Liu Z, Liu T, Hai Y, et al. - The present study was performed to explore changes in shoulder balance and prediction of final shoulder imbalance during growing-rod treatment for early-onset scoliosis. Researchers included a total of 24 consecutive patients who had undergone growing-rod (GR) treatment until final fusion. They assessed radiographic shoulder balance parameters, including the radiographic shoulder height, clavicle angle, and T1 tilt angle, before and after each step of the entire treatment. They examined demographic data, surgical-related factors, and radiographic parameters to distinguish risk factors for final shoulder imbalance. It was shown that shoulder balance could be improved by GR implantation but often changes during the multistep lengthening process, and the final result is relatively unpredictable. As per the results, final fusion could further adjust the prefusion shoulder imbalance. The data exhibited that focusing on the prefusion shoulder balance of GR graduates and providing patients with early shoulder balance after fusion might be necessary.