Scoliosis is a curvature of the spine to one or both sides, accompanied by twisting of the spine. Scoliosis may manifest as unequal shoulders, a protruding back, and/or a trunk shifted to one side. The most common type of scoliosis in children is adolescent idiopathic scoliosis, which tends to develop after the age of 10 years and has an unknown etiology. Considerable efforts have been made to identify the cause of juvenile idiopathic scoliosis, but there is still no consensus on the etiology of this particular type of scoliosis. Although there are many theories as to the etiology of the disease, including hormonal imbalance, growth asymmetry, and muscle imbalance, most patients are healthy and have no prior medical history. Approximately 30% of patients with idiopathic scoliosis have a family history, so the disease appears to be genetically related. Many members of the Scoliosis Research Society are conducting research on the genetic identification of scoliosis, and this area of research is growing rapidly. Perhaps in the future more genes associated with scoliosis will be identified that will be useful in identifying scoliosis and determining the risk of scoliosis progression. In general, adolescent idiopathic scoliosis does not present with pain or neurological symptoms, and the curved spine does not cause pressure on organs such as the lungs or heart, nor does it present with symptoms such as shortness of breath. With scoliosis that begins in adolescence, patients often experience back pain, especially in the lower back. Although low back pain is often thought to be associated with scoliosis, overall the bending does not produce pain. Overall, lower back pain is not a common occurrence in adolescent idiopathic scoliosis. Many adolescent idiopathic scoliosis patients who experience low back pain are more active and do not adequately stretch the abdominal, lumbar, and N-cord tendons. In general, adolescent idiopathic scoliosis does not produce low back pain or neurological problems, but if these symptoms occur, an in-depth examination, including MRI, is indicated. Adolescent idiopathic scoliosis has many distinct symptoms, and depending on the type and size of the curve or the massive curvature, the scoliosis is either rarely detected or the symptoms are so obvious that they are readily apparent. One of the most common symptoms is unequal shoulders, with one side higher than the other and the trunk favoring the left or right side, especially if the patient has only one separate curvature in the thoracic or lumbar spine, with no second curvature to balance the spine. This usually manifests as an asymmetry of the lumbar region, with one hip higher than the other, and therefore walking with one leg longer than the other. The most common sign of idiopathic scoliosis in adolescents is a protrusion of the back or bulging ribs due to rotation of the vertebrae. The typical radiological examination to determine scoliosis is a full-length standing X-ray of the spine, both anterior and posterior and lateral, which often requires a lead screen to protect the patient in order to get a clear picture. The doctor will measure the x-ray to determine the degree of scoliosis, using the Cobb method. A straight spinal curvature is 0°, and a curvature of more than 10° is considered scoliosis. A curvature between 0° and 10° is not true scoliosis, but can be caused slightly by the patient’s standing position during the pre-x-ray examination and other reasons. Lateral X-rays are used to understand the degree of thoracic kyphosis (manifested as a rounded back) and lumbar kyphosis (excessive depression of the back).