Global Spine Journal最新文献

{"title":"Nomogram to Assess the Risk of Deep Venous Thrombosis After Posterior Lumbar Fusion: A Retrospective Study.","authors":"Xiang Li, Jinlong Ma, Lu Xue, Limin Wang, Guangjun Jiao, Yunzhen Chen","doi":"10.1177/21925682241289119","DOIUrl":"10.1177/21925682241289119","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objectives: </strong>Deep venous thrombosis (DVT) is a common complication following lumbar spine surgery, which can lead to adverse consequences such as venous thromboembolism and pulmonary embolism. This study aimed to investigate whether predictors of DVT can improve clinical interventions.</p><p><strong>Methods: </strong>The study included patients who underwent posterior lumbar fusion between 2012 and 2022. In the training cohort, stepwise logistic regression, based on the Akaike information criterion minimum, was used to identify variables for constructing the nomogram. The nomogram was evaluated and validated using calibration curves, Brier scores, receiver operating characteristic (ROC) curves, C-index, decision curve analyses (DCAs), clinical impact curves (CICs), and risk stratification analyses.</p><p><strong>Results: </strong>A total of 9216 patients were enrolled after screening. The nomogram included seven variables: cerebrovascular disease, diabetes, body mass index, age, pedicular screw quantity, D-dimer, and hypertension. Calibration plots demonstrated favorable agreement between predicted and observed probabilities. The C-index indicated satisfactory discriminatory ability of the nomogram (0.772 for the training cohort and 0.792 for the validation cohort). Additionally, the DCA and CIC revealed that the nomogram could provide clinical benefits for patients.</p><p><strong>Conclusions: </strong>This study successfully developed and validated a nomogram that can assess the risk of DVT following posterior lumbar fusion. The nomogram will assist surgeons in making informed clinical decisions.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPINE20 Recommendations 2024 -Spinal Disability: Social Inclusion as a Key to Prevention and Management.","authors":"Cristiano M Menezes, Carlos Tucci, Koji Tamai, Harvinder S Chhabra, Fahad H Alhelal, André E Bussières, Eric J Muehlbauer, Lisa Roberts, Hana I Alsobayel, Guido Barneschi, Marco A Campello, Pierre Côté, Luís Miguel Duchén Rodríguez, Alexandre F Cristante, Komal Kamra, Kazuya Kitamura, Robert Meves, Marcelo I Risso-Neto, Adriaan J Vlok, Sanjay Wadhwa, Karsten Wiechert, Ratko Yurac, Thomas Blattert, Giuseppe Costanzo, Bambang Darwono, Margareta Nordin, Yahya S Al Athbah, Ahmed Alturkistany, Rupinder Chahal, Joerg Franke, Manabu Ito, Markus Arand, Paulo Pereira, Carlo Ruosi, William J Sullivan, André L F Andújar, Carlos Henrique Ribeiro, Luis Eduardo Carelli, Jamir Sardá, Ana Lígia G E Machado, Sami AlEissa","doi":"10.1177/21925682241290226","DOIUrl":"10.1177/21925682241290226","url":null,"abstract":"<p><p>Spine disorders are the leading cause of disability worldwide. To promote social inclusion, it is essential to ensure that people can participate in their societies by improving their ability, opportunities, and dignity, through access to high-quality, evidence-based, and affordable spine services for all.To achieve this goal, SPINE20 recommends six actions.- SPINE20 recommends that G20 countries deliver evidence-based education to the community health workers and primary care clinicians to promote best practice for spine health, especially in underserved communities.- SPINE20 recommends that G20 countries deliver evidence-based, high-quality, cost-effective spine care interventions that are accessible, affordable and beneficial to patients.- SPINE20 recommends that G20 countries invest in Health Policy and System Research (HPSR) to generate evidence to develop and implement policies aimed at integrating rehabilitation in primary care to improve spine health.- SPINE20 recommends that G20 countries support ongoing research initiatives on digital technologies including artificial intelligence, regulate digital technologies, and promote evidence-based, ethical digital solutions in all aspects of spine care, to enrich patient care with high value and quality.- SPINE20 recommends that G20 countries prioritize social inclusion by promoting equitable access to comprehensive spine care through collaborations with healthcare providers, policymakers, and community organizations.- SPINE20 recommends that G20 countries prioritize spine health to improve the well-being and productivity of their populations. Government health systems are expected to create a healthier, more productive, and equitable society for all through collaborative efforts and sustained investment in evidence-based care and promotion of spine health.