Adolescent idiopathic scoliosis (AIS) is a condition that severely affects children, adolescents and adults. A segment of the spine that deviates from the midline and forms a curve is called scoliosis. The spine has many characteristic physiological curves that allow our bodies to move as well as bend. In scoliosis, the spine bends and rotates in the sagittal, coronal, and horizontal planes. Scoliosis deformities can coexist with more than physiologic forward or backward curvature deformities. The greater the degree of scoliosis, the more severe the rotation. The greater the degree of scoliosis, the more severe the rotation. The deformation of the ribs and thorax, the asymmetry of the thorax on both sides, seriously affects the cardiopulmonary development and function. There are many reasons for scoliosis, but more than 80% of them are unknown, and this type of scoliosis is called idiopathic scoliosis. It is more frequent in young children and adolescents, and is more common in women than in men. The main clinical manifestations of idiopathic scoliosis are: razorback deformity. The two shoulders and both sides of the anterior superior iliac spine are unequal, and the thorax is asymmetrical. Visceral compression symptoms: the most important is the compression of the circulatory system, heart displacement, restricted cardiac function, and accelerated heartbeat. This is followed by reduced lung capacity and accelerated breathing. Again, the digestive system is compressed resulting in indigestion and loss of appetite. The neurological aspect can produce nerve root pain and spinal cord paralysis. Treatment of idiopathic scoliosis After entering puberty, the spine enters a period of rapid growth, during which the spine grows rapidly, and at the same time, scoliosis will rapidly increase. The rapid growth period generally lasts for about 3 years. The signs of the rapid growth period of puberty are mainly based on breast and pubic hair development and the first menstrual period. The signs of this period should be slightly earlier than or equivalent to the breast and pubic hair development period for girls, equivalent to the beginning of the age of 11 and ending at the age of 14, and slightly later than the pubic hair development period for boys, equivalent to the beginning of the age of 13 and ending at the age of 16. For children in the clinical observation phase, if they are in the rapid growth phase, they should be examined at least once every six months to take X-rays to observe changes in the angle of scoliosis, and if an increase in the angle is found, X-rays should be taken 2-3 months, and when a progressive increase in the angle of scoliosis is found, brace treatment or even surgery should be taken. During the observation period, the child should be encouraged to maintain proper sitting posture, participate in regular physical activities, and strengthen the muscles of the low back. At present, the effective non-surgical treatment is considered to be bracing. Brace therapy is effective for patients whose skeletal growth and development have not yet ceased; for patients with insufficient growth potential, such as those with Risser’s sign greater than 4° or more or those who have had menstrual flow for more than 1 year, brace therapy has lost its significance. Patients with initial Cobb’s angle below 20° can be followed up. Patients with initial Cobb’s angle between 20° and 30° should be treated with bracing if the progression is more than 5° per year. If the initial Cobb angle has reached 30°, immediate bracing should be performed. In patients with severe cosmetic deformity at the initial diagnosis and a high risk of progression, bracing is very ineffective and surgery should be considered. The principles of brace therapy are induced correction, passive correction, and coupled motion correction. Commonly used braces are the Milwaukee brace, which is fixed to the cervical spine, and the axillary type Boston brace. For patients during brace treatment, the wearing time is strictly observed, at least 23 hours a day. The biggest problem during the treatment period is that the child is not able to adhere to the brace and needs to be encouraged and convinced to wear it. In addition, during the brace wearing period, care should be taken to prevent skin pressure injury and regular hospital review. If the brace does not prevent the further development of scoliosis, surgery is required on a case-by-case basis. The goals of surgery for idiopathic scoliosis are: to prevent progression of the deformity; to restore the spine, trunk, and overall balance; to correct the deformity; and to prevent nerve damage. The degree of correction of scoliosis depends largely on the flexibility of the scoliosis itself. The more flexible the scoliosis, the greater the degree of correction. The degree of correction of scoliosis varies by age and angle and etiology, usually ranging from 60 – 80%. There are various methods of predicting the degree of correction, but the common one is to take an x-ray of the convex side of the bend, measure the angle of the scoliosis, and then subtract 10-15 degrees, which is basically the effect of the correction by surgery. Surgical indications 1, idiopathic scoliosis, adolescent development is faster, Cobb angle greater than 40 ° should be surgical treatment. Congenital scoliosis, especially stiff type, or neuromuscular scoliosis causing spinal collapse, should be operated early. Because the longer the disease, the more serious the development of correction is more difficult. 2, general instrumentation orthopedic fixed fusion surgery is performed after the age of 12. For congenital scoliosis, early surgery should be performed to prevent the local fusion of scoliosis aggravation. 3, rotation of heavier thoracic scoliosis, accompanied by obvious thoracic deformity or humpback (hump angle large) deformity, than the lumbar scoliosis to be operated in advance to prevent the impact of respiratory function aggravation. 4, scoliosis and early paraplegia should be operated early, decompression to lift the paraplegia factor, correction and prevent further aggravation of the deformity. 5, for older adults with scoliosis, back pain due to vertebral hyperplasia at the deformity site, or spinal instability, fixed fusion surgery can also be considered.