Purpose or Case Report: The major concern for scoliosis in young children is the potential for poor pulmonary function and increased mortality. Early arthrodesis as well as severe spinal deformities can lead to ‘thoracic insufficiency syndrome’ by arresting spine growth and altering the shape of the thorax which results in restrictive lung disease. Several growth friendly instrumentation systems have been introduced to allow for growth until the timing is appropriate for spinal fusion for early onset scoliosis. The terminolgy of ‘growth friendly procedures ‘ is used for those which guide the growth of the spine. Growth modulation procedures are different from growth friendly procedures in the sense that vertebral growth is modulated and not guided. We aim to familiarize the radiologist by reviewing the types of ‘growing spine’ procedures performed at our hospital with an emphasis on what the radiologists should know and include in their reports.
Methods & Materials: We present several examples of imaging for postsurgical follow-up of patients with different growth friendly and growth modulation spinal instrumentation procedures performed at our hospital. The relevant information which should be included in a radiologist’s report along with the measurements that would be helpful for the decision of optimal fusion timing are discussed.

Results: ‘Growing spine’ instrumentation in early onset scoliosis is a useful method for preserving lung volumes. As the current methods can only establish improvement in one plane, they are far from sufficent and need further development. Therefore it is a hot topic in orthopedics practice. However; to our knowedge there are no articles in radiology literature regarding this concept.
Conclusions: Following review of this exhibit, pediatric radiologists will be more familiar with the types of “growing spine” procedures currently utilized and be able to provide useful information for the orthopedist.