Hemivertebral deformity is the most common cause of congenital scoliosis, a disorder of vertebral body formation, resulting in scoliosis accounting for approximately 46% of congenital scoliosis. It can be classified as unsegmented, partially segmented and fully segmented. Since fully segmented hemivertebrae have normal growth capacity, the resulting deformity is progressive and requires early surgical treatment. Wang Kelai, Department of Pediatric Surgery, Qilu Hospital, Shandong University The surgical methods include anterior-posterior convex epiphyseal block, convex epiphyseal block with concave subcutaneous spreading and hemivertebral resection. Anterior-posterior convex epiphyseal block can stop or slow down the progression of scoliosis in some cases, but it has no orthopedic effect and the external fixation time is long. Convex epiphyseal block with concave subcutaneous spreading, although it has some orthopedic effect, requires multiple surgeries, a long treatment process, and a heavy mental and financial burden on the patient. Hemilaminectomy can directly remove the deformity-causing factors and is a more ideal treatment method. At present, there are two types of hemivertebrectomy: anterior and posterior stage or staged hemivertebrectomy and posterior hemivertebrectomy. The adjacent cartilage endplates must be completely removed to expose the cancellous bone, and the gap left after compression is filled with cancellous bone. After hemilaminectomy, the adjacent vertebrae produce a solid intervertebral fusion without pseudarthrosis and low orthopedic loss (within 5°). Posterior hemilaminectomy alone provides satisfactory orthosis in both the coronal and sagittal planes, achieving the same orthopedic results as anterior and posterior hemilaminectomy. The younger the age at the time of surgery, the more flexible the compensatory bend, the better the orthopedic result, and the shorter the fused segment. The softer bone quality and smaller diameter of the pedicle in pediatric patients narrow the choice of internal fixation devices. In this group of cases, the Stryker posterior cervical nail bar fixation system was used under the age of 5 years; the Stryker DIAPASON posterior spinal fixation system was used over the age of 5 years. Whenever appropriate internal fixation devices are available, the procedure should be performed nearly as early as possible to shorten the extent of fusion. The main complication of posterior hemivertebrectomy is arch cut, mainly due to the concentration of stress in the short segment fixation and the soft bone quality of the child. To avoid pedicle dissection, the hemivertebral body should first be completely removed until there is no significant resistance to compression, with slow and gentle intraoperative force. If pedicle dissection occurs, the pedicle screw placement should be repositioned. In scoliosis due to hemivertebrae, the spinal cord tends to drift to the concave side, and the pedicle of the hemivertebrae is thicker than normal, so the cancellous bone in the vertebral body is easier to remove through the pedicle, and the interference with the spinal cord is small. The incidence of neurological complications of anterior and posterior hemivertebrae resection is 1-20.5%, and the most common nerve root compression at the corresponding level is manifested as transient muscle weakness. In our group, there was a case of postoperative lower limb numbness and muscle weakness on the hemivertebral side of the child, which recovered after half a month, considering that it may be related to surgical stimulation. Intraoperatively, attention should be paid to check whether the dura is compressed and whether the nerve root foramen is patent. If the dura is compressed, decompression is performed by biting off the laminae upward and downward; the nerve root foramen is narrowed to relax and add pressure appropriately. Compared with anterior and posterior hemilaminectomy, the advantages of posterior hemilaminectomy are shorter operation time, less interference with thoracoabdominal organs, and less surgical trauma. In cases with spinal cord deformity, spinal canal exploration, release of spinal cord and cauda equina adhesions, resection of the longitudinal fibrous septum or bony septum of the spinal cord, spinal membrane repair and end filament release can be performed simultaneously. Due to the restricted posterior surgical field, it is more difficult to deal with epidural plexus bleeding during resection of the posterior wall of the vertebral body, which is the reason for more bleeding in the posterior approach. Posterior hemivertebral resection can achieve the same orthopedic results as anterior and posterior stage surgery, with less surgical trauma, a lower incidence of neurological complications, and a wide range of indications.