A, Birth radiograph of girl with 50-degree congenital scoliosis due to multiple vertebral anomalies. B, Curve had increased to 83 degrees by age 3 years. She underwent anterior convex spinal fusion and developed respiratory insufficiency 6 months after surgery, requiring supplemental nasal oxygen. C, “False” lateral decubitus view, better showing changes in dimensions of thorax in addition to spinal curvature. D, CT scan shows extreme hypoplasia of chest and underlying lungs.