Spine deformity最新文献

{"title":"Effect of mixing dissimilar metals on serum metal ion levels following spinal deformity surgery.","authors":"Jennifer C Urquhart, Vahagn Karapetyan, Firoz Miyanji, Omar Siddiqi, Karim Kantar, Timothy Carey, Christopher S Bailey, Ravi Ghag, Brent Lanting, Supriya Singh, Parham Rasoulinejad","doi":"10.1007/s43390-026-01363-5","DOIUrl":"10.1007/s43390-026-01363-5","url":null,"abstract":"<p><strong>Purpose: </strong>The increased use of hybrid spinal implants combining dissimilar metals raises concerns for galvanic corrosion, which can affect metal ion release and implant longevity. This study examines the variation in post-fusion metal ion concentrations among different hybrid implant constructs.</p><p><strong>Methods: </strong>In this prospective multicenter observational study, patients undergoing elective surgery for idiopathic or neuromuscular scoliosis received either cobalt-chromium (CoCr/Ti) or stainless steel (SS/Ti) rods with titanium screw implants. Blood metal ion concentrations were measured preoperatively and at 3, 12 and 24 months. Longitudinal data were analyzed using linear mixed-effects models adjusted for repeated measures.</p><p><strong>Results: </strong>A total of 37 patients were enrolled in the CoCr/Ti group and 35 in the SS/Ti group, with a majority of females (68% in CoCr/Ti vs. 71% in SS/Ti). There were no significant differences between the groups in age, BMI, number of rod attachments or rod surface area. Chromium (Cr) levels initially increased then plateaued, remaining consistently higher in the SS/Ti group, and significantly above baseline at 24 months. Cobalt (Co) concentrations also initially increased in both groups, but were higher in CoCr/Ti. Titanium (Ti) levels increased in both groups but continued to show a positive trajectory in CoCr/Ti at 24 months. Higher titanium concentrations also correlated with the number of rod attachments and instrument-related complications in CoCr/Ti but not the SS/Ti group.</p><p><strong>Conclusions: </strong>With consideration of the different material properties in hybrid implant components, our findings suggest that differences in surface hardness appear to be more pertinent to metallic wear than galvanic corrosion.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1587-1598"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699684","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":"Sagittal balance dynamics during gait in patients with degenerative spine disease.","authors":"Armand Dominik Škapin, Janez Vodičar, Matej Supej, Nina Verdel, Miha Vodičar","doi":"10.1007/s43390-026-01347-5","DOIUrl":"10.1007/s43390-026-01347-5","url":null,"abstract":"<p><strong>Study design: </strong>Observational Case-Control Study.</p><p><strong>Purpose: </strong>To evaluate the dynamics of sagittal balance during gait in patients with degenerative spine disease compared with matched controls.</p><p><strong>Methods: </strong>33 patients with pathological sagittal balance parameters on standing radiographs and 31 matched controls underwent three-dimensional motion capture analysis during a six-minute walking assessment. Data were collected across five phases: pre-walk, initial-walk, mid-walk, end-walk, and post-walk. Spino-pelvic (pelvic angle, lumbar lordosis, thoracic kyphosis) and sagittal balance parameters (sagittal trunk shift and angle, global tilt), as well as lower limb joint angles were assessed.</p><p><strong>Results: </strong>The greatest decrease in sagittal balance occurred during the transition from standing to walking, with significantly larger changes observed in the study group (C7-L5-sagittal trunk shift increasing from 69.1 ± 50.6 mm to 138.7 ± 51.9 mm) compared to controls (increase from 20.9 ± 18.8 mm to 69.2 ± 19.7 mm; p = 0.020). The decrease was primarily due to increased thoracic kyphosis and, in some cases, reduced pelvic retroversion. During continued walking, sagittal balance remained stable at the group level, with only a subgroup in both groups demonstrating a notable decrease. No significant differences in changes during walking were found between groups. After walking, parameters largely returned close to baseline in a standing position, indicating an almost complete recovery of sagittal balance.</p><p><strong>Conclusions: </strong>Compensatory mechanisms for maintaining sagittal balance are significantly more effective in a standing position than during walking. While sagittal balance remains stable in most patients during short-term walking, a notable decrease occurred in several individuals. Therefore, further research is needed to identify prognostic factors associated with a decrease in sagittal balance during walking.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1671-1685"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594422","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}

