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13+6-year-old female developed an extremely severe 158-degree scoliosis with her ribcage abutting her pelvis when standing. She was treated with a two-stage anterior and posterior spinal reconstruction and placed in halo traction for 3 months between stages. 5 years after surgery, she has excellent radiographic alignment and clinical posture. She also demonstrates a more normal body habitus that occurs after realignment of a severe deformity in patients who are often very thin because of their difficulty breathing and increased metabolism that can be associated severe spinal deformity.