[Music] for foree for soina is an eight-year-old patient who presented to us from Bangladesh uh she suffers from Down syndrome and has uh multiple medical comorbidities uh she underwent cardiac surgery when she was four years old uh and following the sternotomy her curvature significantly progressed uh she presented to us with uh nearly uh 20° uh deformity there was aloc costal impingement as a result the abdominal cavity was reduced used and uh she was failing to thrive uh we have hence we decided to go in for a definitive Fusion uh she was a highrisk case due to her cardiac condition and uh she had significant uh blood loss as uh uh bleeding as well as a result and hence the procedure had to be done quickly uh and I think we have achieved uh a good result in this case you can see that the uh Alo uh Coastal distance has been significantly [Music] improved