目的　通过影像学方法分析单个半椎体所致的中重度脊柱侧凸的解剖特点，根据解剖特点设计手术方案并评价初期手术效果。  方法　中重度先天性脊柱侧凸患者16例，术前行X线、CT检查，分析半椎体位置、生长潜质、类型以及脊柱的侧后凸Cobb角、柔韧度，根据解剖特点选择后路截骨矫形、后路截骨矫形加前路植骨支撑术，评价术后临床疗效。  结果　患者均顺利完成手术，手术时间4.0～8.0 h，平均5.8 h ；术中出血量500～4000 mL，平均1350 mL。术前侧凸（67.8±8.4）°，术后（25.3±6.8）°，矫正率(63.1±6.1) %。术前后凸Cobb角为（73.5±10.7）°，术后（29.1±5.6）°，矫正率(60.1±6.2)%。无脊髓神经损伤、深部感染、深静脉血栓形成等并发症发生。随访X线片证实植骨均融合，未发现内固定物松动断裂、假关节形成等并发症，获得的矫形均无丢失。  结论　脊柱解剖特点对手术操作有指导意义，采用经后路矫正术对中重度先天性脊柱侧凸是一有效、可行的方法，如果半椎体相邻椎体楔形变严重，前路植骨支撑融合术是必要的。

Objective　To study anatomy of imaging technology on medium-to-severe congenital scoliosis caused chiefly by single hemivertebrae and evaluate the early clinical outcome of surgical approaches based on anatomy.　Methods　A total of 16 cases with medium-to-severe congenital scoliosis underwent X-ray and spiral CT reconstruction preoperatively, which were taken as the basis for surgical approaches, including location and growth potential and type of hemivertebrae, kyphoscoliosis Cobb angle and flexibility of spine. Techniques of posterior osteotomy or posterior osteotomy and anterior bone graft fusion were performed to correct the scoliosis. And clinical outcome of surgical approaches were analyzed.   Results　All surgeries were finished successfully. The surgical duration was 4.0~8.5 hours (mean, 5.8 hours), and the perioperative bleeding was 500~4000 mL (mean, 1350 mL). There was no occurrence of neurological deficit, infection or deep venous thrombosis. The scoliosis Cobb's angle was (67.8±8.4)° preoperatively, and (25.3±6.8)° postoperatively respectively, the correction rate of being (63.1±6.1)%. The kyphoscoliosis Cobb's angle was (73.5±10.7)°preoperatively, and (29.1±5.6)° postoperatively, the correction rate of being (60.1±6.2)% . Bony fusion was achieved in all patients and no pseudoarthrosis and implant failure occurred after the last follow-up. No obvious correction loss was observed either in coronal or sagittal plane.  Conclusions  Anatomy of spine are helpful for guidance of surgical program. Posterior surgical correction is a feasible and an effective procedure in the treatment of medium-to-severe congenital scoliosis. Anterior bone graft fusion will be a necessary procedure  if adjacent wedge-shaped vertebral bodies are severe.