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Of the 359 patients (78.6% female) who underwent PSF or VBT for idiopathic scoliosis, 75 (20.9%) met IDE criteria for VBT (57 had PSF and 18 had VBT). 284 were not appropriate for thoracic VBT 77 (21.4%) had a non-thoracic primary curve, 80 (22.3%) were too mature at presentation, 36 (10.0%) had a lumbar curve 34°, 9 (2.5%) had a main thoracic curve out of range, and 1 had a proximal thoracic curve 40°. 81 patients (22.6%) had multiple exclusionary criteria. After decades with a successful treatment for AIS (PSF), we are at a