Spine deformity最新文献

{"title":"Development of a classification system for potential sources of error in robotic-assisted spine surgery.","authors":"Ritt R Givens, Terrence T Kim, Matan S Malka, Kevin Lu, Thomas M Zervos, Joseph Lombardi, Zeeshan Sardar, Ronald Lehman, Lawrence Lenke, Rajiv Sethi, Stephen Lewis, Daniel Hedequist, Themistocles Protopsaltis, A Noelle Larson, Sheeraz Qureshi, Brandon Carlson, David Skaggs, Michael G Vitale","doi":"10.1007/s43390-025-01066-3","DOIUrl":"https://doi.org/10.1007/s43390-025-01066-3","url":null,"abstract":"<p><strong>Purpose: </strong>Robotic-assisted spine surgery (RASS) has increased in prevalence over recent years, and while much work has been done to analyze differences in outcomes when compared to the freehand technique, little has been done to characterize the potential pitfalls associated with using robotics. This study's goal was to leverage expert opinion to develop a classification system of potential sources of error that may be encountered when using robotics in spine surgery. This not only provides practitioners, particularly those in the early stages of robotic adoption, with insight into possible sources of error but also provides the community at large with a more standardized language through which to communicate.</p><p><strong>Methods: </strong>The Delphi method, which is a validated system of developing consensus, was utilized. The method employed an iterative presentation of classification categories that were then edited, removed, or elaborated upon during several rounds of discussion. Voting took place to accept or reject the individual classification categories with consensus defined as ≥ 80% agreement.</p><p><strong>Results: </strong>After a three-round iterative survey and video conference Delphi process, followed by an in-person meeting at the Safety in Spine Surgery Summit, consensus was achieved on a classification system that includes four key types of potential sources of error in RASS as well as a list of the most commonly identified sources within each category. Initial sources of error that were considered included: cannula skidding/skive, penetration, screw misplacement, registration failure, and frame shift. After completion of the Delphi process, the final classification included four major types of pitfalls including: Reference/Navigation, Patient Factors, Technique, and Equipment Factors (available at https://safetyinspinesurgery.com/ ).</p><p><strong>Conclusion: </strong>This work provides expert insight into potential sources of error in the setting of robotic spine surgery. The working group established four discrete categories while providing a standardized language to unify communication.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construct-construct \"rail technique\" decreases screw strain during spinal deformity corrective maneuvers: a mechanical analysis.","authors":"Alekos A Theologis, Jason DePhillips, Nathaniel A Myers, Jonathan M Mahoney, Brandon S Bucklen","doi":"10.1007/s43390-025-01079-y","DOIUrl":"https://doi.org/10.1007/s43390-025-01079-y","url":null,"abstract":"<p><strong>Purpose: </strong>To compare screw strains adjacent to a simulated spinal osteotomy between segmental compression (SC) and cantilever bending (CB) to SC and CB performed over a construct-to-construct lateral accessory rod (\"rail\").</p><p><strong>Methods: </strong>10 PCF foam blocks were instrumented with 6 polyaxial pedicle screws, each with a linear strain gage. SC and CB were performed over a traditional construct (midline rods) or over a construct-to-construct lateral accessory rod. Real-time screw strains were collected and peak strains were reported and compared between corrective techniques.</p><p><strong>Results: </strong>Strains in screws closest to the osteotomy were significantly less during \"rail\" compression compared to traditional SC. Maximum screw strains were significantly lower during \"rail\" SC (p < .001) and CB (p = 0.003) compared to traditional SC and CB, respectively. Total screw strain was more evenly distributed over all 6 screws during \"rail\" compression and CB compared to traditional techniques, which concentrated strain at individual screws adjacent to the osteotomy.</p><p><strong>Conclusions: </strong>Performing SC and CB across an accessory construct-to-construct lateral (\"rail\") rod resulted in significantly lower strain on individual pedicle screws adjacent to a simulated spinal osteotomy compared to traditional SC and CB. As such, the \"rail\" may lessen risk of screw pull-out and screw plow during maneuvers to correct spinal deformities. Future work focused on building upon this controlled study in cadaveric specimens will be important to validate these findings in more clinically relevant scenarios.