Case example of a 13 year-old old female with progressive AIS. Clinical photographs show spinal imbalance, and elevated right shoulder (preoperative panels A, G). Adam's forward bend test shows right thoracic prominence correlating with vertebral rotation and right rib elevation. Radiographs in postero-anterior and lateral views show a proximal thoracic curve of 40°, a main thoracic curve of 74°, and a lumbar curve of 42° (panel C), with normal sagittal parameters (panel D). A posterior correction with fusion from T4-L2 was performed. Five years postoperatively, radiographs show a 97% correction of the proximal and main thoracic curves with a good maintenance of sagittal balance (panels E, F). Clinical photographs at 5 years show a restoration of spinal balance (panel B). The Adam's forward bend shows reduction of thoracic rib prominence (panel H). The pictures were kindly provided by courtesy of Dr. Larry Lenke.