Spine deformity最新文献

{"title":"Does transitioning to a dual surgeon approach improve outcomes for posterior spinal fusion of adolescent idiopathic scoliosis and neuromuscular scoliosis?","authors":"Nicholas B Taylor, Dana Perim, Marlon Murasko, Ashar Ata, Kelley Banagan","doi":"10.1007/s43390-025-01059-2","DOIUrl":"https://doi.org/10.1007/s43390-025-01059-2","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective, chart review.</p><p><strong>Purpose: </strong>Improvements in operative time, blood loss, and length of stay (LOS) when using a dual surgeon approach for the treatment of scoliosis have been suggested in the literature; however, the external validity of these findings has been debated. In this study, we examined the impact of transitioning from a single surgeon to a dual surgeon approach in the treatment of adolescent idiopathic scoliosis (AIS) and neuromuscular scoliosis (NMS) across non-contemporary periods at a single institution.</p><p><strong>Methods: </strong>Through a retrospective chart review we identified 208 adolescent patients who underwent spinal fusion for the treatment of AIS or NMS between November 2015 and January 2022. The 73 cases meeting inclusion criteria were analyzed for operative time, blood loss, pre-and post-operative Cobb angles, and hospital length of stay.</p><p><strong>Results: </strong>The dual surgeon AIS group was found to have a shorter hospital (3.6 vs. 5.2 days, p < 0.001) and ICU length of stay (0.3 vs. 3.7 days, p < 0.001), greater Cobb angle correction (35.6 vs. 23.3 degrees, p < 0.001), and lower transfusion requirement compared to the single surgeon AIS group (0.1 vs. 0.7 units, p = 0.003). Total operative time and estimated blood loss (EBL) were not significantly different. The dual surgeon NMS group only showed shorter ICU length of stay (2.9 vs. 9.1 days, p = 0.043).</p><p><strong>Conclusions: </strong>Utilizing a dual surgeon approach for AIS patients could improve hospital and ICU length of stay, blood transfusion requirements, and Cobb angle correction without an increase in operative time.</p><p><strong>Level of evidence: </strong>Level III, retrospective, comparative study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425937","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":"Pain catastrophizers undergoing posterior spinal fusion (PSF) for idiopathic scoliosis have lower preoperative SRS-30 scores but do not require increased postoperative narcotics.","authors":"Elaine Tran, David Thornberg, Anne-Marie Datcu, Chan-Hee Jo, Brandon Ramo","doi":"10.1007/s43390-025-01058-3","DOIUrl":"https://doi.org/10.1007/s43390-025-01058-3","url":null,"abstract":"<p><strong>Background: </strong>Pain catastrophizing has been linked to poorer patient-reported pain outcomes for orthopedic surgery, but its effect on perioperative pain and narcotic use is poorly understood. Our purpose was to determine if pain catastrophizing has a negative effect on perceptions of perioperative pain and narcotic use in patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis (IS).</p><p><strong>Methods: </strong>A retrospective, IRB-approved review of prospectively collected data of IS patients undergoing PSF. Patients were considered PCs when they scored above the 75th percentile in the PCS (total score ≥ 30). Inpatient narcotic consumption was calculated as morphine equivalent per Kg (mEq/Kg).</p><p><strong>Results: </strong>Five hundred seventeen patients (411F, 106M) underwent PSF for IS. Forty-five (8.7%) patients were pain catastrophizers (PCs). PC patients had significantly lower pain, appearance, and mental scores. PCs scored slightly higher on VAS pain scores (2.20 vs 1.92, p = 0.015) in the first 24 h only. There were no differences in opioid use between PC vs. non-PC cohorts for inpatient (2.01 vs 2.14 mEq/Kg, p = 0.4), discharge (5.6 vs 5.87 mEq/Kg, p = 0.3), or total narcotics (7.61 v 8.01 mEq/Kg, p = 0.2). Fifty-five patients out of five hundred seventeen requested narcotic refills with no difference in refill rates between cohorts (p = 0.7076).</p><p><strong>Conclusion: </strong>We found that pain catastrophizers had lower pre-operative SRS-30 scores across all domains except satisfaction. We found no association between pain catastrophizing and increased opioid use in either the inpatient stay or post-discharge. While pain catastrophizing has been associated with lower pre- and post-operative pain scores, it does not appear to predispose to higher narcotic utilization perioperatively.</p><p><strong>Level of evidence: </strong>II: retrospective comparative study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410632","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 single-centre early experience of the Pulse™ navigation system for posterior spinal fusion in adolescent idiopathic scoliosis (AIS).","authors":"Adam P Lloyd, Haiming Jin, George McKay, Mathew Sewell, Jwalant Mehta, David S Marks, Morgan E B Jones","doi":"10.1007/s43390-025-01054-7","DOIUrl":"https://doi.org/10.1007/s43390-025-01054-7","url":null,"abstract":"<p><strong>Purpose: </strong>Pedicle screw-based constructs are the standard of surgical management in AIS. Several manufacturers have developed navigation systems utilising intraoperative 3D imaging to improve screw placement accuracy. However, concerns remain regarding intraoperative radiation exposure utilising these systems compared to traditional techniques. The aim of this study was to evaluate our experience of 3D intraoperative imaging compared to techniques utilising 2D fluoroscopy for pedicle screw placement in cases of posterior spinal fusion (PSF) for AIS.