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in patients with tether rupture after anterior vertebral tethering for adolescent idiopathic scoliosis: the good, the bad, and the ugly.","authors":"John T Braun, Sofia C Federico, David M Lawlor, Brian E Grottkau","doi":"10.1007/s43390-025-01077-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01077-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Though multiple studies have reported tether rupture rates after anterior vertebral tethering (AVT) as high as 50%, few have adequately analyzed the clinical significance of tether rupture and factors that potentially increase the likelihood of revision surgery. We reviewed 262 consecutive adolescent idiopathic scoliosis (AIS) patients after AVT with the goal of identifying early and late tether ruptures and categorizing these tether ruptures as inconsequential, consequential, problematic, or beneficial. Our hypothesis was that the tether rupture rate after AVT for AIS would be significant but only a small percentage of patients would require revision surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Charts, radiographs, and CT scans were reviewed for tether rupture in 262 consecutive AIS patients treated with AVT for thoracic and thoracolumbar/lumbar curves 33-77°. Early tether rupture occurred &lt; 2 years and late tether rupture ≥ 2 years postoperatively. Tether rupture was further categorized as inconsequential (final curve &lt; 40° and no pain), consequential (curve ≥ 40° and/or convex back pain), problematic (revision surgery required), or beneficial (improvement of overcorrection) at follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 262 consecutive AIS patients status post AVT (106 thoracic curves, 53 thoracolumbar curves, and 103 double curves), tether rupture was found in 45 patients with 66 curves (34 thoracic and 32 thoracolumbar/lumbar) treated at age 14.5 years and at Risser 2.6 and Sanders 4.7. Curves with tether rupture corrected from 50.3° preoperatively to 20.8° postoperatively, but lost 7.2° of correction with tether rupture settling at 28.0° final at 2.6 years (0-11 years). Early tether rupture occurred in 12/133 (9%) and late tether rupture in 33/129 (26%) patients with 2-11 year follow-up. Tether rupture was inconsequential in 67% (30/45) of patients, consequential in 13% (6/45), problematic in 16% (7/45), and beneficial in 4% (2/45). In those patients with tether rupture, 69% occurred in a thoracolumbar/lumbar curve and 47% demonstrated a rupture at L2,3. Revision surgery for a thoracolumbar/lumbar tether rupture involved tether replacement alone in 4 patients and thoracic fusion in 2 additional patients, 1 requiring thoracic fusion alone, and 1 requiring thoracic fusion with thoracolumbar/lumbar tether replacement (hybrid). Revision surgery for a thoracic tether rupture involved 1 tether replacement and 1 thoracic fusion. Revision surgery was unrelated to curve correction or loss of correction, but was related to multiple tether ruptures and convex back pain (p &lt; 0.005).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrated an early tether rupture rate of 9% and late tether rupture rate of 26% in a large series of patients treated with AVT for AIS over 14 years. While the majority of patients had inconsequential tether rupture (67%), with 7.2° loss of correction, a final curve &lt; 40°, and no pain, a numbe","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal impact of a perioperative pathway for spinal fusion in adolescent idiopathic scoliosis: a quality improvement project.","authors":"Lorena V Floccari, Michael T Bigham, Matthew Holloway, Kenzie D Lundqvist, Alexandria Rundell, Richard P Steiner, Kenneth T Bono, Todd F Ritzman","doi":"10.1007/s43390-024-01032-5","DOIUrl":"https://doi.org/10.1007/s43390-024-01032-5","url":null,"abstract":"<p><strong>Objective: </strong>Prior studies show that recovery pathway implementation after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) reduces length of stay (LOS) without increasing complications, but little is known about the sustainability and longitudinal outcomes of these initiatives. This study aimed to establish and continually improve a perioperative pathway for AIS patients undergoing PSF while tracking long-term LOS performance with iterative improvements.</p><p><strong>Methods: </strong>Implementation of the AIS care pathway at a single freestanding tertiary children's hospital was initiated in January 2016 (Phase 1) with iterative annual changes and a comprehensive update in September 2021 (Phase 2). The pathway involves preoperative optimization, standardized protocols, multi-modal pain regimen, early transition to oral pain medications, and early and frequent mobilization. Outcomes were tracked longitudinally using quality-improvement methodology, and comparisons between each group were performed.