Scoliosis of the cervicothoracic junction is a scoliosis deformity that affects both cervical and thoracic vertebrae, with the apex of the scoliosis located at the cervicothoracic junction, including the range of C6 to T2. Most of the causes of this type of scoliosis are congenital embryonic developmental abnormalities resulting in vertebral deformities, which can be simple hemivertebrae, poor segmentation, or a mixture of deformities, the most common being the mixed type. The clinical incidence of this type of scoliosis is low, but due to the proximity of the deformity to the head and neck, the compensatory capacity of the upper and lower segments of the vertebrae is poor, and a smaller bending angle (Cobb angle >25°) can result in obvious cosmetic abnormalities, such as: unequal shoulders, sloping neck, skewed trunk, asymmetric facial development, and limited neck movement, etc. These deformities seriously affect the appearance and psychology of the child, and even affect the development of other organs (heart, These deformities seriously affect the child’s appearance and psychology, and even affect the development of other organs (heart, lungs, eyes). Most of these deformities worsen progressively with the development of the child, and delayed treatment can have serious consequences. The indications for surgery are: Lateral convexity with a Cobb angle greater than 30° that progresses with age, severe trunk loss, unequal shoulders, sloping neck; or the child has a need for cosmetic improvement. Surgical modalities include: post-stage hemivertebral resection; medullary osteotomy; concave cribriform joint release; spinal cord longitudinal fracture resection; cervical arch or lateral block screw placement; cervicothoracic transfer bar or PCF system fixation and other techniques. Efficacy evaluation: Coronal and sagittal Cobb angles, trunk offset, head tilt angle, and height difference between shoulders were measured and analyzed before and after surgery. The mean coronal Cobb angle was 45.8° preoperatively and 16.2° postoperatively, with a correction rate of 64.6%; all patients regained trunk balance; the mean head tilt angle was 6.8° preoperatively and 1.2° postoperatively, with a correction rate of 82.3%. There were no postoperative complications such as neurological complications. The advanced technology and its characteristics The cervicothoracic junction area, due to its special anatomical location, is surrounded by important blood vessels, nerves, trachea and other structures, which brings great challenges to the surgical treatment. Based on our mastery of posterior pedicle implantation and vertebral osteotomy techniques, our department has performed cervical pedicle or lateral block screw placement, C7~T5 vertebral osteotomy, and cervicothoracic shift rod fixation. The technique of posterior stage osteotomy for congenital scoliosis in the cervicothoracic junction area has reached the advanced level in China. The congenital deformity in the cervicothoracic junction area can cause lateral kyphosis in the cervicothoracic segment, which is difficult to treat surgically. Compared with the previous in situ fusion, posterior one-stage osteotomy with screw system orthopedic fixation in the cervicothoracic segment can achieve satisfactory results, which is a safe and effective method. It shortens the hospitalization time, reduces the number of operations, greatly reduces the financial burden for the child’s family, and allows the child to regain self-confidence. The social and economic benefits are remarkable.