 Hello, my name is Dr. Thomas Kishan, I am a spine and scoliosis specialist at Manipal Hospital Bangalore. So scoliosis is a sideward curvature of the spine and there is another related condition called kyphosis which is a forward curvature of the spine. So a normal spine when you look at it from the front or the back looks straight. In scoliosis there is a bend in the spine like this and kyphosis involves a forward curvature of the spine like this what is colloquially known as hunchback. So the causes of scoliosis are multiple. There are some children who have congenital or birth defects in their spine and that can result in a abnormal curvature of the spine. There are some children who have conditions like neurofibromatosis and Maffan syndrome who can develop scoliosis but in a vast majority of them we do not really know the cause and hence we term it idiopathic. So congenital scoliosis is something that is present since birth. There are some other types of scoliosis that present in the first decade of life but most idiopathic scoliosis present in the teenage years. So these are the children who are at risk of developing scoliosis and some of them can be picked up in a school scoliosis screening program. So the diagnosis of scoliosis is done in two parts. There is a clinical diagnosis that is by looking at the patient itself or the child you can know whether the spine is bent or not. So typically their shoulders may be at unequal heights. They may be a prominence of the scapula or the ribs on one side. They may be an asymmetry of the waist creases. So these are the clinical features of scoliosis but the final radiological diagnosis is using an x-ray. So treatment of scoliosis can be divided into three parts. They refer to them as the three O's observation, orthosis or bracing and operation. So some of them some children with very small curves can be observed at serial intervals of four months or six months or a year to see whether the scoliosis is increasing or not. So that is the observation group. Once the scoliosis goes a little bigger they may benefit with a brace or an orthosis which needs to be worn for most parts of the day. If the scoliosis continues to increase or if the scoliosis is already quite large at presentation then they will benefit with surgery the third O operation. So scoliosis surgery is a complex surgery that requires multiple doctors involved and requires a lot of equipment. So if you are considering scoliosis surgery you need to consider a large hospital that has got multiple specialties. You need to have a hospital that has a particularly equipment like neuro monitoring system that can actually make sure that the nerves are not damaged during surgery or if there is anything happening that can be picked up very early. This is called a neuro monitoring system. You need to have a pediatric ICU if you are planning to do scoliosis because some of the large large curves post surgery may require ICU admission for a couple of days before they come out and you need to have a team of highly qualified surgical professionals and who work as a team so that the best results can be offered to the patients and I think Manipal Hospital is very well equipped. We have all the equipment necessary to perform scoliosis surgery safely.