</p><p><strong>Results: </strong>Four hundred thirty six AIS patients (86 pre-implementation, 257 Phase 1, 93 Phase 2) who underwent PSF were included. Baseline patient demographics and Cobb angles were similar. Hospital LOS decreased from 5.1 days pre-implementation to 2.3 days in a stepwise fashion corresponding with pathway modifications. Intensive care unit (ICU) admissions decreased from 100% pre-implementation to 0% during Phase 2. Perioperative order set compliance increased from 0% pre-implementation to 100%. There were no significant increases in readmissions or reoperations. Direct hospitalization costs decreased by $5854.95 per case.</p><p><strong>Conclusions: </strong>A multidisciplinary perioperative pathway for AIS patients undergoing PSF significantly reduced hospital LOS by 55% and direct costs by 11.3%. Continuous improvement and data monitoring led to sustained positive outcomes over eight years.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trunk endurance differences between female adolescents with and without idiopathic scoliosis.","authors":"Hanh Thi Nguyen, Thanh-Van Le, Tan Minh Pham, Hieu Kim Huynh, Philippe Mahaudens, Ngoc-Minh Nguyen","doi":"10.1007/s43390-025-01075-2","DOIUrl":"https://doi.org/10.1007/s43390-025-01075-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared trunk muscle endurance between female adolescents with idiopathic scoliosis (AIS) and non-AIS groups.</p><p><strong>Methods: </strong>This cross-sectional study included 91 females. Trunk muscle endurance was assessed using the Ito-Shirado and Biering-Sørensen tests. Anthropometric and radiographic data were collected. The Mann-Whitney U test compared endurance and abdominal-to-paraspinal endurance ratio between groups. Spearman's correlation assessed relationships between endurance and participant characteristics.</p><p><strong>Results: </strong>The AIS group's performance on the Ito-Shirado and Biering-Sørensen tests was 57% and 68% of the non-AIS group's test durations, respectively (p = 0.001). However, there was no significant difference in the abdominal-to-paraspinal endurance ratio between the two groups (p = 0.7). Additionally, a low negative correlation was observed between paraspinal muscle endurance and both weight (rho = - 0.29, p = 0.006)) and BMI (rho = - 0.3, p = 0.005) in the AIS group, while abdominal endurance correlated negatively with height (rho = - 0.25, p = 001).</p><p><strong>Discussion: </strong>Females with AIS exhibit significantly reduced endurance in both paraspinal and abdominal muscles compared to healthy controls, despite maintaining a similar abdominal-to-paraspinal endurance ratio. The findings suggest the need for trunk muscle endurance evaluation and training in rehabilitation programs for individuals with AIS.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are abnormal preoperative hematological screening tests associated with allogeneic transfusion in idiopathic scoliosis surgery?","authors":"Vivien Chan, Suhas Etigunta, Armaan K Malhotra, Geoffrey Shumilak, David E Lebel, Kenneth D Illingworth, David L Skaggs","doi":"10.1007/s43390-025-01078-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01078-z","url":null,"abstract":"<p><strong>Purpose: </strong>Previous studies have suggested routine preoperative laboratory assessment may be unnecessary or excessive. The primary aim of this study was to determine the association between abnormal preoperative laboratory screening tests on allogeneic transfusion in pediatric patients receiving posterior spinal fusion for idiopathic scoliosis correction.</p><p><strong>Methods: </strong>The NSQIP Pediatric database for years 2016-2022 was used. Patients who were (1) < 18 years old, (2) received posterior arthrodesis for idiopathic scoliosis correction, and (3) had recorded preoperative laboratory tests were included in this study. Preoperative bloodwork values of interest were hematocrit, albumin, platelet count, international normalized ratio (INR), and partial thromboplastin time (PTT). Descriptive statistics were used to characterize patient demographics, surgical metrics, and preoperative laboratory values. Rate of allogeneic transfusion was stratified by laboratory value cut-offs and compared using G-test. Standardized cut-offs were used to define abnormal values. A multivariable logistic regression analysis was used to assess the impact of abnormal bloodwork values on rate of allogeneic transfusion.</p><p><strong>Results: </strong>There were 6057 patients included in this study. The mean age was 13.8 years. There were 13.6% that received allogeneic transfusion. The mean transfusion volume was 62.1 mL. Patients with abnormal preoperative INR (13.1% vs. 20.0%; p < 0.001), hematocrit < 35 (12.4% vs. 25.9%; p < 0.001), and albumin < 3.4 (13.4% vs. 25.8%; p = 0.004) had higher rates of transfusion. In the multivariable logistic regression analysis, INR > 1.2 (OR 1.4, p = 0.023) and hematocrit < 35 (OR 2.3, p < 0.001) were significantly associated with higher odds of allogeneic transfusion.