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Background Posterior hemivertebra resection and short-segment fusion with pedicle screws are an established treatment in congenital scoliosis, which require pediatric-specific instrumentation. The purpose of this study was to report the results of utilizing cervical lateral mass screws instead of pedicle screws in the treatment of congenital scoliosis in children younger than 5 years old. Methods In an IRB-approved retrospective chart review study, patients <5 years old with congenital scoliosis who underwent posterior hemivertebra resection and fusion with lateral mass screws from 2013 to 2017 were included. Demographic information, pre- and post-operative radiographs, complications, and outcomes were extracted from the charts. Results Twenty-three patients were included in the final analysis with a mean age of 40 months, of which 14 were female. Patients were followed for a mean of 51.3±13.2 months. The mean blood loss was 210ml, and patients were hospitalized for a mean of 4 days post-operatively. The correction rate of the main coronal curve, compensatory cranial curve, compensatory caudal curve, and segmental sagittal curve was 74.8%, 68%, 65.2%, and 68.9%, respectively. Three complications were observed: one intra-operative pedicle fracture, one case of implant failure, and one deep surgical-site infection, all of which were successfully managed. Conclusions Our findings suggest that adult lateral mass screws can be used for transpedicular fixation of the thoracic and lumbar vertebrae in low-resource settings where pediatric-specific pedicle instruments are not readily available. The correction rate, outcomes, and complications are similar and comparable to pediatric-specific pedicle screws, in addition to being low-profile and less bulky compared to adult implants.

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Our aim was to introduce a new minimally invasive approach for surgical excision of femoral head–neck junction osteoid osteoma (FHNJOO) and review the available literature regarding its clinical manifestations and treatment methods. We included nine patients with FHNJOO in this series, who underwent resection via the minimally invasive direct anterior approach (DAA), from January 2010 to 2013. The functional outcomes were hip range of motion (ROM), visual analogue scale for pain (VAS), and Harris hip score (HHS), which were assessed pre- and postoperatively at 3 months at the last follow-up. We had nine patients with a mean age of 17.25 ± 6.75 years. The mean diagnosis delay was 23.56 ± 4.67 months. We had a mean follow-up of 93.67 ± 18.02 months. The hip ROM, VAS, and HHS were significantly improved from 97.78 ± 8.70 degrees to 121.11 ± 4.86 degrees, 63.93 ± 10.47 to 99.11 ± 1.76 degrees, and 7.3 ± 1.5 to 0.1 ± 0.3 degrees at 3-month and the last follow-up, respectively (p < 0.001). We observed no recurrence or complications. The minimally invasive DAA approach for surgical resection of FHNJOO can provide immediate pain relief and improve hip functional scores with no complication or recurrence on long-term follow-up. It provides easy and complete access to the lesion and causes no morbidity due to minimal dissection.