To correct spinal deformity and harness the natural growth of a child’s spine, the Shilla growth guidance system has been developed. With more than 10 years of experience with this system, the author (developer) describes the best method for insertion of the Shilla device. Radiographic images aid in the placement of apical screws that fixate to the rod, and with mobility gained from spinal osteotomies, the apex is corrected to neutral in all planes and fused. Growing screws placed through the muscle with the aid of C-arm imagery are attached to the rod in such a way as to permit the continued control of spinal growth. The use of a provisional, convex rod allows for the first step in correction, followed by a sagittal-contoured concave rod placement, which is left long at both ends. A permanent convex rod replaces the provisional rod, which is removed. This is then followed by a derotational maneuver and the locking of 2 rods together with a crosslink. Wound closure begins with suture of the muscle and fascia over the implants to the midline.