Spine deformity最新文献

{"title":"Construct-construct \"rail technique\" decreases screw strain during spinal deformity corrective maneuvers across a thoracic vertebral column resection: a cadaveric analysis.","authors":"Alekos A Theologis, Jason DePhillips, Izabella T Lachcik, Jonathan M Mahoney, Brandon S Bucklen","doi":"10.1007/s43390-025-01195-9","DOIUrl":"https://doi.org/10.1007/s43390-025-01195-9","url":null,"abstract":"<p><strong>Purpose: </strong>To biomechanically compare screw strains above and below a vertebral column resection (VCR) during segmental compression (SC) and cantilever bending (CB) performed via traditional methods and a novel, construct-to-construct accessory rod (\"rail\") technique.</p><p><strong>Methods: </strong>Eight cadaveric torsos underwent a VCR with 25⁰ kyphosis at T8 with pedicle screws implanted three levels above and below the VCR (T5-7; T9-11). Four screws (T6, T7, T9, T10) were instrumented with strain gauges to capture screw strains during SC and CB. Both deformity corrective maneuvers were performed over a traditional construct (central rod) and over a construct-to-construct accessory (\"rail\") rod. Real-time screw strains were collected and peak strains were compared between corrective techniques.</p><p><strong>Results: </strong>Strains in screws closest to the VCR were significantly less during \"rail\" compression compared to traditional SC (T7: p = 0.015). Maximum screw strains were significantly lower during \"rail\" SC and CB compared to traditional SC (T6: p = 0.037; T7: p = 0.015) and CB (T6: p = 0.018; T9: p < 0.001). Total screw strain was more evenly distributed over all screws during \"rail\" compression and CB compared to traditional techniques, which concentrated strain at individual screws adjacent to the VCR.</p><p><strong>Conclusions: </strong>Performing segmental compression and cantilever bending across a lateral accessory construct-to-construct (\"rail\") rod resulted in significantly lower strain on individual pedicle screws adjacent to a thoracic VCR compared to traditional SC and CB. As such, the \"rail\" may lessen risk of screw pull-out and screw plough during maneuvers to correct spinal deformities across a VCR.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239417","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":"Natural history study of scoliosis in patients with 22q11.2 deletion syndrome, starting before disease onset.","authors":"P P G Lafranca, S de Reuver, A Abdi, M L Houben, M C Kruyt, K Ito, R M Castelein, T P C Schlösser","doi":"10.1007/s43390-025-01193-x","DOIUrl":"https://doi.org/10.1007/s43390-025-01193-x","url":null,"abstract":"<p><strong>Purpose: </strong>To date, natural history studies on scoliosis development describe only curve progression but do not include its initiation. Around 50% of children with 22q11.2 Deletion Syndrome (22q11.2DS) develop a scoliosis. Longitudinal data from a large cohort of 22q11.2DS patients is available. This study aims to inventory the natural history of scoliosis development, starting before curve onset, in 22q11.2DS patients.</p><p><strong>Methods: </strong>22q11.2DS patients are biennially radiographically screened for scoliosis from age 6 to adulthood. All available radiographs were analyzed. Outcome measures were: skeletal maturity (modified Risser classification), coronal Cobb angles, curve angle fluctuation and treatment (bracing, surgery or no treatment). An evaluation was performed of scoliosis onset, risk of progression to > 30°, curve angle fluctuation and treatment.</p><p><strong>Results: </strong>722 full-spine standing radiographs of 292 patients were included. 116 (40%) of the patients developed a curve ≥ 10°, 44% of girls and 36% of boys. Thirteen (4%) progressed to a curve > 30° and seven (2%) required surgical treatment. In patients with radiographs before age 10, 49% already had a scoliosis. 22% of the patients already had a curve ≥ 10° at first visit. More fluctuation compared to a predicted trend line was seen in future scoliosis patients.</p><p><strong>Conclusion: </strong>It appeared that many 22q11.2DS patients already have fluctuating spinal asymmetry before age 10, often without progression, and that only a subset develops a severe progressive deformity. This longitudinal dataset provides the opportunity for future risk-profiling to distinguish between stable versus progressive scoliosis for the 22q11.2DS population.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233227","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":"Modern Luque Trolley technique in the surgical management of early onset scoliosis: a case report of a patient followed to maturity and final fusion.","authors":"John-David Brown, Jennifer Hurry, Jean Ouellet, Ron El-Hawary","doi":"10.1007/s43390-025-01191-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01191-z","url":null,"abstract":"<p><strong>Purpose: </strong>To present a case where the novel Modern Luque Trolley (MLT) technique was used to manage a patient with early onset scoliosis (EOS) and to assess the outcomes including graduation to fusion.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 5-year-old female with EOS associated with Prader-Willi syndrome underwent T5-L4 MLT surgery in April 2015. The operation, post-operative course, and 9-year follow-up period were uncomplicated. No autofusion occurred throughout the 7-year growth phase. In April 2022, the patient underwent elective uncomplicated \"graduation\" surgery to remove the MLT and posterior T5-L4 instrumented fusion was performed. Thirty-one months post-graduation, no complications occurred. During the 7-year growth phase, pre-index, immediate post-index, and 7-year post-index radiographs were analyzed. Scoliosis decreased from 52° to 10° post-index and then increased at 7 years to 31°. Maximal kyphosis increased from 24° to 27° post-index to 43^o at 7 years. T1-T12 coronal height increased from 16.0 cm post-index to 20.7 cm at 7 years. T1-S1 coronal height increased from 25.9 cm post-index to 33.9 cm at 7 years. T1-T12 sagittal spine length (SSL) was 15.6 cm post-index and then increased to 20.4 cm at 7 years. T1-S1 SSL increased from 27.2 cm post-index to 35.8 cm 7 years. T1-T12 3D true spine length (3D-TSL) increased from 16.2 cm post-index to 21.5 cm 7 years and T1-S1 3D-TSL increased from 27.3 cm post-index to 36.4 cm 7 years.</p><p><strong>Conclusion: </strong>These findings demonstrate the potential of MLT to decrease spine deformity and permit spinal growth while reducing autofusion.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233242","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":"Google and ChatGPT responses to common patient questions about scoliosis: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s43390-025-01179-9","DOIUrl":"https://doi.org/10.1007/s43390-025-01179-9","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186778","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":"Letter to the editor regarding \"Impact of a novel patient-specific, patient-matched Bezier parametric curve rod platform on proximal junction biomechanics in an in silico thoracolumbar instrumented fusion model\".","authors":"Leela Kumaran, Sheifali Gupta","doi":"10.1007/s43390-025-01170-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01170-4","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150775","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":"Impact of sex on S2-alar-iliac pelvic screw position and lumbosacral rod alignment in adult spine deformity.","authors":"Ramone M Brown, Wasil Ahmed, Matthew S Miyasaka, Daniel Berman, Jeremy Steinberger, Samuel K Cho, Jun S Kim, James D Lin","doi":"10.1007/s43390-025-01178-w","DOIUrl":"https://doi.org/10.1007/s43390-025-01178-w","url":null,"abstract":"<p><strong>Background: </strong>S2 Alar-Iliac (S2AI) screw placement is a common method to achieve stable lumbosacral fixation in the setting of multilevel fusion constructs. Differences in pelvic morphology between males and females can result in a more medial screw starting point in males. This can affect the ability to easily connect the pelvic screw to the rest of the construct. The purpose of this study is to assess the impact of sex and pelvic anatomy on the location of S2AI screw placement and lumbosacral rod alignment in the coronal plane.</p><p><strong>Methods: </strong>Consecutive cases with S2AI screw placement were identified. Radiographic measurements included the distance between the posterior superior iliac spine (PSIS) on preoperative computed tomography (CT) imaging, distance between S2AI screw heads, and rod-to-rod angles.</p><p><strong>Results: </strong>Females exhibited significantly greater distance between PSIS compared to males, reflecting sex-based anatomical differences in pelvic structure (p < 0.01). Average rod-to-rod angles were significantly more convergent distally in males than in females (p < 0.05). No significant differences were observed between freehand and stereotactic navigation techniques for rod-to-rod angles or screw distances. PSIS distance was a strong predictor of both rod-to-rod angle (β = 3.3, p < 0.01) and screw distances (β = 0.3, p < 0.01). When evaluating sex and technique as predictors, only sex was significant for PSIS distance (p < 0.01) and rod-to-rod angle (p < 0.05).</p><p><strong>Conclusions: </strong>The placement of S2AI screws demonstrate sex-based anatomical differences in the location of S2AI screw placement. These anatomical differences should be taken into account in preoperative planning.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200947","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":"Three novel orbito-cervical parameters: highly repeatable and simple measurements of horizontal gaze.","authors":"Féthi Laouissat, Sonia Ramos-Pascual, Jean-Charles Le Huec, Danilo Casasola, Ankitha Kumble, Mo Saffarini, Pierre Roussouly","doi":"10.1007/s43390-025-01186-w","DOIUrl":"https://doi.org/10.1007/s43390-025-01186-w","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this single centre radiographic study on healthy volunteers was to evaluate three novel orbito-cervical parameters in a population of healthy volunteers and calculate the observer agreements and errors for these parameters.</p><p><strong>Methods: </strong>The cohort comprised 126 healthy adult volunteers, 88 females and 38 males, aged 33.6 ± 12.0, with full-spine sagittal radiographs and no history of back and/or neck pain, spine and/or lower limb pathologies, or spine and/or hip surgeries. The following were measured on radiographs: C1-slope (C1S), orbito-cervical tilt (OCT), orbito-cervical incidence (OCI), chin-brow vertical angle (CBVA), McGregor's slope (McGS), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Pearson's correlation coefficients were calculated between all radiographic measurements.</p><p><strong>Results: </strong>C1S was 9.8 ± 6.6°(range, 0.1-29.1), OCT was 66.7 ± 6.9°(range, 48.7-82.0), and OCI was 75.9 ± 7.2°(range, 52.5-89.8). All measurements had excellent observer agreements (ICC > 0.900) and low observer errors (MAE < 2.5). OCI strongly correlated with C1S + OCT (r = 0.95, p < 0.001). OCT strongly correlated with McGregor's slope (r = - 0.78, p < 0.001), moderately correlated with CBVA (r = 0.64, p < 0.001), but weakly correlated with OCI (r = 0.46, p < 0.001). C1S moderately correlated with OCT (r = - 0.51, p < 0.001), OCI (r = 0.5, p < 0.001), CBVA (r = - 0.52, p < 0.001), and McGregor's slope (r = 0.64, p < 0.001).</p><p><strong>Conclusion: </strong>OCI is strongly correlated with C1S + OCT and these orbito-cervical parameters are to some extent correlated with existing sagittal cervical parameters. Furthermore, they have excellent observer agreements (ICC > 0.900) and low inter- and intra- observer errors (MAE < 2.5). The authors recommend the use of these orbito-cervical parameters in clinical practice to provide a better understanding of horizontal gaze, leading to improved preoperative planning for spinal fusion.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114180","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":"Utilizing stable vertebra on push-prone traction radiographs for the determination of the lowest instrumented vertebra: a novel approach for AIS patients with Lenke type 3C and 6C.","authors":"Tinnakorn Pluemvitayaporn, Suttinont Surapuchong, Nuttavut Chavalparit, Piyabuth Kittithamvongs, Warot Ratanakoosakul, Kitjapat Tiracharnvut, Chaiwat Piyasakulkaew, Sombat Kunakornsawat","doi":"10.1007/s43390-025-01188-8","DOIUrl":"https://doi.org/10.1007/s43390-025-01188-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess whether using stable vertebra on push-prone traction radiographs for selecting the lowest instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 3C and 6C undergoing posterior spinal surgery can preserve more lumbar motion segments while still achieving satisfactory surgical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;AIS patients requiring surgical treatment typically present with progressive curves exceeding 40° and are skeletally immature. This study specifically focuses on AIS patients exhibiting Lenke curve types 3C and 6C, which include structural thoracic as well as thoracolumbar and lumbar curves. The selection of the LIV remains a contentious issue due to concerns about distal adding-on and the potential for spinal imbalance postoperatively. Existing literature suggests that longer fusion constructs and positioning the LIV below L3 can lead to significant functional limitations and accelerated disc degeneration. While Lenke advocated for identifying the stable vertebra (SV) as the LIV, our recent study indicates that push-prone traction radiographs provide superior predictability for correcting postoperative spinal alignment. This study aims to evaluate the effectiveness of using the stable vertebra identified through push-prone traction radiographs as the LIV in preserving segmental motion during posterior spinal surgery for managing Lenke type 3C and 6C curves.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;AIS patients with Lenke type 3C and 6C who underwent posterior spinal surgery between 2021 and 2024 were enrolled in the study. Preoperative 36-inch whole spine radiographs, including push-prone traction view, were obtained for curve flexibility assessment. The lowest instrumented vertebra (LIV) was determined by identifying the stable vertebra (SV) on push-prone traction radiographs. Demographic data, including sex, age, BMI, Lenke's curve type, and pre- and postoperative major coronal Cobb angle, thoracic kyphosis, lumbar lordosis, and C7 to central sacral vertical line (C7-CSVL), were collected. Statistical analysis was conducted to assess the differences in curve magnitudes between pre- and postoperative measurements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-six AIS patients (33 female and 3 male) with a mean age of 13.9 ± 2.2 years were included in this study, with a mean follow-up period of 28.4 months. Preoperatively, the cohort presented with Lenke type 3C (24 out of 36) and Lenke type 6C (12 out of 36). The preoperative thoracic curve was corrected to an average of 5.7°, demonstrating an average correction rate of 