Thoracoscopically assisted surgery is a new approach to access the anterior spine to perform biopsies, anterior releases, diskectomies, and anterior instrumentation and fusion for idiopathic thoracic scoliosis. This approach compromises the chest wall less than an open thoracotomy does because it uses several small portal incisions. It has been suggested that this approach allows fusion of fewer motion segments and better correction of curvature than does posterior spinal fusion and instrumentation. The technique, which is still evolving, is technically demanding, requiring advanced training and special instrumentation and anesthesia techniques.