</p><p><strong>Methods: </strong>This was a single-centre, retrospective analysis of cases undergoing PSF for AIS using 3D navigation or freehand screw insertion techniques. The two groups were matched for curve type, curve magnitude, implant density and fused levels. We compared the correction achieved, intraoperative radiation exposure, operating time and rates of intraoperative screw repositioning.</p><p><strong>Results: </strong>A total of 52 cases were identified (26 navigated and 26 freehand). No significant differences were observed in baseline characteristics between the two groups. There were no significant differences observed in correction achieved between groups; however, mean radiation exposure in the navigated cases was approximately 11 times higher. Operative time was significantly longer in the navigated group but there was a significant reduction in requirement for intraoperative screw repositioning using navigation at 0.2% versus the freehand group at 1.5%.</p><p><strong>Conclusions: </strong>Our early experience of intraoperative 3D imaging for navigated implant insertion for AIS has shown equivalence to freehand techniques in achieved correction, with fewer changes in intraoperative screw positioning at the expense of significantly increased overall radiation exposure and procedure duration.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390387","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":"Posterior spinal fusion versus vertebral body tethering for paediatric scoliosis: a meta-analysis of comparative studies.","authors":"Abdulrahman O Al-Naseem, Abdulaziz Al-Naseem, Buthaina Al Balushi, Yousef Marwan, Julian Leong, Roozbeh Shafafy","doi":"10.1007/s43390-025-01050-x","DOIUrl":"https://doi.org/10.1007/s43390-025-01050-x","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior spinal fusion (PSF) is currently the gold standard technique for surgical correction of scoliosis however, there is a growing interest in non-fusion techniques like vertebral body tethering (VBT). The aim of this study is to compare surgical outcomes between PSF and VBT.</p><p><strong>Methods: </strong>This systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines with a search of the following databases to identify all comparative studies: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL).</p><p><strong>Results: </strong>A total of 11 comparative studies with 1112 patients were included. PSF offered significantly greater percentage coronal curve correction postoperatively (P = 0.0001) and at 2 years (P < 0.00001). Time to revision (P = 0.03), number of instrumented levels (P < 0.0001), estimated blood loss (EBL) (P = 0.001), operation duration (OD) (P < 0.00001) and postoperative shoulder height difference (P < 0.00001) were significantly greater in the PSF group. Odds of unplanned surgical revisions were lower in the PSF group (P < 0.0001). Secondary outcome data showed that VBT patients had significantly lower preoperative cobb angles (P < 0.00001), a younger age at surgery (P = 0.002), less postoperative pain (P = 0.002) and lower opioid consumption (P = 0.02). VBT tether breakage events were reported at rates of 13-23%. VBT also offered faster return to sports and greater lumbar flexibility. No significant difference was seen in length of hospital stay (P < 0.05).</p><p><strong>Conclusion: </strong>PSF and VBT are viable treatment options with different pros and cons. Choice of treatment should consider individual patient characteristics and daily requirements.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190604","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":"Etiology remains king: health-related quality of life outcome at 5 years following growth friendly instrumentation for EOS.","authors":"K Aaron Shaw, David Thornberg, Anna McClung, Chan-Hee Jo, Mark Erickson, Michael Vitale, Scott Luhmann, Lindsay Andras, Peter Sturm, Hiroko Matsumoto, Brandon Ramo","doi":"10.1007/s43390-024-01029-0","DOIUrl":"https://doi.org/10.1007/s43390-024-01029-0","url":null,"abstract":"<p><strong>Purpose: </strong>The etiology of early-onset scoliosis (EOS) has been shown to significantly influence baseline parent-reported health-related quality of life (HRQoL) measures as assessed by the Early Onset Scoliosis Questionnaire (EOSQ). However, it remains unclear how etiology influences mid-term outcomes following growth friendly instrumentation (GFI) for EOS.</p><p><strong>Methods: </strong>A retrospective review of a multi-center prospective spinal database was performed. Children undergoing primary distraction-based, GFI for EOS with complete baseline, 2-year, and 5-year post-surgical EOSQ were included. The identified children were subdivided by etiology as classified by the C-EOS system. EOSQ scores were compared over time according to etiology cohorts and between instrumentation types. Minimal clinically important difference (MCID) was defined as ≥ 20% change in domain score and compared across etiologies. Dominance analysis was used to assess for drivers of treatment satisfaction.