Purpose: The aim of this study was to evaluate clinical outcomes of surgical treatment for congenital scoliosis (CS) in cervicothoracic (CT) regions via combined antero-posterior approaches.

Subjects and Methods: Ten patients met the following criteria: 1) vertebral anomalies in the CT (C6-T2) level, 2) age < 20 years at the time of surgery and 3) minimum follow up of 1 year. Clinical charts and radiographs of the spine were reviewed retrospectively to investigate surgical outcomes.

Results: All patients underwent osteotomy and corrective fusion with one-staged combined anterior and posterior approaches. To prevent neurological complications, we resected pedicle of anomalous vertebrae and released nerve root completely. Mean age at OP: 11.9 y/o., duration: 411 minutes, EBL: 1031 ml. Magnitude of main curvature at preop, postop., and final follow-up were 48.6°, 32.2°. 29.1° , respectively. Head tilt angle were 10.9°, 5.3°, and 6.2°,respectively. Perioperative complications included misplacement of pedicle screws in two patients (20%) and neurological deficits in six patients. All patients who had neurological deficits were C8 palsy (MMT 1: 4., MMT 2: 1, MMT 4: 1). Revision surgeries were performed in 3 patients. All patients showed complete recovery, however, it took more than 6 months.

Conclusion: C8 palsy was a worrisome complication in corrective surgery with osteotomy for patients with cervicothoracic vertebral anomalies even though combined antero-posterior approaches was chosen for minimum retraction of the neural tissues with meticulous exposures.