12+6-year-old female presented with a severe 159-degree idiopathic thoracic scoliosis (Lenke curve classification 4AN). Her spine was nearly touching her ribcage. She underwent preliminary halo-gravity traction followed by a two-stage posterior spinal fusion and a posterior-based VCR for correction of her severe deformity. At 5 years postoperative, she has excellent correction of her curve, nicely maintained lung fields as well as clinical posture and appearance.