When surgery (fusion and instrumentation) is required for scoliosis, internal fixation of the spine to achieve correction and bony fusion is performed. Surgical correction via posterior fusion is typically performed for curves greater than 40 - 50°, often with accompanying discectomy and release of the anterior longitudinal ligaments for curves greater than 75°. Smaller incisions or use of portals for anterior surgery became available in the early 1990's with video-assisted thoracoscopic surgery (VATS). Potential advantages include less muscular and chest wall disruption, less impact on pulmonary function, quicker recovery time and smaller scars. Arlet (2000) completed a meta-analysis of 10 articles with a total of 151 patients, where VATS was utilized in scoliosis surgery. Of the 151 patients, 18% (27 complications) experienced major and minor complications, including major bleeding (3), prolonged ventilation (10), pulmonary complications (6), intercostal neuralgia (number not specified), aborted procedure (3), and one each chylothorax, infection, and tachycardia. A conclusion could not be drawn as to whether the complication rate is increased or decreased with VATS. The correction rate was similar to open thoracotomy.