{"title":"Does pelvic fixation impact reoperation outcomes for neuromuscular scoliosis surgery? A 10-year matched cohort analysis.","authors":"Suhas K Etigunta, Vivien Chan, Adeesya Gausper, Andy Liu, Christopher Mikhail, Alexander Tuchman, Kenneth D Illingworth, David L Skaggs","doi":"10.1007/s43390-026-01352-8","DOIUrl":"10.1007/s43390-026-01352-8","url":null,"abstract":"<p><strong>Purpose: </strong>To report revision surgery rates in neuromuscular scoliosis (NMS) patients undergoing posterior spinal fusion with or without pelvic fixation.</p><p><strong>Methods: </strong>The PearlDiver database identified patients who underwent posterior spinal fusion for NMS from 2015 to 2021. Two cohorts-patients with pelvic fixation and those without-were matched for age, gender, number of levels fused, and wheelchair use. Primary outcomes were rates of subsequent posterior spinal fusion and instrumentation, and spinal wound debridement. Secondary outcome assessed subsequent posterior spinal fusion rates after further matching for wound debridement status.</p><p><strong>Results: </strong>A total of 952 patients (476 with pelvic fixation, 476 without) were analyzed. The 10-year rate of subsequent posterior spinal fusion was similar between the two groups (6.9% pelvic fixation vs. 7.1% no pelvic fixation, p > 0.05). Subsequent posterior spinal fusion was more common in the early postoperative period (< 1 year). Wound debridement was more frequent in the pelvic fixation cohort at 10 years (10.5% vs. 6.1%, p < 0.05), with a higher proportion requiring early intervention within the first two months postoperatively.</p><p><strong>Conclusion: </strong>No significant difference was found in subsequent posterior spinal fusion rates between the pelvic fixation group and no pelvic fixation group. The pelvic fixation group exhibited higher rates of spinal wound debridement in the early postoperative period. Our results suggest that the addition of pelvic fixation may not be necessary in every case to reduce the rates of instrumentation revision or failure. These findings represent associations within matched cohorts and provide comparative outcome data rather than guidance for individual patient decision-making.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1863-1869"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646468","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}

{"title":"Comment on \"patient-perceived recovery after posterior spinal fusion: evaluating minimum clinically important difference (MCID) in adolescents with idiopathic scoliosis\".","authors":"Deepti M Sati, Vanashri Dhananjay Shinde, Chhaya Agarwal","doi":"10.1007/s43390-026-01415-w","DOIUrl":"10.1007/s43390-026-01415-w","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1957-1958"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933386","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":"Intraoperative neurophysiological monitoring changes during surgical correction of pediatric neuromuscular scoliosis: a single-institution report.","authors":"Mo Chen, Sara J Morgan, Aaron Patterson, Salma Noor, Daniel J Miller, Zack D Thompson, Eduardo C Beauchamp, Walter H Truong, Tenner J Guillaume, Joseph H Perra, Allysa Kimber, Timothy Feyma","doi":"10.1007/s43390-026-01366-2","DOIUrl":"10.1007/s43390-026-01366-2","url":null,"abstract":"<p><strong>Purpose: </strong>Intraoperative neurophysiological monitoring (IONM) is a tool that can improve safety during spinal surgery. Patients with neuromuscular scoliosis (NMS) have inherent neural axis or primary muscle pathology that may present challenges to neuromonitoring. An understanding of IONM event rates, patterns, and outcomes would better prepare surgeons to counsel patients and families.</p><p><strong>Methods: </strong>IONM data from pediatric spine deformity correction procedures in patients with neuromuscular scoliosis at a single quaternary care center between 2012 and 2022 were reviewed to determine cases with monitorable IONM data as well as cases with IONM events. Surgical data and radiographic measures were compared between cases with and without lower extremity IONM events.