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor for: Comparison of Surgical Site Infection After Instrumented Spine Surgery in Patients With High Risk of Infection According to Different Antibiotic Prophylaxis Protocols: A Cohort Study of 132 Patients With a Minimum Follow-Up of 1 Year.","authors":"Pierre Ferrer Pomares, Pablo Duque Santana, Fernando Moreno Mateo, Charles Louis Mengis Palleck, Felix Tomé Bermejo, Luis Álvarez Galovich","doi":"10.1177/21925682241278324","DOIUrl":"https://doi.org/10.1177/21925682241278324","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Cost-Effectiveness of Hospital Outpatient Versus Ambulatory Surgery Center Lumbar Decompression Surgery.","authors":"Parimal Rana, Jane Brennan, Andrea Johnson, Chad M Patton, Justin J Turcotte","doi":"10.1177/21925682241290171","DOIUrl":"10.1177/21925682241290171","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Chart Review.</p><p><strong>Objectives: </strong>Outpatient spinal surgeries in Ambulatory Surgery Centers (ASCs) have gained traction due to their potential cost efficiencies and improved perioperative processes. This study aims to compare the cost-effectiveness and patient outcomes of lumbar laminectomies performed in hospital settings vs ASCs.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 771 patients who underwent 1 or 2-level outpatient laminectomy between 2019 and 2023. Patient demographics, 90-day and one-year clinical and patient-reported outcomes (PROs), and one-year episode of care costs were evaluated. A one-year cost-effectiveness analysis was performed using the EQ-5D to measure quality-adjusted life years (QALYs).</p><p><strong>Results: </strong>ASC patients demonstrated lower body mass index and American Society of Anesthesiologists (ASA) scores, with a higher prevalence of 1-level laminectomies compared to hospital patients. ASC-based laminectomy was associated with lower initial surgery cost and one-year episode of care costs ($5662 ± 4748 vs $10229 ± 9202, <i>P</i> < 0.001), with similar rates of complications and postoperative resource utilization. These trends remained after controlling for patient demographics, comorbidities, and number of levels treated. In patients completing baseline and 1-year EQ-5D scores, ASC-based laminectomy was over twice as cost-effective as hospital procedures ($64873/QALY gained vs $152630).</p><p><strong>Conclusions: </strong>The findings support the safety and one-year cost effectiveness of ASCs for appropriately selected patient populations undergoing lumbar laminectomy. Additional studies are needed to replicate these findings across institutions, and to assess the cost effectiveness of ASC-based laminectomy beyond one-year postoperatively.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Clinical Impact of Coronal Malalignment Following Circumferential Minimally Invasive Surgery (CMIS) for Adult Spinal Deformity Correction.","authors":"Teerachat Tanasansomboon, Babak Khandehroo, Worawat Limthongkul, Wicharn Yingsakmongkol, Neel Anand","doi":"10.1177/21925682241290759","DOIUrl":"10.1177/21925682241290759","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>To determine prevalence and clinical importance of patients who had postoperative CM after CMIS for ASD correction.</p><p><strong>Methods: </strong>We reviewed patients who underwent CMIS technique. Inclusion criteria were patients who were diagnosed with ASD, which is defined as having at least one of the following: coronal Cobb angle >20, SVA >50 mm, PI-LL >10, PT >20. They underwent >4 spinal levels fusion with CMIS technique and had at least 1-year follow-up. Preoperative and 1-year postoperative radiographs and clinical outcome measures (VAS, ODI, and SRS-22 scores) were used to make the comparisons.</p><p><strong>Results: </strong>120 patients were included. Radiographic outcomes, including CVA, coronal Cobb angle, LSF curve, SVA, LL, and PI-LL, and clinical outcomes, were significantly improved postoperatively in each of the 3 preoperative subgroups (Bao type A, B, and C). At 1-year post-operation, 10 patients (12.4 %) of type A turned out to be CM, 4 patients (21.1%) of type B, and 8 patients (40%) of type C remained CM. Comparing coronally aligned (CA) to coronally mal-aligned patients at 1-year follow-up in each coronal subtype revealed that clinical and radiographic outcomes were comparable.</p><p><strong>Conclusions: </strong>CMIS technique significantly improves radiographic and clinical outcomes for ASD patients. Incidence rates of postoperative CM were similar to open surgery. Type C patients were at risk of postoperative CM than types A and B. However, most 1-year outcomes were not significantly different between postoperative CA and CM patients regardless of the preoperative coronal alignment characteristics except ODI scores in type A.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Applications and Future Implications of Artificial Intelligence in Spine Surgery and Research: A Narrative Review and Commentary.","authors":"Alexander T Yahanda, Karan Joseph, Tim Bui, Jacob K Greenberg, Wilson Z Ray, John I Ogunlade, Daniel Hafez, Nicholas A Pallotta, Brian J Neuman, Camilo A Molina","doi":"10.1177/21925682241290752","DOIUrl":"10.1177/21925682241290752","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objectives: </strong>Artificial intelligence (AI) is being increasingly applied to the domain of spine surgery. We present a review of AI in spine surgery, including its use across all stages of the perioperative process and applications for research. We also provide commentary regarding future ethical considerations of AI use and how it may affect surgeon-industry relations.