Spine deformity最新文献

{"title":"Ultrasound assessment of MCGR distraction and distractibility in early onset scoliosis.","authors":"Martin M Estefan, Nigil Palliyil, Alan M Gessara, Masood Shafafy","doi":"10.1007/s43390-025-01144-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01144-6","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620351","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 a novel patient-specific, patient-matched Bezier parametric curve rod platform on proximal junction biomechanics in an in silico thoracolumbar instrumented fusion model.","authors":"Franck Le Naveaux, Bahe Hachem, Sasha Vaziri, Varun Puvanesarajah, Saeed Sadrameli, David O Okonkwo, Thomas J Buell, Amit Jain, Hamid Hassanzadeh, Craig Forsthoefel, Reginald Fayssoux, Zachary J Tempel, Alekos A Theologis, Christopher S Ahuja","doi":"10.1007/s43390-025-01146-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01146-4","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the biomechanical performance of a novel Bezier surface-smoothed transition rod, and to compare it to conventional and stepped rods, focusing on correction capability, spinal stabilization, instrumentation and spinal loading related to risk of proximal junctional kyphosis (PJK).</p><p><strong>Methods: </strong>A spine finite element model with patient-specific 3D spinal geometry (severe sagittal imbalance from thoracolumbar kyphosis) was used. Surgical instrumentation with five rod types was simulated: (1) constant 6.0 mm diameter, (2) stepped 6.0 mm-5.0 mm diameter, (3) Bezier 6.0 mm-5.5 mm-5.0 mm diameter, (4) constant 5.5 mm diameter, and (5) Bezier 5.5 mm-5.0 mm-4.75 mm diameter. Gravitational forces and flexion movements were simulated to compare load transfer between the spine and instrumentation.</p><p><strong>Results: </strong>All rod configurations achieved equivalent sagittal correction. Load distribution analysis showed that Bezier rods provided smoother load transitions and better offloading of proximal segments compared to constant diameter rods. The highest moment sustained by the segment adjacent to the instrumentation was observed with the constant 6 mm rod (9N.m), while the Bezier 5.5-5-4.75 mm rod showed the lowest moment (7.5Nm), indicating reduced stress of 16% on the upper adjacent vertebrae. Similarly, the Bezier rods were more effective in offloading pedicle screws up to 45% with respect to the stiffer rod construct, potentially reducing the risk of PJK.</p><p><strong>Conclusions: </strong>The simulation analysis demonstrates Bezier rods offer promising biomechanical benefits particularly in load distribution and stress reduction at adjacent levels of long thoracolumbar instrumentation. Future efforts will focus on clinical validation and optimization of patient-specific designs.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609363","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":"Complications in vertebral body tethering: what are the short term effects on patient reported outcomes?","authors":"Katherine D Sborov, Mansi Agarwal, Michael J Heffernan, Jason B Anari, Benjamin Roye, Stefan Parent, Firoz Miyanji, Selina C Poon","doi":"10.1007/s43390-025-01107-x","DOIUrl":"https://doi.org/10.1007/s43390-025-01107-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Vertebral body tethering (VBT) has continued to gain popularity for the treatment of idiopathic scoliosis (IS); however, complication and reoperation rates have been reported as high as 25%. There is a paucity of data on the clinical and long-term outcomes of VBT. The purpose of this study is to determine how complications from VBT effect patient quality of life (QOL) up to three years after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort study, the patients were identified via an analysis of multi-center electronic medical record data from the Pediatric Spine Study Group (PSSG). All patients who underwent VBT for IS were included. The dataset was screened to include only patients who had patient reported outcome data documented both before and after surgery. Patient demographics, surgery dates, complications, Early Onset Scoliosis Questionnaire (EOSQ) scores, and Scoliosis Research Society (SRS) scores were collected. Complications were classified using the modified Clavien-Dindo-Sink (mCDS) complication classification system. The analysis of QOL after surgery was determined comparing survey scores of patients with and without any complication over time. Additional analysis was similarly performed comparing patients with no or mild complications, defined as mCDS grade I and II, to those with severe complications, defined as mCDS grade IIIA or above.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study consisted of 339 total surveys from 81 patients with EOSQ data and 293 total surveys from 101 patients with SRS data. Among the 81 patients with EOSQ data, 15 patients experienced a complication, with eight patients suffering a severe complication. Among the 101 patients with SRS data, 42 patients experienced a complication, and 22 patients suffered a severe complication. When comparing patients with a complication to those with without a complication, patients with complications had significantly lower total EOSQ scores at 2, 2.5, and 3 years after surgery (p = 0.009, 0.001, and &lt; 0.001 respectively); however, there was no difference in total SRS scores at any time point. In comparing patients with severe complications to pts with mild complications/no complication, patients with severe complications had significantly worse total EOSQ at 2, 2.5, and 3 years after surgery (p = 0.018, 0.002, & &lt; 0.001) and SRS scores at 2, 2.5, and 3 years after surgery (p = 0.040, 0.018, 0.010).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with any complication from VBT had worse EOSQ scores at 2 years after surgery. Severe complications (mCDS &gt; IIIA) following VBT manifest with decreasing EOSQ and SRS scores over time and become statistically significant at 2 years and beyond. The magnitude of difference in EOSQ and SRS scores between the groups also increases over time. Longer-term follow-up will ascertain whether these poorer QOL outcomes persist at time points greater than 3 years. Long-term follow up will be importan","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601419","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":"A wide posterior release is associated with better kyphosis restoration in the surgical treatment of adolescent idiopathic scoliosis.","authors":"S Ohrt-Nissen, M Heegaard, L Ragborg, N Tøndevold, T B Andersen, M Gehrchen, B Dahl","doi":"10.1007/s43390-025-01143-7","DOIUrl":"https://doi.org/10.1007/s43390-025-01143-7","url":null,"abstract":"<p><strong>Purpose: </strong>To examine whether the use of a wide posterior osseo-ligamentous release in adolescent idiopathic scoliosis (AIS) improves restoration of thoracic kyphosis.</p><p><strong>Methods: </strong>We retrospectively included a consecutive cohort of AIS patients undergoing surgical treatment involving the thoracic spine (Lenke 5 excluded) over two consecutive time periods. The first time period served as control group. In the second time period, standard surgical technique was supplemented with a wide posterior release of the lamina, spinous process and supraspinous ligaments (no removal of the inferior facet) at 4-5 levels corresponding to the apex of the thoracic curve. Patients were categorized as preoperatively hypo- or normokyphotic and intraoperative data, and 2-year postoperative radiographic data were recorded.</p><p><strong>Results: </strong>We included 191 patients. Mean age was 15.8 ± 2.3 years, and mean Cobb angle was 60 ± 12°. Sixty-two (32%) patients were classified as hypokyphotic (global kyphosis ≤ 30°) preoperatively. Baseline coronal and sagittal parameters were similar between the posterior release and control group. In the hypokyphotic group, the use of posterior release resulted in an increase in kyphosis from 19 ± 7° to 38 ± 11° vs. 22 ± 8° to 32 ± 7° in the control group (p = 0.018). 15% vs. 49% was hypokyphotic at 2-year follow-up (p = 0.020). In the preoperatively normokyphotic group, the change in kyphosis was 6 ± 9° vs - 1 ± 10° (p < 0.001) in the posterior release and control group, respectively, but with no difference in the final 2-year kyphosis (47 ± 8° vs. 46 ± 10°). Two-year major coronal Cobb angle was 28 ± 9° vs. 26 ± 9° in the posterior release and control group, respectively (p = 0.206). Median intraoperative blood loss was 500 (IQR: 412-743) ml vs. 600 (IQR: 500-900). There was one case of neurological injury in the control group and none in the posterior release group.</p><p><strong>Conclusion: </strong>The use of a posterior osseo-ligamentous release results in an increased thoracic kyphosis restoration in preoperatively hypokyphotic patients without increasing blood loss or the risk of neurological injury.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609362","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 lumbar pedicle subtraction osteotomy (PSO) level on global alignment and proportion (GAP) score in revision adult iatrogenic flatback spinal deformities.","authors":"Perry Lim, Aaron J Clark, Austen D Katz, Asra Toobaie, Vedat Deviren, Christopher P Ames, Alekos A Theologis","doi":"10.1007/s43390-025-01141-9","DOIUrl":"https://doi.org/10.1007/s43390-025-01141-9","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the impact of different lumbar pedicle subtraction osteotomy (L-PSO) levels on Global Alignment and Proportion (GAP) scores.</p><p><strong>Methods: </strong>Adults at a single center who underwent lumbar PSOs with revision instrumentation [thoracolumbar junction (T9-L1) to pelvis] and a minimum 2-year follow-up were reviewed. The patients were divided by level of PSO (L2, L3, L4, and L5) and compared with respect to demographic and surgical data, sagittal parameters, GAP scores, and mechanical complications requiring revision operations.</p><p><strong>Results: </strong>152 patients (average age 64.4 ± 10.6 years, average follow-up 9.0 ± 4.1 years) were included for analysis. L3 (40.8%) and L4 (45.4%) PSOs were more common than L2 (4.6%) and L5 (9.2%) PSOs. Average pre-op GAP scores (9.8 ± 2.8) were similar and improved significantly for all L-PSO levels, although post-op GAP scores (7.1 ± 2.2) remained \"disproportioned\" for all L-PSO levels. Post-op Lumbar Distribution Index (LDI) scores were significantly better for lower PSOs (L4 + L5) given better improvement of L4-S1 lordosis. The revisions for mechanical failures were higher in L2 and L3 PSOs. Average post-op GAP scores were not different for patients who did and did not undergo mechanical failure revisions.