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Reports of the prevalence and natural history of spinal deformity in younger pediatric patients became part of the orthopaedic literature in the middle of twentieth century. Formal use of the term “Early Onset Scoliosis” to describe a wide range of spinal pathology based on age of onset did not gain popularity until much later. Early reviews of the natural history of these deformities detailed which patients were at risk of progression, and which patients may benefit from intervention rather than simple observation. However, long-term follow-up of the application of adult spine deformity management principles in skeletally immature patients demonstrated a significant risk of both spinal and associated pulmonary complications over time. Reports of efforts to alter the natural history of these conditions through surgical treatment that attempted to control the deformity, while still allowing spinal growth, emerged in the late 1970s and 1980s.