title: Treatment for severe idiopathic upper thoracic scoliosis in adolescence.
abstract: METHODS
  To review the study of severe upper thoracic scoliosis (>90 degrees) in adolescence treated with pedicle screw constructs.
  
  
  OBJECTIVE
  The purpose of the present study was to analyze the treatment for upper thoracic scoliosis in adolescence.
  
  
  BACKGROUND
  Upper thoracic scoliosis is an uncommon spinal deformity in young children. Upper thoracic scoliosis is special.
  
  
  METHODS
  There were 21 patients (11 boys and 10 girls) with severe upper thoracic scoliosis and their mean age was 15 years (range, 13-18 y). The mean Cobb angle was 102.2 degrees (90-118 degrees) The clavicle angle ranged from 18 to 23 degrees, with an average of 21 degrees. Patients with the major curve of scoliosis located in the upper thoracic spine were treated with a posterior spinal fusion with a pedicle screw-only construct. There was a minimum 2-year follow-up. Follow-up information was obtained clinically and radiologically.
  
  
  RESULTS
  All patients underwent a posterior spinal fusion with a pedicle screw-only construct. Their shoulders were nearly balanced. The preoperative major curve was 102.2±8.9 degrees with a flexibility of 25.8%±8.1% in a side-bending film. The deformity was corrected to 29.7±5.9 and 32.1±5.6 degrees at the most recent follow-up. There was a 3.9-degree correction loss during the postoperative follow-up. There were no neurological or vascular complications at 2 years of follow-up. There was no crankshaft phenomenon.
  
  
  CONCLUSIONS
  The pedicle screw constructs can be safely used for severe upper thoracic scoliosis. Curve correction is powerful for these curves, which are stiff and difficult to manage. Screw accuracy was excellent in this review.
authors.affiliation: Department of Orthopaedics, Pu Ai Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China. zck2003@163.com
authors.forename: Chang-Kun
authors.initials: CK
authors.lastname: Zheng
authors.forename: Wu-Sheng
authors.initials: WS
authors.lastname: Kan
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Zhao
authors.forename: Kun
authors.initials: K
authors.lastname: Li
mesh_terms: D000293:Adolescent; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome