Now she is close to 10 years old.She has attained a precocious menarche.Her Scoliotic curve is extending into the upper lumbar spine.Now that the lung growth is nearly complete it is time for a final intsrumented correction  and fusion.The cobb angle of her thoracolumbar curve measured 60 degrees.Instrumentation with pedicle screws from T4 to L3 was planned based on her standing Ap,standing Lateral & Supine Bending views.At surgery,the thoracic segment from T4 to T11 was found to be completely fused.Pedicle screws were placed in the thoracic and lumbar spine as seen in the prt-op images.Correction was achieved by rod rotation on the convex side at the Thoracolumbar junction and 6mm contoured rods were placed on either side sequentially(DePuy Synthes USSLL & UDS Systems were used).Costoplasty was performed to reduce the rib-hump.The excised ribs were used for the fusion.

She has good sagittal & coronal balance post-op and has no neurological deficit.She is walking independently and has been discharged on the 5th Post-op day in stable condition.the girl as well as her parents are happy with the cosmetic correction achieved.