{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:03:59Z","timestamp":1776755039034,"version":"3.51.2"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"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>The purpose of this study is to investigate the medium- and long-term correction outcomes and complications of early one-stage posterior-only surgery for congenital cervicothoracic scoliosis in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From March 2006 to March 2022, we retrospectively investigated 33 consecutive cases of congenital cervicothoracic scoliosis treated by one-stage posterior-only surgery, including 15 males and 18 females, with a mean age of 3.2 years. Radiographic parameters, including segmental scoliosis, distal compensatory curve, T1 tilt, clavicle angle, neck tilt, coronal balance distance, segmental kyphosis, and sagittal vertical axis, were measured preoperatively, postoperatively, and at the last follow-up. The results of the measurements were statistically analyzed using paired-sample <jats:italic>t<\/jats:italic>-tests. Complications were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean operation time was 199.8\u2005min (100\u2013340\u2005min) with an average blood loss of 261.5\u2005ml (80\u2013600\u2005ml). The mean follow-up period was 75.8 months (28\u2013182 months). Fusion levels averaged 3.4 segments (2\u20136 segments). The segmental scoliosis was improved from 48.2\u00b0\u2009\u00b1\u200910.7\u00b0 preoperatively to 10.0\u00b0\u2009\u00b1\u20096.0\u00b0 postoperatively (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), with a correction rate of 79.3%\u2009\u00b1\u200911.2%. The distal compensatory curve was spontaneously corrected from 23.4\u00b0\u2009\u00b1\u20099.8\u00b0 preoperatively to 9.2\u00b0\u2009\u00b1\u20095.7\u00b0 postoperatively (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), with a correction rate of 58.8%\u2009\u00b1\u200919.4%. One case of pleural rupture, three cases of transient nerve root injury, one case of Horner syndrome, and two cases of pleural effusion. Two cases underwent revision surgery due to loss of correction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early one-stage posterior-only surgery for congenital cervicothoracic scoliosis in children can effectively correct the local deformities and improve the appearance, and the medium- and long-term correction outcomes are satisfactory. Hemivertebra resection without internal fixation may be considered for some very young children. For the higher level of thoracic hemivertebra, the osteotomy level being shifted down one vertebra is a feasible and safer surgical procedure.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1473800","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T07:02:14Z","timestamp":1737615734000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Early one-stage posterior-only surgery for congenital cervicothoracic scoliosis in children: medium- and long-term follow-up"],"prefix":"10.3389","volume":"12","author":[{"given":"Cefei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuyun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiming","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufeng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/s0268-0033(02)00030-x","article-title":"Influence of age on cervicothoracic spinal curvature: an ex vivo radiographic survey","volume":"17","author":"Boyle","year":"2002","journal-title":"Clin Biomech (Bristol)"},{"key":"B2","doi-asserted-by":"publisher","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)"},{"key":"B3","doi-asserted-by":"publisher","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)"},{"key":"B4","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":"B5","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.2106\/JBJS.18.01428","article-title":"Outcomes of 360\u00b0 osteotomy in the cervicothoracic spine (C7-T1) for congenital cervicothoracic kyphoscoliosis in children","volume":"101","author":"Wang","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"B6","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/j.spinee.2018.11.006","article-title":"Evaluation of a combined approach to the correction of congenital cervical or cervicothoracic scoliosis","volume":"19","author":"Yu","year":"2019","journal-title":"Spine J"},{"key":"B7","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":"B8","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":"B9","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.2106\/00004623-198264080-00003","article-title":"The natural history of congenital scoliosis. 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