Cervical scoliosis is encountered in patients with neurofibromatosis type I, Klippel-Feil syndrome, Goldenhar syndrome, and hemivertebrae. Radiculopathy is a common presentation with the coronal deformity being a secondary finding. If surgical management is pursued, the goal is to address the symptomatic etiology. In the setting of radiculopathy, the symptomatic levels can be addressed only without attempting risky procedures in order to correct the coronal deformity. However, if radiculopathy is arising from a hemivertebrae, then resection of the hemivertebrae can be performed via an anterior-posterior approach with concurrent decompression and stabilization. If neck pain is the main presentation of a patient with cervical scoliosis and non-operative management has failed, then posterior column osteotomies (Ponte or Smith-Peterson osteotomies) are an option. In conclusion, cervical scoliosis is rare, and if operative intervention is elected, it should be tailored to the patient’s symptomatology first and the scoliosis second.
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