{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T01:51:56Z","timestamp":1771033916929,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the feasibility of a minimally invasive spine surgery strategy for congenital cervicothoracic scoliosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>From April 2022 to August 2022 in the hospital, three patients with torticollis and\/or shoulder imbalance due to a cervicothoracic hemivertebra were performed on by hemivertebra resection and short fusion of the adjacent vertebrae. Resection was operated by a posterior approach. The average age of three patients of surgery was 8 years 2 months and the mean follow-up period was 6 months. Radiographic assessments and cosmetic outcomes were documented on changes in measurements of segmental scoliosis, neck tilt, head shift, shoulder balance, and sagittal profiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean operating time of the procedure was 283\u2005min and the instrumentation density was 1.5 pedicle screws per vertebra. The mean estimated blood loss was 257\u2005ml, which was 20% less than the data described in various literatures. The mean segmental Cobb angle at the cervicothoracic deformity was 35.9\u00b0 before surgery, 20.7\u00b0 after surgery, and 16.3\u00b0 at the latest follow-up, with a correction rate of 54.59%. Neck tilt decreased from 17.3\u00b0 before surgery to 14.3\u00b0 after surgery, and 11.7\u00b0 at the latest follow-up, with a correction rate of 32.37%. T1 tilt improved from 16.5\u00b0 before surgery to 12.9\u00b0 after surgery, and 7.6\u00b0 at the latest follow-up, with a correction rate of 53.94%. The clavicle angle improved from 4.8\u00b0 before surgery to 3.1\u00b0 after surgery, and 1.9\u00b0 at the latest follow-up, with a correction rate of 60.42%. Head shift improved from 21.4\u2005mm before surgery to 9.2\u2005mm after surgery, and 12.3\u2005mm at the latest follow-up, with a correction rate of 42.52%. The correction of torticollis and shoulder asymmetry was achieved in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Minimally invasive spine surgery strategy may be an option for congenital cervicothoracic scoliosis. A good correction of cervicothoracic dissymmetry is achieved, accompanied by fewer pedicle screws and less blood loss. By deliberate operation in young kids, surgical intervention for severe compensatory curves can be prevented.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1137675","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T05:30:28Z","timestamp":1679549428000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Minimally invasive spine surgery strategy for congenital cervicothoracic scoliosis in children: Less blood loss and shortened segmental fusions\/fewer pedical screws"],"prefix":"10.3389","volume":"10","author":[{"given":"Zhou","family":"Zhiguo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liu","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Yuanxue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wu","family":"Xing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang","family":"Si","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ruichen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e172","DOI":"10.1097\/BPO.0000000000000922","article-title":"What's new in congenital scoliosis?","volume":"38","author":"Pahys","year":"2018","journal-title":"J Pediatr Orthop"},{"key":"B2","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/S0030-5898(20)31911-8","article-title":"Congenital scoliosis of the cervical or cervicothoracic spine","volume":"25","author":"Smith","year":"1994","journal-title":"Orthop Clin North Am"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2050","DOI":"10.1111\/os.13480","article-title":"Strategy and efficacy of surgery for congenital cervicothoracic scoliosis with or without hemivertebra osteotomy","volume":"14","author":"Zhang","year":"2022","journal-title":"Orthop Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3447","DOI":"10.1007\/s10143-021-01520-6","article-title":"Surgical challenges in posterior cervicothoracic junction instrumentation","volume":"44","author":"Balestrino","year":"2021","journal-title":"Neurosurg Rev"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.14245\/ns.2244554.277","article-title":"Evaluation and comparation of a novel surgical technique and hemivertebra resection to the correction of congenital cervical scoliosis in lower cervical and cervicothoracic spine","volume":"19","author":"Cao","year":"2022","journal-title":"Neurospine"},{"key":"B6","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/j.wneu.2017.12.026","article-title":"Posterior rigid instrumentation of C7: surgical considerations and biomechanics at the cervicothoracic junction. 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