{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T16:57:20Z","timestamp":1773421040822,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Congenital scoliosis (CS) associated with multiple vertebral anomalies (MVAs) represents a biologically dynamic deformity in which cumulative segmental asymmetry, residual growth potential, and mechanobiological modulation interact to drive progression. Unlike isolated congenital lesions, MVAs exhibit growth-dependent and configuration-specific behavior, complicating risk stratification and timing of intervention. Despite extensive literature on congenital deformities, an integrated growth-oriented decision framework for this subgroup remains lacking. Methods: This narrative review synthesizes embryological, biomechanical, and clinical evidence related to vertebral growth potential, anomaly configuration, progression patterns, and age-dependent treatment strategies in CS with MVAs. A structured literature search of major databases was performed, and findings were analyzed thematically to propose a biologically grounded growth-based decision framework. Results: Across the literature, three interdependent determinants of progression consistently emerge: anomaly configuration, residual segmental growth capacity, and mechanobiological amplification during growth. High-risk configurations\u2014particularly mixed formation\u2013segmentation defects and fully segmented hemivertebrae with contralateral growth arrest\u2014demonstrate rapid and often non-linear progression. Thoracic involvement further modifies clinical urgency due to its impact on pulmonary development. Integration of developmental biology and mechanobiological principles supports a structured, growth-informed approach to surveillance and intervention timing. Conclusions: MVAs should be conceptualized as dynamic growth systems rather than static structural defects. A shift from angle-driven to growth-informed decision-making may enhance early identification of high-risk patterns while minimizing unnecessary premature fusion in lower-risk cases. Adoption of a structured growth-based framework provides a biologically coherent foundation for individualized management and long-term optimization of spinal and thoracic development.<\/jats:p>","DOI":"10.3390\/jcm15062198","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:06:22Z","timestamp":1773414382000},"page":"2198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Growth-Based Decision-Making in Congenital Scoliosis with Multiple Vertebral Anomalies"],"prefix":"10.3390","volume":"15","author":[{"given":"Seidali","family":"Abdaliyev","sequence":"first","affiliation":[{"name":"National Scientific Center for Traumatology and Orthopedics Named After Academician N.D. Batpenov, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniyar","family":"Yestay","sequence":"additional","affiliation":[{"name":"National Scientific Center for Traumatology and Orthopedics Named After Academician N.D. Batpenov, Astana 010000, Kazakhstan"},{"name":"The Institute of Life Sciences, Karaganda Medical University, Karaganda 100000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"Saginova","sequence":"additional","affiliation":[{"name":"National Scientific Center for Traumatology and Orthopedics Named After Academician N.D. Batpenov, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Chsherbina","sequence":"additional","affiliation":[{"name":"National Scientific Center for Traumatology and Orthopedics Named After Academician N.D. Batpenov, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daulet","family":"Baitov","sequence":"additional","affiliation":[{"name":"National Scientific Center for Traumatology and Orthopedics Named After Academician N.D. Batpenov, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serik","family":"Serikov","sequence":"additional","affiliation":[{"name":"National Scientific Center for Traumatology and Orthopedics Named After Academician N.D. Batpenov, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1186\/s40001-025-02943-3","article-title":"Advances in the diagnosis and treatment of congenital scoliosis","volume":"30","author":"Peng","year":"2025","journal-title":"Eur. J. Med. 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