For a study, the researchers sought to determine how video-assisted anterior thoracic instrumentation (VATS), all hooks/hook-pedicle screw hybrid instrumentation (HHF), and all pedicle screw instrumentation (PSF) procedures for T-AIS compare in terms of results. The study included 3 groups of T-AIS patients who underwent thoracic fusion: VATS was performed on 98 patients with a mean curve of somewhere between 49.0° and 9.5° (Group 1); HHF was performed on 44 patients with a mean curve of somewhere between 51.1° and 7.4° (Group 2); and PSF was performed on 47 patients with a mean curve of somewhere between 47.6° and 9.9° (Group 3). Preoperative and postoperative radiological outcomes were compared. Surgical results were recorded till the most recent follow-up. When compared to the other groups, Group 1 had less blood loss, lower fusion levels, a longer surgical duration, and a longer hospital stay (P<0.01). With 78.8% and 78.2% immediate curve rectification, and 72.9% and 72.1% at 5 years, respectively, Groups 1 and 3 were equivalent across all time periods. In all time periods, Group 2 exhibited lower correction (P<0.0001). Group 3 showed a decrease in thoracic kyphosis and lumbar lordosis, while Groups 1 and 2 showed an improvement (P<0.0001). Group 1 had a higher rate of respiratory problems. Deep wound infections were more common in the back groups. For implant-related problems,2 patients in Group 1 and one patient in Group 2 underwent revision surgery. Only the posterior groups had reoperations for deep wound infections. This was the first study to compare the 5-year outcomes of anterior and posterior T-AIS surgery. Although all 3 surgical techniques produced considerable and long-lasting scoliosis correction, HHF curve correction was inferior to both VATS and PSF, with the latter 2 groups obtaining identical coronal correction. VATS, on the other hand, required fewer segments, improved kyphosis, and had no deep wound infection, whereas PSF required less time in the operating room, shorter hospital stays, and no revision surgery due to implant-related issues.