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001). The mean improvement of superior scapular angle (S.S.A) and inferior scapular angle (I.S.A) were 16 and 21° respectively (p less then 0.001). Conclusion It is intuitive that more cosmetic scapular lowering with little chance of neurovascular problems can be achieved after VSO. In addition, scapular rotation can be corrected using this technique, which should be considered as one of the advantages of this technique.We believe that a properly applied VSO procedure in severe deformities is safe with predictable outcomes in the treatme

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