First, a brief word about the classification of scoliosis. This is very closely related to treatment. The most common type of scoliosis is idiopathic scoliosis. The reason it is called “idiopathic” is that no cause can be found. The progression of scoliosis in these children is generally slow, although there are exceptions. If the scoliosis is less than 20°, observation is preferred. If the scoliosis progresses rapidly within six months, brace intervention is required. If the scoliosis is 25-40°, bracing is required. If the scoliosis is >40°, or >30°, but progresses rapidly at follow-up, surgical intervention is required. In addition, congenital spinal deformities are more common. This type of scoliosis is primarily the result of developmental abnormalities of the vertebral bodies. These include vertebral hypoplasia and subsegmental dysplasia. Dysplasia means that the vertebrae have not completed their development, resulting in hemivertebrae or cuneiform vertebrae, etc. Vertebral subsegmentation dysplasia means that several vertebrae are connected to each other. If these deformities are symmetrical from left to right, they generally do not lead to deformity. If these deformities are asymmetrical, growth and development will cause one side of the spine to grow faster than the other, leading to scoliosis. The child named “xi” we saw last week was a child with scoliosis due to sacral 1 vertebral dysplasia. In these children, the prognosis is often poor if the deformity is hemivertebral or unilateral segmentation dysplasia, as there is often rapid progression of the deformity and prompt medical attention is needed. However, the “xi” abnormality in the sacral 1 vertebral body and the predominantly wedge-shaped changes can be followed closely and do not require immediate surgical intervention. In addition, scoliosis can include neurofibromatosis, neuromuscular, degenerative, etc. The child named “yi” had a scoliosis of nearly 20° and a coffee spot was visible on his back, so neurofibromatosis should be considered. Because of the simple lumbar curvature, idiopathic spinal deformity is relatively rare and can be called “atypical idiopathic scoliosis. Therefore, she should be advised to have an MRI of the spine to see if there are any other co-morbid spinal cord lesions. It is recommended that she have a full spinal frontal and lateral x-ray review in 3-6 months. Moving on to the main topic, let’s talk about functional exercises. This is mainly for children with idiopathic scoliosis, but other children can also be considered. There has been a lot of controversy about the effectiveness of functional exercise for scoliosis. Therefore, most books specializing in spine surgery pass over it. Personally, I think that exercise is better than no exercise at all. Even if it does not improve scoliosis, it can also enhance physical fitness, at least it is also able to play a good body capital in case of surgery. The back muscle exercise: 1, “small swallow fly”: the main point is to lie prone on the bed, head and chest up, legs up. After lifting, hold on for 5 seconds, then relax and lie down on the bed for 5 seconds, counting a cycle of action. 2-3 times a day, each time 30 cycles of action. 2, “five-point pose”: if the back strength is weak children, this method can be used. Lie flat on the bed, have the head, shoulders and feet support, lift the buttocks away from the trauma. Lift and hold for 5 seconds, then relax and lie down on the bed for 5 seconds, counting one cycle of movement. 30 circular movements 2-3 times a day. Swimming: backstroke, breaststroke, freestyle, no limit. Suspension or pull-up: This method does not correct the deformity, but helps trunk balance maintenance. Self-balance correction: Personally, I think this method is very important. The specific method can be called “love beauty”. Look in the mirror and adjust the balance of your shoulders and pelvis in front of the mirror, and go through the process of maintaining the balance of your shoulders and pelvis. In fact, most children with scoliosis have a slightly larger back deformity, and when they wear loose clothing, it does not affect their appearance much. Instead, it is the balance of the shoulders and pelvis that has a greater impact on appearance, especially the shoulders, which have a greater impact on aesthetics. Therefore, looking in the mirror to adjust their posture should be a daily ritual for children. Fortunately, both children are predominantly bent at the waist, without comparable shoulder imbalance, and have a relatively good appearance. We hope to exercise carefully and follow up regularly to try to maintain a good body shape.