The application of mechanical hemiepiphysiodesis to treat progressive scoliosis challenges the use of external bracing and/or observation (watchful waiting). Comparing the pooled rates for these two non-operative interventions shows no clear advantage of either approach; therefore, one cannot recommend one non-operative approach over the other to prevent the need for surgery in adolescent idiopathic scoliosis. Arresting curve progression with the HemiBridge System and avoiding fusion may significantly impact quality of life while reducing total lifetime patient care cost. Providing patients with a surgical alternative that is superior to the current non-operative standard of care is a paradigm shift that must be studied further to determine its safety and indications for use.