</p><p><strong>Methods: </strong>We conducted a comprehensive literature review of peer-reviewed articles that examined applications of AI during the pre-, intra-, or postoperative spine surgery process. We also discussed the relationship among AI, spine industry partners, and surgeons.</p><p><strong>Results: </strong>Preoperatively, AI has been mainly applied to image analysis, patient diagnosis and stratification, decision-making. Intraoperatively, AI has been used to aid image guidance and navigation. Postoperatively, AI has been used for outcomes prediction and analysis. AI can enable curation and analysis of huge datasets that can enhance research efforts. Large amounts of data are being accrued by industry sources for use by their AI platforms, though the inner workings of these datasets or algorithms are not well known.</p><p><strong>Conclusions: </strong>AI has found numerous uses in the pre-, intra-, or postoperative spine surgery process, and the applications of AI continue to grow. The clinical applications and benefits of AI will continue to be more fully realized, but so will certain ethical considerations. Making industry-sponsored databases open source, or at least somehow available to the public, will help alleviate potential biases and obscurities between surgeons and industry and will benefit patient care.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Curve of Endoscopic Lumbar Discectomy - A Systematic Review and Meta-Analysis of Individual Participant and Aggregated Data.","authors":"Chan Hee Koh, James Booker, David Choi, Danyal Zaman Khan, Hugo Layard Horsfall, Parag Sayal, Hani J Marcus, George Prezerakos","doi":"10.1177/21925682241289901","DOIUrl":"10.1177/21925682241289901","url":null,"abstract":"<p><strong>Study design: </strong>A systematic review and meta-analysis of individual participant and aggregated data.</p><p><strong>Objectives: </strong>To define the learning curves of endoscopic discectomies using unified statistical methodologies.</p><p><strong>Methods: </strong>Searches returned 913 records, with 118 full-text articles screened. Studies of endoscopic lumbar spine surgery reporting outcomes by case order were included. Mixed-effects nonlinear, logistic, and beta meta-regressions prdwere conducted to define the learning curves.</p><p><strong>Results: </strong>13 studies involving 864 patients among 15 surgeons were included in total. For transforaminal endoscopic discectomy, the estimated operating time for the first case was 95 min [CI: 87-104], and the estimated plateau was 66 minutes [CI: 51-81]. An estimated 21 cases [CI: 18-25] were required to overcome 80% of this deficit, but near-plateau performance was expected only after 59 cases [CI: 51-70]. The estimated risk of surgical complications on the first case was 25% [CI: 11%-46%], with an 80% reduction in relative risk requiring an estimated 41 cases. The expected postoperative VAS leg pain score after the first case was 2.7 [CI: 1.8-3.8], with an 80% improvement requiring an estimated 96 cases. Similar numbers were required to overcome the learning curves in interlaminar and biportal endoscopic discectomies.</p><p><strong>Conclusions: </strong>Approximately 60 cases are required to achieve proficiency in endoscopic lumbar spine surgery, although the greatest part of the learning curve can be overcome with 20 cases. This should be considered when designing implementation programmes for surgeons and service providers that wish to incorporate endoscopic spinal surgery into their practice.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Specialty Outcome Differences for Major Spinal Procedures in Low-Acuity Patients.","authors":"Anthony Price, Christopher File, Alvin LeBlanc, Nathan Fredricks, Rylie Ju, Nathan Pratt, Rishi Lall, Daniel Jupiter","doi":"10.1177/21925682241288500","DOIUrl":"10.1177/21925682241288500","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objectives: </strong>There is an ongoing debate as to the influence of specialty training on spine surgery. Alomari et al. indicated the influence of specialty on ACDF procedures. However, deeper analysis into other spine procedures and lower-acuity procedures has yet to occur. In this study, we aim to determine if the outcomes of the low American Society of Anesthesiologists (ASA) classification (ASA 1&2) patients undergoing spine surgery vary based on whether the operating surgeon was an orthopedic surgeon or a neurosurgeon.</p><p><strong>Methods: </strong>The NSQIP databases from 2015 to 2021 were queried based on the CPT code for nine common spine procedures. Indicators of surgical course and successful outcomes were documented and compared between specialties.</p><p><strong>Results: </strong>Neurosurgeons had minimally shorter operative times in the ASA 1&2 combined classification (ASA-C) group for cervical, lumbar, and combined spinal procedural groups. Neurosurgeons had a slightly lower percentage of perioperative transfusions in select ASA-C classes. Orthopedic surgeons had shorter lengths of stay for the cervical groups in ASA-C and ASA-1 classes (ASA-1). However, many specialty differences found in spine patients become less pronounced when considering only ASA-1 patients. Finally, postoperative complication outcomes and re-admission were similar between orthopedic and neurological surgeons in all cases.