</p><p><strong>Results: </strong>443 surgical cases were reviewed with 404 (91.2%) monitorable. Of monitorable cases, 37 (9.2%) cases had an IONM event. There were 363 (82.0%) cases were monitorable from the lower extremities, and of these, there were 27 (7.4%) cases had IONM events. One case (1/363 = 0.3%) had clinically identifiable post-surgical neurological complications. Statistical comparisons revealed more blood loss (p = 0.0473) and a trend toward more severe deformity angular ratio (p = 0.07) in cases with lower extremity intraoperative IONM events than those without.</p><p><strong>Conclusion: </strong>This study provides an estimate of IONM events and clinically identifiable neurological injury for children with neuromuscular scoliosis. These rates were similar to those reported in studies of other populations of children with spine deformity which supports the feasibility of IONM. Our data suggest that lower extremity IONM events tend to happen in more severe spine deformity cases.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1881-1890"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699671","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":"Comparison of postoperative infection risk with and without topical vancomycin in adult posterior spinal fusion: a propensity-matched cohort study of 126,910 patients.","authors":"Haad A Arif, Devan Devkumar, Hesham Tanbour, Michael J Conklin, Steven M Theiss","doi":"10.1007/s43390-026-01378-y","DOIUrl":"10.1007/s43390-026-01378-y","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical site infections (SSIs) are the third most common complication following spine surgery. The effect of topical vancomycin in addition to perioperative systemic cefazolin remains uncertain. This study sought to investigate the effect of topical vancomycin administration on 90-day postoperative infection risk following adult posterior spinal fusion (PSF).</p><p><strong>Methods: </strong>The TriNetX Global Collaborative database was queried to identify adult patients undergoing PSF. Patients were stratified into two cohorts based on documented administration of topical vancomycin and systemic cefazolin (topical cohort) versus systemic cefazolin alone (control cohort). Patients underwent 1:1 propensity matching based on demographics and relevant comorbidities. The primary outcomes of interest included 90-day rates of infection-related complications. Subgroup analyses were performed to identify the influence of neuromuscular scoliosis, PSF with osteotomies, pelvic fixation, or fusion of greater than six levels on infection rates. Infectious complication rates were also compared between patients receiving topical vancomycin with and without topical gentamicin or tobramycin.</p><p><strong>Results: </strong>After propensity matching, 63,455 patients were included in each cohort. Patients in the topical cohort demonstrated comparable rates of overall infection (3.0% vs. 3.1%, p = 0.794), superficial surgical site infection (SSI) (0.9% vs. 0.8%, p = 0.151), deep SSI (0.6% vs. 0.6%, p = 0.070) and all other infectious complications when compared to the control cohort. Subgroup analysis revealed decreased rate of deep SSI when using topical gentamicin or tobramycin with vancomycin versus topical vancomycin alone (0.7% vs. 1.7%, p = 0.019). No other between-group differences were observed.</p><p><strong>Conclusion: </strong>This study found no significant difference in 90-day postoperative infectious complications following PSF when topical vancomycin was added to standard systemic cefazolin prophylaxis compared to cefazolin prophylaxis alone. Vancomycin with the addition of gentamicin or tobramycin, however, was associated with decreased rates of deep SSI.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1629-1637"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780304","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}

{"title":"Response to Letter to the Editor concerning \"Does pelvic fixation impact reoperation outcomes for neuromuscular scoliosis surgery? A 10-year matched cohort analysis\" by Etigunta SK, et al.","authors":"Suhas K Etigunta, Vivien Chan, Adeesya Gausper, Andy Liu, Christopher Mikhail, Alexander Tuchman, Kenneth D Illingworth, David L Skaggs","doi":"10.1007/s43390-026-01409-8","DOIUrl":"10.1007/s43390-026-01409-8","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1949-1950"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974955","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":"Adoption outpaces reimbursement in navigation-assisted pediatric posterior spinal fusion.","authors":"Soham Ghoshal, Margaret L Sullivan, Shanika D Silva, Craig M Birch, M Timothy Hresko, Grant D Hogue","doi":"10.1007/s43390-026-01362-6","DOIUrl":"10.1007/s43390-026-01362-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate reimbursement trends and surgical volumes associated with computer-assisted navigation (CAN) in pediatric posterior spinal fusion (PSF), with a focus on the impact of payer mix on institutional financial sustainability.