Abstract
Anterior vertebral body tethering (AVBT) offers an alternative to traditional spinal fusion for adolescent idiopathic scoliosis (AIS) that preserves spinal mobility. However, its novelty means that there is limited data on its associated complications. This case report details a rare postoperative complication: nephropleural fistula resulting in urinothorax occurring in a patient with AIS undergoing AVBT. This patient required extended hospital stays and multidisciplinary management. This occurrence underscores the need for identifying and managing unusual complications related to AVBT. Enhancing awareness can improve patient safety and optimize procedural outcomes in the evolving landscape of AIS treatment.