Scoliosis is a three-dimensional spinal deformity defined by a lateral curvature of the spine with vertebral rotation, with a Cobb angle of ≥10° on standing full-spine X-rays as the diagnostic threshold. It is classified into four main types: idiopathic scoliosis (the most common, accounting for 80% of cases), congenital scoliosis (caused by vertebral malformation), neuromuscular scoliosis (secondary to cerebral palsy, spinal muscular atrophy, etc.), and syndromic scoliosis (associated with genetic syndromes).

• Etiology: The cause of adolescent idiopathic scoliosis (AIS), the most common form, remains unclear, with genetic, hormonal, biomechanical, and neuromuscular factors implicated. Congenital scoliosis is caused by embryonic vertebral developmental anomalies, while neuromuscular and syndromic scoliosis are secondary to underlying systemic conditions.
• Clinical Manifestations: Early-stage scoliosis is often asymptomatic, presenting only with cosmetic abnormalities such as shoulder height asymmetry, thoracic asymmetry, waistline asymmetry, and a rib hump (razorback deformity) upon forward bending. Severe progressive scoliosis can lead to chronic back pain, restrictive pulmonary dysfunction, cardiac impairment, neurological deficits, and substantial psychological distress in adolescents.
• Diagnosis: Standing full-spine anteroposterior and lateral X-rays are the gold standard for diagnosis, with Cobb angle measurement to assess curve severity and progression risk. MRI is used to rule out intraspinal pathology (e.g., syringomyelia, tethered cord), and pulmonary function testing evaluates cardiopulmonary impact in severe curves.

• Conservative Management: Indicated for patients with a Cobb angle of 10-25° and remaining skeletal growth potential. Core interventions include regular radiographic follow-up, bracing (the only evidence-based non-surgical treatment to prevent curve progression), and structured rehabilitation (e.g., Schroth method), physical therapy, and core muscle strengthening.
• Surgical Treatment: Indicated for patients with a Cobb angle ≥40°, rapidly progressive curves, curves with neurological deficits, severe deformity with cardiopulmonary impairment, or unacceptable cosmetic deformity. The standard procedure is spinal deformity correction with posterior spinal fusion and instrumentation using pedicle screw systems, to correct the three-dimensional spinal deformity, restore spinal balance, and prevent curve progression. For young children with remaining growth potential, growth-friendly procedures (e.g., growing rods, magnetically controlled growing rods) are used to correct deformity while preserving spinal growth.