</p><p><strong>Conclusions: </strong>These results, while statistically significant, are very likely clinically insignificant. They demonstrate that both orthopedic surgeons and neurosurgeons perform spinal surgery exceedingly safely with similarly low complication rates. This lays the groundwork for future exploration and benchmarking of performance in spine surgeries across neurosurgery and orthopedics.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Osteopenia and Osteoporosis on Screw Loosening in MIS-TLIF and Dynamic Stabilization.","authors":"Hsuan-Kan Chang, Chih-Chang Chang, Yu-Wen Cheng, Ching-Lan Wu, Tsung-Hsi Tu, Jau-Ching Wu, Wen-Cheng Huang","doi":"10.1177/21925682241290747","DOIUrl":"10.1177/21925682241290747","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective series.</p><p><strong>Objective: </strong>Screw loosening in the surgical treatment of lumbar spine disease is a major complication of osteopenia or osteoporosis. This study investigated the risk of screw loosening following either MIS-TLIF or pedicle screw-based dynamic stabilization (DS) in patients with osteopenia or osteoporosis.</p><p><strong>Methods: </strong>We retrospectively enrolled patients receiving 1- or 2-level MIS-TLIF or DS in a single institute. All patients were diagnosed as having lumbar spondylosis without concurrent spondylolisthesis and found by dual-energy X-ray absorptiometry to have osteopenia or osteoporosis. Screw loosening was identified by X-ray and CT. Clinical outcomes were also assessed.</p><p><strong>Results: </strong>A total of 103 patients (50 MIS-TLIF and 53 DS) were confirmed to have osteopenia (-2.5<T-score < -1.0) or osteoporosis (T-score≦-2.5). The two groups, which were followed for 33.6 ± 24.7 and 52 ± 34.5 months, had similar T-scores (-1.97 ± 0.7 and -1.97 ± 0.6, respectively, <i>P</i> = 0.960). While both groups had significant improvements in back and leg pain assessed by VAS, ODI, and JOA scores, there was a significant difference in overall screw loosening rates between the MIS-TLIF and DS groups analyzed by percent of patients 38% and 18.9% (<i>P</i> = 0.039*) and by percent of screws 16.9% and 8% (<i>P</i> = 0.002*), respectively. Subgroup analysis showed a significant difference in screw loosening rate in osteopenia patients (<i>P</i> = 0.039* by person; <i>P</i> = 0.002* by screw), but no difference in osteoporosis patients.</p><p><strong>Conclusion: </strong>The screw loosening rate was higher in the MIS-TLIF group in the entire cohort. Osteopenia patients receiving MIS-TLIF were at significantly higher risk of screw loosening, while that risk was not different for osteoporosis patients, compared to DS.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlling the Apex in Early Onset Scoliosis Through Active Apex Correction (APC) Non Fusion Growth Modulating Technique, Is It a Myth?","authors":"Alaaeldin Ahmad, Majed Dwaik, Nam Vo, Abdullah Shah, Walid Yaseer, Mohammad Armouti, Farah Shahin, Mohammad Awad, Haya Warasna, Mohamad Banat, Bashar Awad, Ahmad Hammad, Yehia Bromboly","doi":"10.1177/21925682241289902","DOIUrl":"10.1177/21925682241289902","url":null,"abstract":"<p><strong>Study design: </strong>A multicenter retrospective study.</p><p><strong>Objectives: </strong>To determine the rate of Apex facet fusion in children with Early Onset Scoliosis treated surgically with the Active Apex Correction (APC) technique.</p><p><strong>Methods: </strong>Seventeen patients were treated with the APC technique as index surgery for Early Onset Scoliosis with more than 1 year of follow-up. A 3D CT scan was done to determine the facet fusion rate in the deformity's apex controlled with posterior tethering.</p><p><strong>Results: </strong>The average follow-up time was 26.4 months (12-56), Average age at index surgery was 81.2 months (30-132), and average number of surgeries done 1.3. Apical vertebrae studied for facet fusion were the 3 vertebrae in the apex in each patient that were subjected to posterior tethering according to the APC technique. In total they were 86 apical vertebrae (172 Facets studied with 86 convex side, 86 concave side). Our observations showed that 29 facet joints were fused (16% of the total facets studied),15 were on the convex, 14 on the concave side (no statistically significant difference). Regarding the facet joint distance in the non-fused facets was 0.99 mm on the convex side and 1.08 mm on the concave side with no statistical significance difference.</p><p><strong>Conclusion: </strong>APC for Early Onset Scoliosis achieves apical growth modulation and control utilizing posterior tethering without inducing fusion. This study demonstrated that APC is an effective non-fusion technique through the low incidence of facet fusion levels at the Apex, limiting the crankshaft phenomena seen in cases with apex control through arthrodesis.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}