Abstract Adolescent idiopathic scoliosis (AIS) is a relatively common spinal health problem in the adolescents, whose pathogenesis remains unclear. AIS substantially affects the mind, intellect and body shape in children and adolescents. From a neurophysiological perspective, this article discusses progress in domestic and international research on the anatomical morphology, physiological function and neuromodulation of muscle metabolism in the nervous system in AIS, and analyses the dynamic balance in regulatory mechanisms of the neuromuscular system affecting spinal movement, which argues that an imbalance between the synergistic control of the central nervous system and the spinal neuromuscular system results in a series of kinetic compensatory responses of the spine, thus leading to AIS generation and/or development. This article is aimed at providing theoretical guidance for educational intervention approaches to address adolescent spinal health problems.