The patient was an 8-year old girl with early onset congenital scoliosis. X-rays revealed long thoracic scoliosis of 56°. Midline incision was made from Th1 to L5 vertebrae. Screws were placed at T2,3,4 and L2,3,4 bilaterally. Spinal processes were removed from Th6 to L1 and four steel rods were secured with screws and wires that enable adjusting the lenght as the patient grows. Scoliosis is a medical condition in which a person's spine has a sideways curve. The curve is usually "S"- or "C"-shaped. In some the degree of curve is stable, while in others it increases over time. Mild scoliosis does not typically cause problems, while severe cases can interfere with breathing. The cause of most cases is unknown but believed to involve a combination of genetic and environmental factors. It can also occur due to another condition such as muscles spasms, cerebral palsy, Marfan syndrome, and tumors such as neurofibromatosis. Diagnosis is confirmed with plain X-rays. Credit: Hossein Mehdian at: oot-esj.com FOLLOW us @medicalpedia for more extreme cases!