Gajaseni P, Labianca L, Kalakoti P, et al. - This study was undertaken to investigate outcomes of proximal hooks and distal screws (PHDSs) technique. Between 2006 and 2015, researchers conducted a retrospective review of consecutive AIS patients undergoing posterior spinal fusion by a single surgeon. They reported patient demographics and radiographical parameters (radiographic shoulder height (RSH), T1 tilt, clavicle angle) at baseline, 6-week and 2-year post-operation. The primary endpoint included variation in RSH from baseline measurements evaluated applying repeated measures one-way analysis of variance with Bonferroni correction. The study population consisted of 219 patients (mean age at surgery: 13.68 years; 82% female). The PHDS was found to be the potential for additional shoulder balance improvement. It was shown that extension of fusion to structural proximal thoracic spine is the key to success for shoulder balance. It remains to be seen whether these improvements will translate into enhanced clinical results in the longer term.