</p><p><strong>Conclusions: </strong>L-PSOs, irrespective of the level, improve GAP scores. While residual disproportionate post-operative alignment was observed for all L-PSO levels, distal PSOs improved L4-S1 lordosis and LDI scores to a greater extent than proximal PSOs. Although more distal lumbar PSOs also had lower rates of revision operations for mechanical complications, other patient and surgical factors also likely played a role in the observed rates of mechanical failures.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592098","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":"All-pedicle screw posterior spinal fusion after magnetically controlled growing rods in walking early-onset scoliosis patients: radiographic and surgical outcomes.","authors":"Sergio De Salvatore, Paolo Brigato, Leonardo Oggiano, Davide Palombi, Gian Mario Sangiovanni, Edoardo Costici, Sergio Sessa, Pier Francesco Costici","doi":"10.1007/s43390-025-01139-3","DOIUrl":"https://doi.org/10.1007/s43390-025-01139-3","url":null,"abstract":"<p><strong>Purpose: </strong>Early-onset scoliosis (EOS) significantly affects lung development and life expectancy. Magnetically Controlled Growing Rods (MCGR) effectively promote thoracic growth while managing curvature progression. This study aims to assess the impact of definitive spinal fusion on residual deformity and complications in EOS patients treated with MCGRs.</p><p><strong>Methods: </strong>The study included 27 EOS patients who underwent final fusion surgery between January 2017 and September 2022. The primary outcome was the evaluation of coronal and sagittal radiographic parameters postoperatively and at a minimum of 2 years of follow-up (FUP). Secondary outcomes included major complications (≥ IIIB, according to Clavien-Dindo Classification), surgery duration, blood loss and length of hospital stay (LOS).</p><p><strong>Results: </strong>Major curve (45.5° and 33.5°, p = 0.003, Brunner-Munzel Test Statistic = - 3.869254) and Thoracic Kyphosis (TK) (19.8° and 13.5°, p = 0.002, Brunner-Munzel Test Statistic = - 2.258845) were statistically impacted by arthrodesis, and maintained at the final follow-up. The surgeries had an average duration of 254.2 ± 39.5 min (range: 195-336 min) and an average blood loss of 574.1 ± 255.1 mL (range: 200-1300 mL). The mean LOS was 8.5 ± 1.8 days (range: 6-13 days). Following the final fusion, 5 patients (18.5%) developed a complication, of which one was classified as major.</p><p><strong>Conclusions: </strong>This study demonstrated substantial improvements in coronal and sagittal alignment following graduation surgery, with results maintained at the two-year FUP. Further research with larger sample sizes is needed to provide a more comprehensive assessment of radiographic and surgical outcomes and to establish guidelines for implant density in MCGR graduation surgery.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576217","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":"Turning the screw: assessing the impact of full power-assisted versus manual pedicle screw insertion in paediatric spine surgery.","authors":"Weronika Nocun, Neel Badhe, Vasanth Bharathidasan, Gayathri Vimal, Kalyani Parvathi Nair, Elie Najjar","doi":"10.1007/s43390-025-01138-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01138-4","url":null,"abstract":"<p><strong>Background: </strong>Long-level pedicle screw placement involves repetitive, forceful rotational movements that increase the risk of musculoskeletal pain and disorders in spine surgeons. Full power-assisted pedicle screw insertion may mitigate these risks, but its efficacy and safety compared to manual techniques remain underexplored. Understanding these differences is crucial for optimizing surgical practices and improving outcomes.</p><p><strong>Objective: </strong>To systematically evaluate the outcomes of full power-assisted versus manual pedicle screw insertion in paediatric spine surgery, focusing on operative time and complications.</p><p><strong>Methods: </strong>A systematic review of English-language literature published up to September 2024 was conducted using the search criteria (\"Pedicle Screws\"[Mesh]) and (power), adhering to PRISMA guidelines. Studies comparing full power-assisted and manual pedicle screw insertion were included.</p><p><strong>Results: </strong>Of 2,559 patients, 1,715 underwent full power-assisted insertion (65.7% female, mean age 14.3 years, mean follow-up 20.8 months), and 844 underwent manual insertion (67.9% female, mean age 14.5 years, mean follow-up 26.9 months). Operative times were comparable (248 vs. 251.4 min, p = 0.69), as were screw breach rates (0.49% vs. 1.42%, p = 0.23). However, manual insertion was associated with a significantly higher rate of other complications compared to full power-assisted techniques (0.077% vs. 0.022%, p = 0.03).</p><p><strong>Conclusion: </strong>Full power-assisted pedicle screw insertion is as efficient and accurate as manual techniques, with fewer complications in pedicle screw placement surgery. These findings support the use of power assistance to enhance surgical safety. Further research should validate these results in diverse patient populations and long-term follow-up.