{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:52Z","timestamp":1787755612720,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2019,8,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There have been many reports on the treatment of congenital kyphoscoliosis. However, congenital deformities in the cervicothoracic spine (C7-T1) have not been well described because of the rarity of these conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The medical records and imaging studies of 25 children who were treated with 360\u00b0 osteotomy for congenital deformities in the cervicothoracic spine (C7-T1) at a mean age of 11.4 years were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All 25 children presented with torticollis; 4 presented with neck pain; 10, with facial asymmetry; and 3, with preoperative neurological deficits. Twenty-three patients had congenital deformities in other regions of the spine. Six patients had a total of 8 intraspinal deformities. On average, the cervicothoracic curve was corrected from 53\u00b0 preoperatively to 14\u00b0 at the latest follow-up, the segmental kyphosis was corrected from 25\u00b0 to 12\u00b0, and the head tilt improved from 25\u00b0 to 5\u00b0. Nineteen patients had a total of 28 complications, including 1 transient cord injury together with a permanent C8 nerve root injury, 11 transient nerve root injuries, 1 transient Horner syndrome, 9 cases of decompensation of a compensatory curve, 2 implant failures, 2 cases of hemothorax, 1 dural tear, and 1 case of delayed wound-healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Most congenital cervicothoracic deformities are fixed, and early surgical intervention may be needed. A 360\u00b0 osteotomy is indicated for this type of rigid deformity and may provide satisfactory correction. However, 360\u00b0 osteotomy in the cervicothoracic spine (C7-T1) is technically demanding with a higher risk of nerve root injuries, although most injuries tend to be transient. If the compensatory thoracic curve is severe and rigid, 1-stage or staged surgery in this region may be required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.18.01428","type":"journal-article","created":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T14:29:36Z","timestamp":1565706576000},"page":"1357-1365","source":"Crossref","is-referenced-by-count":18,"title":["Outcomes of 360\u00b0 Osteotomy in the Cervicothoracic Spine (C7-T1) for Congenital Cervicothoracic Kyphoscoliosis in Children"],"prefix":"10.2106","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7144-1503","authenticated-orcid":false,"given":"Shengru","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6741-6321","authenticated-orcid":false,"given":"Guanfeng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3971-6474","authenticated-orcid":false,"given":"Yang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2174-0297","authenticated-orcid":false,"given":"Siyi","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0083-5190","authenticated-orcid":false,"given":"Qianyu","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5662-2920","authenticated-orcid":false,"given":"Ye","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3129-5190","authenticated-orcid":false,"given":"Jianguo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking Union Medical College Hospital, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"1","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1097\/01.brs.0000192679.25878.f9","article-title":"CT imaging techniques for describing motions of the cervicothoracic junction and cervical spine during flexion, extension, and cervical traction","volume":"31","author":"Simon","year":"2006","journal-title":"Spine (Phila Pa 1976)."},{"issue":"4","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"833","DOI":"10.2106\/00004623-195840040-00007","article-title":"Osteotomy of the cervical spine; report of a case of ankylosing rheumatoid spondylitis","volume":"40","author":"Urist","year":"1958","journal-title":"J Bone Joint Surg Am."},{"issue":"22","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"2389","DOI":"10.1097\/00007632-199911150-00017","article-title":"Correction of cervical kyphosis using pedicle screw fixation systems","volume":"24","author":"Abumi","year":"1999","journal-title":"Spine (Phila Pa 1976)."},{"issue":"2","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1302\/0301-620X.79B2.0790197","article-title":"Osteotomy of the cervical spine in ankylosing spondylitis","volume":"79","author":"McMaster","year":"1997 Mar","journal-title":"J Bone Joint Surg Br."},{"issue":"9","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1007\/s00586-006-0290-x","article-title":"C7 decancellisation closing wedge osteotomy for the correction of fixed cervico-thoracic kyphosis","volume":"16","author":"Tokala","year":"2007","journal-title":"Eur Spine J."},{"issue":"2","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"174","DOI":"10.3171\/2011.3.SPINE10536","article-title":"Technique of cervicothoracic junction pedicle subtraction osteotomy for cervical sagittal imbalance: report of 11 cases","volume":"15","author":"Deviren","year":"2011","journal-title":"J Neurosurg Spine."},{"issue":"5","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"E342","DOI":"10.1097\/BRS.0b013e318245bcd4","article-title":"Pedicle subtraction osteotomy in the cervical spine","volume":"37","author":"Wollowick","year":"2012","journal-title":"Spine (Phila Pa 1976)."},{"issue":"6","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"695","DOI":"10.3171\/2010.5.SPINE08608","article-title":"Cervicothoracic junction kyphosis: surgical reconstruction with pedicle subtraction osteotomy and Smith-Petersen osteotomy. Presented at the 2009 Joint Spine Section Meeting. Clinical article","volume":"13","author":"Samudrala","year":"2010","journal-title":"J Neurosurg Spine."},{"issue":"8","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1007\/s00586-017-5071-1","article-title":"Three-column osteotomy for correction of cervical and cervicothoracic deformities: alignment changes and early complications in a multicenter prospective series of 23 patients","volume":"26","author":"Smith","year":"2017","journal-title":"Eur Spine J."},{"issue":"Suppl 1","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1007\/s00586-014-3655-6","article-title":"Three-column osteotomies of the lower cervical and upper thoracic spine: comparison of early outcomes, radiographic parameters, and peri-operative complications in 48 patients","volume":"24","author":"Theologis","year":"2015","journal-title":"Eur Spine J."},{"issue":"21","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"e95","DOI":"10.2106\/JBJS.16.00096","article-title":"Outcomes of spinal fusion for cervical kyphosis in children with neurofibromatosis","volume":"98","author":"Helenius","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1097\/BRS.0000000000002325","article-title":"Posterior-only hemivertebra resection for congenital cervicothoracic scoliosis: correcting neck tilt and balancing the shoulders","volume":"43","author":"Chen","year":"2018","journal-title":"Spine (Phila Pa 1976)."},{"issue":"Suppl 1","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/s00586-015-4352-9","article-title":"Multiple cervical hemivertebra resection and staged thoracic pedicle subtraction osteotomy in the treatment of complicated congenital scoliosis","volume":"25","author":"Zhuang","year":"2016","journal-title":"Eur Spine J."},{"issue":"6","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.jspd.2018.09.064","article-title":"Outcomes of 3-column osteotomy in cervicothoracic spine (C7\/T1) for congenital cervicothoracic scoliokyphosis in children [abstract]","volume":"6","author":"Zhang","year":"2018","journal-title":"Spine Deformity."},{"issue":"10","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.2106\/00004623-199910000-00002","article-title":"Natural history of congenital kyphosis and kyphoscoliosis. A study of one hundred and twelve patients","volume":"81","author":"McMaster","year":"1999","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201908070-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:12Z","timestamp":1787751912000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201908070-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,7]]},"references-count":15,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.18.01428","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,7]]}}}