Pigmented villonodular synovitis (PVNS) is a proliferative disorder of the synovial membrane of uncertain etiology. It commonly affects synovial joints of the appendicular skeleton and rarely affects the spine. We present the case of a young man presenting with a rapidly progressive myelopathy due to spinal cord compression by PVNS arising from a thoracic facet joint, which finally resulted in paraplegia.The spinal location of PVNS has been seldom emphasized in the rheumatologic literature. PVNS should be considered as a possible cause of soft tissue masses arising from the facet joints, with variable degrees of nerve root or spinal cord compression.

Surgical treatment of idiopathic scoliosis is recommended in curves of 45°, requiring reduction and transpedicular fixation. In 2007, we published our experience in the management of scoliosis using four screws in the construct base, two compression screws at the convexity apex, two cross-links and proximal hooks and sublaminar wires, and we reported satisfactory results. Since 2008, we used pedicle screw in the curve with better correction, balance, and rate of arthrodesis consolidation than the technique we performed before; however, this increased the cost, making the surgery inaccessible for our patients.This is the reason we use new constructions with a lower number of fused levels and with reduction in the number of implants to improve cost. The anterior approach with reduction and fixation has good clinical results and lower cost.We include patients with curves under 70° with the concavity to the left, performing anterior approach, reduction, and fixation. Ten patients with a 5-year follow-up were without loss of reduction or pseudoarthrosis, conserving sagittal and coronal balance.