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567795","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":"Failure to replace removed growth friendly implants results in deteriorating radiographic outcomes.","authors":"Matan S Malka, Lawrence G Lenke, Ritt R Givens, Kevin Lu, Christina C Rymond, Richard McCarthy, Amer F Samdani, Burt Yaszay, Joshua Pahys, Michael G Vitale, Benjamin D Roye, Pediatric Spine Study Group","doi":"10.1007/s43390-025-01137-5","DOIUrl":"https://doi.org/10.1007/s43390-025-01137-5","url":null,"abstract":"<p><strong>Introduction: </strong>Management of early onset scoliosis (EOS) patients can require growth-friendly surgery to manage spinal deformity in children too immature for a definitive fusion. There is limited literature on outcomes for patients with failed growing constructs requiring removal of implants (ROI).</p><p><strong>Methods: </strong>We studied EOS patients from an international registry undergoing removal of growth-friendly implants, comparing early re-implantation (within 12 months of ROI) to observation-only. We examined demographic data and radiographic measurements with a significance level of p < 0.05.</p><p><strong>Results: </strong>Sixty-four patients met the inclusion criteria for radiographic analysis: 53 had early re-implantation and 11 were observed. There were no significant differences between the groups in age at index, ROI, or etiology. Pre-ROI, observation and re-implantation groups had similar coronal Cobb angles (55° vs 47°, p = 0.35) and similar time from index procedure to ROI. However, at two years post-ROI, the observation group had a larger coronal Cobb angle than the re-implantation (81° vs 53°, p = 0.003). In the re-implantation group, 16 (30%) patients progressed ≥ 5° vs 7 (64%) in the observation group (p = 0.04). The re-implantation group had a smaller difference in major Cobb angle between post-ROI and two years post-ROI (-2° vs 12°, p = 0.01). The re-implantation group had no significant progression in the major Cobb angle at two years post-ROI compared to immediate post-ROI (55° vs 53°, p = 0.36), while the observation group increased by about 13° (68° vs 81°, p = 0.03), resulting in a total increase of more than 25° from pre-ROI.</p><p><strong>Conclusion: </strong>Our interim data strongly suggest that promptly replacing removed implants stabilizes curves in this population of EOS patients. Timely re-implantation should be a priority, when possible, to enhance outcomes, despite technical challenges for some patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561065","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":"Surgery partially mitigates a 2-decade decline in health-related quality of life for adolescents with idiopathic scoliosis undergoing spinal fusion at 2 years.","authors":"Adam A Jamnik, Anne-Marie Datcu, Emily Lachmann, Karl Rathjen, Megan Johnson, David Thornberg, Chan-Hee Jo, Brandon Ramo","doi":"10.1007/s43390-025-01136-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01136-6","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate how 2-year postoperative SRS scores for patients with adolescent idiopathic scoliosis (AIS) who underwent spine fusion have evolved over time.</p><p><strong>Methods: </strong>Single center, retrospective review of AIS patients who underwent fusion between 2002 and 2020. Patients were included if they completed SRS questionnaires preoperatively and 2-years postoperatively (21-49 months). The SRS has seven scoreable domains: Pain, Appearance, Activity, Mental Health, Subtotal (calculated with the four previous domains), Satisfaction, and Total Score. Domain score range from 1 to 5 (worst-best). Multivariable linear regressions were performed on 2-year SRS domain scores. The primary variable was calendar year of SRS completion, but variables also included: preoperative SRS scores, gender, race, age, and time since surgery (months). Subsequently multivariable linear regressions were performed for the change in SRS scores between preoperative and 2-year.</p><p><strong>Results: </strong>Seven hundred eighty seven patients (83.7% female, age 14.3 ± 2.0) were included in this study. Of the variables included, preoperative SRS scores, gender, race, and time since surgery contributed significantly to the regression models. More recent calendar years for SRS completion were associated with worse Mental Health and Activity domain scores (coefficient = - 0.010, p = 0.0432; coefficient = - 0.007, p = 0.0340). Each additional year was associated with a ~ 0.01 decline in Mental Health and Activity scores. Regression analysis between preop and 2-year scores found that patients with more recent SRS completion years had greater improvements in Pain and Subtotal scores (coefficient = 0.014, p = 0.013, coefficient = 0.009, p = 0.023).</p><p><strong>Conclusion: </strong>AIS patients undergoing spinal fusion in more recent years report worse HRQoL in the Activity and Mental Health domains postoperatively. However, Pain and Subtotal scores had greater improvements from preoperative to 2-year, suggesting a mitigating effect of surgery in the setting of declining preoperative scores.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561075","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":"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":"1241-1251"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}