Definition: A condition in which a segment of the spine deviates persistently from the midline of the body, causing the spine to project laterally in an arc or “S” shape. Scoliosis refers to the deviation of one or more segments of the spine from the midline in the coronal plane to bend laterally, forming a curved spinal deformity, usually accompanied by rotation of the spine and an increase or decrease in the sagittal plane posterior or anterior protrusion, as well as inequality of the ribs, rotational tilt deformity of the pelvis, and abnormalities of the paravertebral ligaments and muscles, which is a symptom or x-ray sign and can be caused by a variety of diseases . Scoliosis usually occurs in the direction of bending (1) Lateral convexity: that is, part of the spinal spine deviates from the midline of the body called scoliosis, there are left-sided convexity, right-sided convexity and S-shaped bend, C-shaped bend. (2) posterior convexity: refers to the thoracic segment of the spine convexity exceeds the range of physiological curve. (3) saddleback: refers to the local destruction of a vertebral body, the vertebral body suddenly convex backward. (4) Round back: refers to the whole spine like a bow bulging backward. (5) Deformed chest: there are two types of deformed chest, one is the sternum protruding outward, and the other is the sternum depressed inward. (6) Rotational (twisted): It is formed because the lumbar transverse process is high on one side and low on the other or the sternum is twisted, and this kind of bending is the most complicated and difficult to treat. (1) History Ask in detail about everything related to the spinal deformity, such as the patient’s health status, age and sexual maturity. Past history, surgical history and history of trauma should also be noted. Young children with spinal deformities should know the health status of their mothers during pregnancy, any history of medication during the first three months of pregnancy, and any complications during pregnancy and delivery. Family history should be noted for spinal deformities in other individuals. Family history is particularly important in neuromuscular spinal cases of kyphosis. (b) X-ray examination 1. Full frontal and lateral images of the spine in the upright position. The upright position must be emphasized when taking X-rays, not the recumbent position. If the patient cannot stand upright, it is appropriate to use a seated image so that the true picture of scoliosis can be reflected. This is the most basic means of diagnosis. X-rays need to include the entire spine. 2. Left and right bending and traction in supine position. It reflects its flexibility. Cobb’s angle is greater than 90 degrees or neuromuscular scoliosis, as there is no appropriate muscle to correct the scoliosis, traction images are often used to check its flexibility to estimate the degree of correction of the scoliosis and the length required for fusion of each column. The softness of the kyphosis requires the taking of lateral images in the hyperextension position. 3. Oblique image. To check the fusion of the spine, oblique images of the lumbosacral region are used for patients with spondylolisthesis and isthmic bifida. 4.Ferguson image. To examine the lumbosacral joint junction, in order to eliminate anterior lumbar convexity, the bulbous canal is tilted 30 degrees to the cephalad side in male patients and 35 degrees in female patients, so that a true orthostatic lumbosacral image is obtained. 5. Stagnara image. In patients with severe scoliosis (>100 degrees), especially those with kyphosis and vertebral rotation, it is difficult to see the deformity of the ribs, transverse processes and vertebral bodies on normal X-rays. Rotation images need to be taken to obtain a true anterior-posterior image. The patient is rotated under fluoroscopy and the film is taken when the maximum curvature appears, with the cassette parallel to the medial side of the rib augmentation and the bulb perpendicular to the cassette. 6.Tomographic image. To examine congenital deformities with unclear lesions, fusion of implant blocks and some special lesions such as osteoid osteoma. 7.Cut image. The patient is bent forward and the bulbous canal is tangential to the back. It is mainly used to examine the rib cage. 8.Myelography. Not routinely used. Indications are spinal cord compression, spinal cord masses, and suspected lesions in the dural sac. X-images see widening of the arch root distance, incomplete closure of the spinal canal, spinal cord longitudinal fracture, spinal cord cavernous disease. In addition, myelography is needed to understand the spinal cord compression when a hemivertebral body is planned to be removed or when a hemivertebral wedge resection is proposed. CT and MRI are helpful for patients with combined spinal cord lesions. Such as spinal longitudinal fracture, spinal cavernous disease, etc. It is important to understand the plane and extent of the bony crest for surgical orthopedics, removal of the bony crest and prevention of paraplegia. However, it is expensive and should not be used as a routine test.