The 48th annual meeting of the Scoliosis Research Society (SRS) in Lyon, France, September 18-21, 2013, featured 129 conference presentations and 105 poster sessions. Adolescent Idiopathic Scoliosis A study from the SRS membership database followed more than 17,400 patients with adolescent idiopathic scoliosis and showed that surgical complications in the surgical treatment of idiopathic scoliosis are decreasing compared to surgical treatment 10 years ago, while the surgery is gradually shifting to a single posterior approach. The reduction in surgical complications may be related to the shift from a combined anterior and posterior approach to a single posterior approach and the widespread use of the pedicle nail, which has been reported to have increased rapidly from 9.5% in 2002 to more than 50% in 2007. The progression of scoliosis angle after surgery for idiopathic scoliosis continues to be one of the areas of current interest. In a 5-year postoperative follow-up study, 22% experienced an increase in distal scoliosis angle (adding on) after posterior spinal fusion, although this phenomenon did not have a significant impact on clinical outcomes or postoperative revision rates. Dr. Stuart Weinstein reported on the National Institutes of Health (NIH) Bracing for Idiopathic Scoliosis in Adolescents Study (BrAIST), a prospective randomized controlled study of bracing for idiopathic scoliosis in adolescents. The short-term follow-up results showed that brace treatment was effective and that the recommendation for brace wear was to wear the brace for more than 13 hours per day while awake. Adult spinal deformities In one study in the SRS member database, more than 7,500 adult spinal deformities were treated surgically. Unlike adolescent patients, the proportion of these patients who underwent combined anterior-posterior approach versus single posterior approach has not changed significantly in recent years and remains approximately equal. The complications associated with combined anterior-posterior approach surgery are slightly higher. However, the results of the International Spine Consortium study show that surgical treatment of adult scoliosis is cost-effective and has better outcomes than non-surgical treatment. The use of rhBMP-2 in long-segment fusions for adult scoliosis is an area that is receiving particular attention. Follow-up studies of adults with spinal deformities for at least two years have shown that rhBMP-2 reduces long-term postoperative complications and postoperative revision rates by reducing internal fixation failure compared with no rhBMP-2. With regard to the possible risk of tumorigenesis associated with rhBMP-2, a follow-up study of more than 12,700 patients on rhBMP-2 reported at the 2013 SRS Annual Meeting showed that age was a significant correlate of postoperative tumorigenesis, whereas rhBMP-2 was not significantly associated with postoperative tumorigenesis. In a multicenter study of the surgical treatment of adult spinal deformities, the results showed that the incidence of postoperative neurological dysfunction complications in adults with spinal deformities reached 17%. Junctional kyphosis proximal to the fused segment remains one of the more problematic issues to date, with three articles focusing on this aspect. Although previous studies have shown a positive correlation between complete correction of sagittal balance and enhanced lumbar kyphosis and postoperative outcome, it is now believed that surgical treatment of elderly patients with spinal deformities should appropriately preserve mild sagittal angulation of the spine and that reconstruction of anterior lumbar kyphosis should be moderate, thereby better preventing the development of junctional kyphosis proximal to the fused segment. In a randomized controlled study, the application of antifibrinolytic drugs reduced intraoperative blood loss in adults with spinal deformity surgery. Neuromuscular scoliosis Infection remains one of the aspects of surgical management of neuromuscular scoliosis that is of great concern. Several studies have shown that topical vancomycin applied to the wound at the end of surgery in patients with neuromuscular scoliosis reduces the incidence of postoperative incisional infections. Moreover, no other adverse effects were evident after topical application. Early-onset scoliosis Some scholars have reported preliminary results of applying vertebral body curvilinear nailing for early-onset scoliosis. However, the sample size is still small and the follow-up period is still short. Basic research Many spine centers are still working on animal scoliosis models. One study used a juvenile model of scoliosis in rats with chondrocyte hormone receptor defects. However, this model is more like osteogenesis imperfecta scoliosis than idiopathic scoliosis. Vitamin D continues to receive attention in basic research, and the results of a related animal study showed a significant increase in the volume and strength of bone fusion in rats supplemented with vitamin D compared to vitamin D-deficient rats.