Alice Baroncini, Aude Kerdoncuff, Daniel Larrieu, Cedric Barrey, Federico Solla, Christian Morin, Corinne Bronfen, Adele Hapiette, Gauthier Eloy, Richard La Croix, Thierry Odent, Ibrahim Obeid
{"title":"Severe scoliotic deformities: results of surgical treatment and complications in a multicentric series of children and young adults.","authors":"Alice Baroncini, Aude Kerdoncuff, Daniel Larrieu, Cedric Barrey, Federico Solla, Christian Morin, Corinne Bronfen, Adele Hapiette, Gauthier Eloy, Richard La Croix, Thierry Odent, Ibrahim Obeid","doi":"10.1007/s43390-025-01122-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The surgical management of severe spinal deformities (> 80°) in children and young adults remains challenging despite technical advances. Large, stiff curves with a short radius present a high complication rate, also in terms of acute or chronic spinal cord injury. There is a lack of consensus regarding the perioperative management of these curves, also due to the limited evidence available. This study aimed to review the strategies used in different hospitals for the surgical management of severe spinal deformities in young subjects and, in particular, to analyze the complication rate in a large series of patients.</p><p><strong>Methods: </strong>Multicentric, retrospective study on surgically treated patients younger than 25 with a coronal or sagittal deformity measuring at least 80°. Perioperative and radiographic data were collected. The rate of mechanical, neurologic, infectious, and other complications was analyzed, along with possible risk factors.</p><p><strong>Results: </strong>Data from 161 patients were analyzed. After surgery, there was a significant improvement of the deformity both on the coronal and sagittal plane. The overall complication rate was 25%. An increased angular ratio in the first postoperative X-ray was the main risk factor for the development of complications, along with a higher correction of the spinosacral angle. Performing a 3CO was associated with a higher risk of infections but not with a higher risk of mechanical complications. The use of an anterior approach did not increase the complication rate. A higher rate of non-mechanical and non-infectious complications was observed in patients who did not wear a brace or did not undergo halo traction before surgery.</p><p><strong>Conclusion: </strong>While spinal fusion is an effective treatment for the management of severe deformities, the rate of complications is still high.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine deformity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s43390-025-01122-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The surgical management of severe spinal deformities (> 80°) in children and young adults remains challenging despite technical advances. Large, stiff curves with a short radius present a high complication rate, also in terms of acute or chronic spinal cord injury. There is a lack of consensus regarding the perioperative management of these curves, also due to the limited evidence available. This study aimed to review the strategies used in different hospitals for the surgical management of severe spinal deformities in young subjects and, in particular, to analyze the complication rate in a large series of patients.
Methods: Multicentric, retrospective study on surgically treated patients younger than 25 with a coronal or sagittal deformity measuring at least 80°. Perioperative and radiographic data were collected. The rate of mechanical, neurologic, infectious, and other complications was analyzed, along with possible risk factors.
Results: Data from 161 patients were analyzed. After surgery, there was a significant improvement of the deformity both on the coronal and sagittal plane. The overall complication rate was 25%. An increased angular ratio in the first postoperative X-ray was the main risk factor for the development of complications, along with a higher correction of the spinosacral angle. Performing a 3CO was associated with a higher risk of infections but not with a higher risk of mechanical complications. The use of an anterior approach did not increase the complication rate. A higher rate of non-mechanical and non-infectious complications was observed in patients who did not wear a brace or did not undergo halo traction before surgery.
Conclusion: While spinal fusion is an effective treatment for the management of severe deformities, the rate of complications is still high.
期刊介绍：
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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