• Ali Börekci, Murat Şakir Ekşi, Mahmoud Osama, Tamer Tunçkale, Mesut Yılmaz, Orkun Koban, Ahmet Öğrenci, and Sedat Dalbayrak.
• Neurosurgery Clinic, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Türkiye.
• World Neurosurg. 2023 Dec 1; 180: 222822-28.

ObjectiveTo present a new technique combining anterior release with allograft insertion and lateral fixation at the concave side of the curve, preserving the hemivertebra and posterior bilateral transpedicular fixation in patients with congenital kyphoscoliosis (CKS) who were not operated on until late adolescence, including long-term follow-up of patients, and a discussion of the literature on CKS with hemivertebra.MethodsTwo patients with CKS concomitant with hemivertebra underwent circumferential (anterior-posterior) instrumentation and fusion using a new technique.ResultsPatient 1 underwent a 2-stage operation, first anterior then posterior. Patient 2 was operated on circumferentially in 1 session. Both patients had >10 years of follow-up showing solid fusion of their operated spine segments. The patients were pain-free, and their body heights were comparable to healthy peers.ConclusionsIn our circumferential approach, we successfully integrated the hemivertebrae in anterior fusions rather than resecting them in older adolescents with CKS. This technique decreased bleeding, shortened operative time, and promised potential benefits compared with the available techniques in the literature.Copyright © 2023 Elsevier Inc. All rights reserved.

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