Surgery for scoliosis has evolved dramatically over the past century—from posterior surgery and casting that resulted in poor deformity correction and high pseudarthrosis rates and that required prolonged bed rest to anterior thoracoscopic and miniopen approaches that result in reproducible curve correction ranging from 55% to 70% with high fusion rates. The future of scoliosis surgery lies in the application of growth-modulation approaches by way of minimally invasive techniques, which will result in curve correction while maintaining spinal motion and disc and motion segment integrity. The optimal approach will use genetic testing to predict curve progression, thereby providing the clinical data required for determining the appropriate candidate for the use of this strategy.