of scoliosis that cannot be controlled with brace therapy; (3) those with significant low back pain or nerve compression symptoms. In patients with congenital scoliosis, if the scoliosis is the type that progresses easily or if the scoliosis progresses significantly during the observation period, surgery should be performed as early as possible, generally at the age of 3 to 5 years. Typical case I. Congenital scoliosis Congenital scoliosis Two years after surgery