Surgical management of scoliosis has undergone dramatic changes over a 50year period. Starting with relatively simple posterior systems such as the Harrington and Luque rods, it evolved to concepts of anterior only procedures and combined procedures from a patient’s front and back. Recently introduced implant systems allow for unprecedented deformity correction from back-sided (posterior) only surgery. Experts from the University of Washington and elsewhere outline the relative merits and drawbacks of these various surgical approaches. They present modern techniques of anchoring a spinal deformity construct to the pelvis with the goal of preventing deformity recurrence. From the Series:Fifth Annual Harborview Spine Symposium