89%. Similarly, the preoperative lumbar curve was corrected to an average of 5° with a correction rate of 90%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Push-prone traction radiographs may serve as an alternative method for determining the optimal LIV level in patients with Lenke type 3C and 6C. Identifying stable vertebra on push-prone traction radiographs","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114199","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":"Spinopelvic alignment and sagittal gait kinematics of adult patients with cerebral palsy.","authors":"Patrick P Nian, Vishnu Deep Chandran, Colson Zucker, Peter Cirrincione, Zhenkun Gu, Silvia Zanini, Jennifer Jezequel, Bridget Assip, Sherry Backus, Dara Jones, David Scher, Paulo Selber","doi":"10.1007/s43390-025-01190-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01190-0","url":null,"abstract":"<p><strong>Purpose: </strong>Sagittal spinopelvic alignment (SPA) is originally calculated by the algebraic expression pelvic incidence-lumbar lordosis (PI-LL), heralded numerous clinically relevant radiographic measures of spine alignment, e.g., T4-L1-pelvic angle. SPA malalignment compromises spine fusion outcomes and quality of life of typically aging persons. This study investigated gait and SPA of patients with cerebral palsy (CP) using multiple sagittal radiographic measures.</p><p><strong>Methods: </strong>Twenty-three patients, mean age 35 years with CP at GMFCS I-II were included. Radiographic measures included C2PA, T4PA, L1PA. PI-LL and T4-L1PA mismatch were defined as > 10°/ < - 10° and > 4°/ < - 4°, respectively. Trunk, pelvis, hips, and knees kinematics were obtained. Statistical parameter mapping (SPM) assessed kinematic differences throughout the gait cycle. Multivariable linear regression assessed the relationship between gait and radiographic parameters.</p><p><strong>Results: </strong>Fourteen and eleven patients (60.9% and 47.8%) presented with PI-LL and T4-L1PA mismatch, respectively. PI-LL mismatched patients demonstrated significantly lower knee flexion during gait. T4-L1PA mismatched patients demonstrated increased anterior pelvic tilt, hip flexion, and decreased knee flexion during gait, which was consistent with SPM analysis. Multivariable linear regression showed T4-L1PA, C2PA, and anterior pelvic tilt were associated with knee flexion.</p><p><strong>Conclusion: </strong>This is the first study to evaluate SPA parameters and gait kinematics in patients with CP. This observational and preliminary data suggested that SPA and knee flexion in gait may be associated. Whether the variations in gait patterns are coping mechanisms or the cause for SPA malalignment requires clarification. The implications of SPA malalignment on the quality of life of this population warrant further investigations.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102998","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":"Defining anatomical landmarks for simulated juxtapedicular screw placement for posterior spinal fusion in adolescent patients with scoliosis.","authors":"Adam A Jamnik, Sarah Pirkle, Dennis P Devito, Joshua S Murphy, Brandon A Ramo, Nicholas D Fletcher","doi":"10.1007/s43390-025-01160-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01160-6","url":null,"abstract":"<p><strong>Purpose: </strong>To define anatomical landmarks on the vertebrae at each spinal level for surgeons to use intraoperatively as a guide for the placement of juxtapedicular screws in the setting of hypoplastic or absent pedicles.</p><p><strong>Methods: </strong>Preoperative computed tomography (CT) of patients with adolescent idiopathic scoliosis (AIS) was analyzed for thoracic pedicles ≤ 3 mm wide, measured between the outer cortices at the isthmus, as these may require a juxtapedicular screw for safe placement. For these pedicles, a simulated juxtapedicular screw was placed into the vertebrae using image reconstruction software. The distance from the screw's insertion point was measured in the axial plane to the medial and lateral borders of the superior articular process (SAP) and to the posterior tip of the transverse process (TP), and in the sagittal plane to the junction of the SAP and TP. Screw trajectory angle was measured between the longitudinal axis of the screw and the sagittal and axial planes.</p><p><strong>Results: </strong>Of 6324 pedicles, a total of 378 pedicles (6.0%) met inclusion. The average distance to the medial and lateral borders of the SAP was 14.7 ± 3.4 mm and 10.7 ± 5.4 mm, respectively; to the tip of the TP was 9.0 ± 3.9 mm, and to the TP/SAP junction 2.8 ± 1.6 mm. The average angle in the axial plane was 21.1 ± 4.4° and in the sagittal plane it was - 4.2 ± 3.6°.</p><p><strong>Conclusions: </strong>Preoperative CT scans were used to map a safe starting point and trajectory for juxtapedicular screw placement in thoracic vertebrae. These findings can assist surgeons with thoracic pedicle screw placement.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087285","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}