Wu L, et al. - Via a retrospective study, the researchers examined the risk factors for pulmonary complications in congenital scoliosis (CS, an early-onset spinal deformity generated by vertebral abnormalities, which are distributed on the basis of failures of formation, segmentation, or both) subjects following posterior spinal instrumentation and fusion. Three hundred and twenty-three consecutive cases who underwent posterior spinal instrumentation and fusion for CS were evaluated. Postoperative pulmonary complications were ascertained in 45 subjects, which included pleural effusion, pneumonia, pneumothorax, atelectasis, pulmonary edema, respiratory failure, and prolonged mechanical ventilation in 34, 24, 3, 4, 2, 2, and 4 cases, respectively. For the development of pulmonary complications, the independent risk factors were age, reoperation, preoperative pulmonary disease, correction rate, middle thoracic screw-setting, and thoracoplasty. On the basis of the predicted probability of the logistic regression, the area under the receiver operating characteristic curve based was 0.903. Hence, for pulmonary complications following posterior spinal instrumentation and fusion in CS cases, age, reoperation, preoperative pulmonary disease, correction rate, middle thoracic screw-setting, and thoracoplasty were concluded as independent risk factors.