</p><p><strong>Conclusion: </strong>Preoperative INR and hematocrit values can aid in risk stratification for allogeneic transfusion requirements. PTT and platelet count did not significantly impact perioperative transfusion rates or volumes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiographic outcomes of 19 proximal thoracic pedicle subtraction osteotomies for adult spinal deformity: a case series.","authors":"Justin Bird, Maxwell M Scott, Christopher Lucasti, Benjamin C Graham, David Kowalski, Emily K Vallee, Danielle E Chipman, Dil V Patel, Christopher L Hamill","doi":"10.1007/s43390-025-01076-1","DOIUrl":"https://doi.org/10.1007/s43390-025-01076-1","url":null,"abstract":"<p><strong>Purpose: </strong>To present a detailed analysis of postoperative clinical and radiographic outcomes of patients who underwent proximal thoracic pedicle subtraction osteotomy (PSO) for adult spinal deformity.</p><p><strong>Methods: </strong>A retrospective chart review was performed on 19 patients who underwent proximal thoracic (T2-T4) PSO between January 2018 and December 2021. Baseline patient characteristics, complications and radiographic outcomes were collected. Radiographic outcomes including thoracic kyphosis correction, overall segment correction, and global sagittal balance correction were measured using preoperative and postoperative radiographs.</p><p><strong>Results: </strong>19 patients with an average age of 66.9 ± 8.3 years underwent thoracic PSO, with 94.7% (n = 18) being females, in the setting of revision surgery. The mean thoracic kyphosis correction was 20.4 ± 8.5°. Overall segmental correction had a mean of 16.2 ± 3.9°. Global sagittal balance correction was an average of 13.9 ± 23.2 mm (mm). The median hospital stay was 4.0 (IQR: 3.0) days with a median of 1.0 (IQR: 2.0) days in the intensive care unit. 36.8% (n = 7) of patients had a major complication within 30 days: proximal junction kyphosis (PJK) (2), neurologic deficits (2), pneumonia (1), cardiopulmonary (1), death (1). 47.4% (n = 9) of patients had a major complication within 2 years: PJK (5), neurologic deficits (2), wound dehiscence/infection (1), pneumonia (1), cardiopulmonary (1), death (2). Average follow up was 636 (range: 43-1320).</p><p><strong>Conclusion: </strong>While thoracic PSO can achieve successful radiographic and clinical outcomes, it is also associated with a high risk of potential major complications and mortality, such as instrumentation or junctional failure and neurologic deficits.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What can we learn from scoliosis in children with the 22q11.2 deletion syndrome? Prognostic factors at pre-adolescent age for fast progressive, mild and self-resolving forms during adolescence.","authors":"Sabrina Donzelli, Peter Lafranca, Marteen Van Smeden, René Castelein, Tom Schlösser","doi":"10.1007/s43390-025-01073-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01073-4","url":null,"abstract":"<p><strong>Introduction: </strong>Longitudinal data starting before adolescence and before curve onset, may elucidate prognostic factors for later scoliotic curve development. The aim is to predict the maximum curve acceleration (MCA; °/month) and the final curve progression in a cohort of 22q11.2DS subjects screened for scoliosis.</p><p><strong>Methods: </strong>Scoliosis screening starts immediately after 22q11.2DS diagnosis. A minimum of 2 years follow-up, two assessments, Risser 0, open triradiate cartilage at start, were the inclusion criteria. Risser ≥ 3 corresponded to skeletally matured. Linear and logistic binary mixed effect models accounting for patients nested into multiple measurement occasions were created to predict MCA during adolescence and progressors (progression to ≥ 30) versus non-progressors (no scoliosis or < 30 at last follow-up).</p><p><strong>Results: </strong>161 subjects (59% females) with a mean baseline age 8.7 ± 2.4 years, follow-up of 4.2 ± 2.4 years and having reached skeletal maturity. Ultimately, 19 subjects became progressors and 142 became non-progressors. Curve magnitude at baseline was 8.8 ± 5.9° (range 0-50), at final follow-up 11.6 ± 12.4 (0-77). The mean curve acceleration was + 0.1 ± 0.5°, respectively + 0.2 ± 0.5°for non-progressors vs progressors during the acceleration phase. A linear mixed model showed that the triradiate cartilage closure accelerates MCA by 2.6 when adjusted for age and female gender. In a logistic mixed model, when the triradiate cartilage closes, the OR of reaching the MCA before the next follow-up is increased by 4.60 (CI95% 2.34-8.90 p < 0.001). No evidence for prognostic value of Risser in all derivated models.