SummaryA thorough knowledge of the anatomy of the pedicles is necessary for the use of pedicle fixation. The pedicle connects the posterior elements to the vertebral body. Medial to the pedicle are the epidural space, nerve root, and dural sac.]There are many classifications of adolescent and adult scolisis for example. Ponseti and Friedman form five main patterns that behave differently: single major curve, single major thoracolumbar curve, combined thoracic and lumbar curve, single major thoracic curve and cervico-thoracic curve.King et al in trial to find a way for selection of fusion levels in idiopathic scoliosis described five idiopathic curve patterns in thoracic scoliosis, rather than as a complete idiopathic pattern classification.Dickson et al had developed simple classification of curve pattern occurring in idiopathic scoliosis:Single thoracic curve,single thoracolurnbar,single lumbar curve,double thoracic/thoracic,double thoracic/thoracolumbar or thoracic/lumbar curve and triple curve pattern.Also, Lenke et al., designed a new classification system includes:Curve type,lumbar spine modifier and sagittal thoracic modifier.The indications of surgery are not always definite. Each patient and each curve is unique and the chief indications are progression of the deformity, type and magnitude of the curve, the malignant group of progressive infantile scoliosis, progressive respiratory deficit, pain and psychological effects.The main goal in surgical intervention for fixation of spinal injury is to achieve a non pathological state between neutral elements and their supporting soft tissue. There are many types of instruments used in spinal fixation and correction of the deformity. Examples of these systems are Harringiton instrumentation system, Leque instrumentation system and pedicle screws system.The pedicle screw system has advantages over hook and wire implants with respect to vertebral anatomy, when they placed bilaterally, they provide rigid triangular cross-linked, also fixation strength.Advantages of thoracic pedicle screws are fixation of three columns of the spine, strong fixation, good safety and high accuracy.However, there are some complications of thoracic screw use including screw misplacement (lateral, medial, superior and inferior), neurological injury (by perforation causing haematoma), pedicle fracture, screw loosening, infection and others as pneumothorax.The surgical technique ,incision and exposure, factectomy, determination of pedicle entry, screws insertion and deformity correction.Other techniques are used as free hand, floroscopic and image guided .evaluation of screws can be done with floroscopic ,CT and EMG3. Allergic complaints , i.e.does the child suffer from asthma / recurrent bronchitis ?. Does the child react with allergic symptoms during or after contact with animals ?. Does the child suffer from eczema ?