Although first attempts at treating spinal deformities date as far back as many years before Christ, those groundbreaking changes that define our contemporary practice of spinal surgery were accomplished by senior spine surgeons still actively practicing today. If we recall that the history of the first universal implant, pedicle screw, multisegmentary instrumentation, or instance of intraoperative neuromonitoring was only 50–60 years ago, we can better grasp the amount of distance that has been traversed in such short time.

Paul R. Harrington, M.D., does not hold historical significance because he invented a type of spinal implant that would solve the problems of innumerable patients, but because he took the first and most crucial step in making surgery imaginable, possible on the previously untouchable human spine. Harrington’s implant today may be only a curiosity of the past. However, the inspiration and courage it kindled endowed contemporary spine surgeons with the resolve to go beyond the acceptable and aim for better, the best results. With the demonstration of this kind of resolve, a wide range of patients from children and adolescents to octogenarians have been able to benefit from the rewards of corrective spinal surgery.

Despite these rapid developments in spinal deformity surgery, early-onset spinal deformity (EOSD) remained an orphan area that did not receive the attention it deserved. The causes for this paucity of interest can be traced back to the rarity of this condition, the lack of sufficient infrastructure and superstructure in many clinics to handle this oft-complicated patient group, and a lack of knowledge regarding the natural history and effective management of the pathology.

Fortunately, today the field of EOSD has changed drastically, becoming an area of passionate discussion, generation of tremendous evidence, and rapid discovery of knowledge. The incendiary effect of two factors that serve to accelerate and facilitate this striking change cannot be denied. The first is the definition of the thoracic insufficiency syndrome by Dr. Robert Campbell and the subsequent development of his implant to correct the problem. The second is the establishment of new standards for a well-known technique that had fallen into disfavor due to its previously disappointing results: the growing rod.

Many other advances have contributed to the invention of new treatment techniques, the design of new implants, and, more importantly, a better understanding of the disease and the conception of more realistic solutions. Among these are the formation of a committee on growing spine problems within the Scoliosis Research Society (SRS) that inspired new research and contributed to its coordination; the International Congress on Early Onset Scoliosis (ICEOS), the first of which convened in Madrid in 2007, bringing together all interested parties (surgeons, nurses, pulmonologists, basic scientists, and others) and providing a consistent scientific platform for the exchange of ideas; the founding of the Growing Spine Study Group (GSSG) and Children’s Spine Study Group (CSSG), the collection of multicenter data; and, last but not the least, the publication of this book, dedicated exclusively to spinal disorders in young children.