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients aged 11-19 years undergoing CAN-assisted PSF at a single pediatric institution from 2021 to 2024. Billing records associated with CPT code 61,783 (computer-assisted spinal navigation add-on) were used to identify procedures. Annual procedure volumes were calculated and analyzed by payer type (private vs. public). Matched payments were adjusted to 2024 USD and analyzed using Wilcoxon rank-sum tests.</p><p><strong>Results: </strong>A total of 759 CAN-PSF procedures were analyzed, with 58% billed to private insurance, 37% to public insurance, and 5% to other payers. Procedure volume increased 70.5% from 2021 to 2024 (CAGR 19.5%). Across all payers, median reimbursement rates declined from 74% in 2021 to 67% in 2024 (p < 0.01). Private insurer reimbursement declined from 81 to 68%, representing a 13% decrease (p < 0.01), while public insurer reimbursement declined from 11 to 9%, representing a 2% decrease (p < 0.01). An inverse relationship was observed between rising procedure volume and declining reimbursement rates.</p><p><strong>Conclusion: </strong>Although CAN utilization in pediatric PSF significantly increased from 2021 to 2024, declining reimbursement rates pose financial challenges for institutions. These trends may limit equitable access to advanced surgical technologies, highlighting a need for policy reforms or adjustments in reimbursement practices to sustain CAN integration in pediatric spine surgery.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1841-1850"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663053","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":"Return to sports after surgery in adolescent idiopathic scoliosis.","authors":"Gabriela Cabrera, Boris Falconi, Lucas Piantoni, Rodrigo Remondino, Eduardo Galaretto, Carlos A Tello","doi":"10.1007/s43390-025-01257-y","DOIUrl":"10.1007/s43390-025-01257-y","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) affects approximately 1-3% of the population, of whom less than 10% will require surgical intervention. Sports activities are inherent to these ages as well as present in the school curriculum. Sports activities can be categorized into non-contact, contact, and collision sports. Currently, there is a lack of consensus in the literature regarding the decision-making process for the resumption of sports activities and the types of activities permitted after posterior spinal fusion in AIS patients. The aim of this study was to explore spine surgeon's recommendations for resuming sports after AIS surgery.</p><p><strong>Materials and methods: </strong>We developed an ad-hoc survey consisting of ten questions and sent it via e-mail to members of the spine society nationwide.</p><p><strong>Results: </strong>Sixty-one members responded to the questionnaire. Overall, 20.7% recommended a return to non-contact sports after 6 months, while 20.7% allowed a return to contact sports and 23.1% a return to collision sports after 12 months or more.</p><p><strong>Conclusion: </strong>Adolescents with idiopathic scoliosis can resume their daily activities and sports after undergoing posterior spinal surgery. However, establishing a clear classification for different types of sports activities remains challenging, leading to discrepancies regarding decision-making during the postoperative period. Internationally validated guidelines for determining the type and timing of return to sports activities are still pending.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1565-1569"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252954","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":"Response to Letter to the Editor: \"Pain in individuals with adolescent idiopathic scoliosis: prevalence and association with physical function and psychosocial well-being using patient-reported outcome measures\".","authors":"Jarod T Griffin, Anita Bagley, Henry Iwinski, Vishwas Talwalkar, Rolando Roberto, David Dueber, Donna Oeffinger","doi":"10.1007/s43390-026-01485-w","DOIUrl":"10.1007/s43390-026-01485-w","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1955-1956"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228076","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}