A multitude of posterior and anterior segmental spinal instrumentation systems are now available for the treatment of idiopathic scoliosis. As a consequence, fixation strategies are more complex than they were with Harrington instrumentation. The newer systems provide better sagittal control and more stable fixation, allowing quicker mobilization of the patient. On thin patients, the bulk of these implants may be a problem. The techniques of fusion and the fusion levels remain constant.