</p><p><strong>Conclusion: </strong>We found no evidence for the parameters in the coronal, sagittal nor transverse plane before curve onset acting as prognostic factors for curve behavior. In the prediction model on a longitudinal database that starts in many patients before scoliosis, no clear radiographic discriminant for later progressive scoliosis could be identified. The closure of the triradiate cartilage resulted as the best sign of pubertal spurt onset and scoliosis acceleration.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My orthopedic brace inventory (MOBI): a new, reliable, and valid questionnaire to identify barriers to brace adherence in adolescent idiopathic scoliosis treatment.","authors":"Omar Elsemen, Marie Beauséjour, Justin-Pierre Lorange, Samuel Sassine, Jean Théroux, Soraya Barchi, Julie Joncas, Sylvie Le May, Carole Fortin, Carl-Éric Aubin, Stefan Parent, Nikita Cobetto, Marie-Claire Ishimo, Hubert Labelle","doi":"10.1007/s43390-025-01074-3","DOIUrl":"https://doi.org/10.1007/s43390-025-01074-3","url":null,"abstract":"<p><strong>Purpose: </strong>Full-time wearing of an orthopedic brace has demonstrated effectiveness in limiting curve progression in adolescents with idiopathic scoliosis. However, treatment adherence is challenging, with an average wearing time of 13 h/day. Despite this issue, barriers to brace adherence have rarely been studied. The aim of this study was to develop and validate a new instrument tool to evaluate factors influencing brace adherence.</p><p><strong>Methods: </strong>Our study followed the COnsensus-based Standards for the selection of health Measurement INnstruments criteria (COSMIN). A conceptual framework was initially defined, and experts elaborated, reviewed, and selected candidate items. We also investigated the MOBI's factorial structure and its psychometric properties.</p><p><strong>Results: </strong>The MOBI initial version included 32 items related to four conceptual barriers to adherence, namely social/emotional, treatment, patient, and health system/professional. The factorial analysis led to an 18-item inventory with an internal consistency of 0.85 with four better-defined barriers (treatment social/emotional support structure, patient's self-image and perception, treatment adverse effects, and treatment acceptability. The MOBI-18f correlates with the SRS-22 domain treatment satisfaction and pain and the SF-12 mental health. Patients with poor brace wear time and more severe scoliosis will score higher on the MOBI-18f questionnaire.</p><p><strong>Conclusion: </strong>The MOBI-18f is a reliable and valid measure of patients' adherence to brace treatment. This questionnaire can be used to develop interprofessional adherence support intervention in AIS patients undergoing brace treatment.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetically controlled rod fracture is related to rod diameter but lower than TGR.","authors":"Matthew Weintraub, Omar Taha, Ritt Givens, Matan Malka, Mehdi M Elfilali, Kevin Lu, Paul Sponseller, Peter Sturm, Oheneba Boachie-Adjei, John Emans, Francisco Sánchez Pérez-Grueso, Michael G Vitale, Benjamin D Roye","doi":"10.1007/s43390-025-01067-2","DOIUrl":"https://doi.org/10.1007/s43390-025-01067-2","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the risk of rod fracture after growth-friendly early-onset scoliosis (EOS) surgery, compare the risk of fracture between magnetically controlled growing rods (MCGR) and traditional growing rods (TGR), and compare the risk of fracture based on rod diameter.</p><p><strong>Methods: </strong>EOS patients undergoing TGR or MCGR instrumentation were identified from a large, multi-national registry (Pediatric Spine Study Group). Subgroup analyses (chi-squared and Mann-Whitney U tests) were performed between rods with diameters ≤ 5 mm and > 5 mm and between MCGR and TGR. To account for difference in follow-up, a log-rank survival analysis was performed between subgroups over a 5-year period.</p><p><strong>Results: </strong>A total of 1588 patients, representing 3176 rods, met the inclusion criteria. There was no difference in pre-operative Cobb angle or maximum kyphosis between MCGR and TGR groups. At index surgery, MCGR patients were slightly older, taller, and heavier, although BMI was similar. The overall 2-year risk of rod fracture was 3.05%. TGR 2-year fracture risk was higher than MCGR (4.96% vs. 1.82%, p < 0.001). Similarly, among MCGRs, rods with a diameter ≤ 5 mm fractured at a higher rate than those > 5 mm. The 5-year survival analysis corroborated our 2-year findings.</p><p><strong>Conclusion: </strong>Although relatively rare, the risk of rod fracture in EOS patients may be higher than previously reported. The overall risk of rod fracture is higher with TGR compared to MCGR, and while smaller rod diameter led to increased risk of fracture in MCGR constructs, the rod diameter was not associated with fracture risk in TGR.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}