</p><p><strong>Results: </strong>A total of 178 children (mean 7.3 ± 2.1 years, 51.1% female) were included. The most common etiology was neuromuscular (NM: 36.5%), with the majority of children treated with MCGR (N = 125). Significant differences between etiology groups were present with congenital and idiopathic cohorts demonstrating similar EOSQ domain scores that were significantly higher than neuromuscular and syndromic cohorts. In assessing clinically important changes in EOSQ scores over the 5-year follow-up period, neuromuscular and syndromic patients demonstrated the greatest capacity for improved outcomes. Instrumentation type had no influence on HRQoL scores at 5-year follow-up. Etiology was a driver of satisfaction with syndromic etiology and transfer domain score at 2 years follow-up associated with dissatisfaction.</p><p><strong>Conclusion: </strong>Curve etiology remains a significant driver of HRQoL domains following growth-friendly instrumentation for EOS. Neuromuscular and syndromic patient have significantly lower domain scores. Despite this, or perhaps because of it, they also demonstrate the greatest capacity for clinically important improvement in HRQoL measures 5 years following intervention.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074868","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":"Instrumentation using robotics coupled with navigation in pediatric spine deformity surgery: a technical report of sacropelvic instrumentation.","authors":"Craig Birch, Nicole Welch, Danielle Cook, Daniel Hedequist","doi":"10.1007/s43390-025-01047-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01047-6","url":null,"abstract":"<p><strong>Purpose: </strong>This technical report presents the intraoperative experience of using robotic-assisted navigation (RAN) for sacropelvic instrumentation in pediatric spine deformity surgery.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent surgery using RAN for sacropelvic instrumentation at a single institution from 2019 to 2022 was conducted. In cases with screw confirmation imaging, screws were evaluated using the Gertzbein and Robbins classification scale.</p><p><strong>Results: </strong>52 cases were included. Average age at surgery was 14.1 years and 67.3% of patients were female. The most common diagnosis was spondylolisthesis (48.1%). The average major curve in scoliosis cases was 77°. A Schanz pin in the posterior superior iliac spine was placed in 98.1% of surgeries compared to 1 case with a spinous process clamp. Intraoperative 3D imaging scans (Scan & Plan) were used for 69.2% of the robotic registrations to the patient and intraoperative fluoroscopy-CT scans were used for 30.8%. 644 total screws were placed, with 427 placed robotically. Specifically, in the sacral-pelvic region, 98 S1, 18 S2, 58 S2AI, and 5 iliac screws were placed using RAN (179 screws). In 17 cases with 139 total robotic screws, post-instrumentation intraoperative 3D imaging or postoperative CT scans were obtained. Of these screws, 99.3% (138/139; 95% CI = 95.5-99.96) were placed accurately (Grade A or Grade B). One S2AI screw had an anterior breach on intraoperative 3D imaging scan and was changed prior to closure. Loss of RAN registration was observed in 2 cases (3.8%). No cases required return to the operating room for screw malposition.</p><p><strong>Conclusion: </strong>This study highlights high screw accuracy with no neurologic compromise associated with the use of RAN technology.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074998","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":"Is it possible to return to skiing following long-construct spinal deformity surgery?","authors":"Kurt Holuba, Alexandra Dionne, Brendan Schwartz, Roy Miller, Josephine R Coury, Varun Arvind, Justin L Reyes, Gabriella Greisberg, Ronald A Lehman, Zeeshan M Sardar, Lawrence G Lenke, Joseph M Lombardi","doi":"10.1007/s43390-024-01031-6","DOIUrl":"https://doi.org/10.1007/s43390-024-01031-6","url":null,"abstract":"<p><strong>Background: </strong>Alpine skiing requires flexibility, endurance, strength and rotational ability, which may be lost after long fusions to the pelvis for adult spinal deformity (ASD). ASD patients may worry about their ability to return to skiing (RTS) postoperatively. There is currently insufficient data for spine surgeons to adequately address questions about when, or if, their patients might RTS.</p><p><strong>Methods: </strong>Patients with a history of spinal fusion to pelvis from T10 or higher were screened for skiing participation during the November 2023-April 2024 season. Adolescent and adult patients ≥12 years old with >2-year minimum follow-up who were recreational skiers (skied ≥5 times in their life and ≥1 time in the 5 years prior to their surgery) provided the following metrics: visual analogue scale (VAS) pain level, self-perceived ski ability, highest slope difficulty comfort level, ski runs completed per day, days skied per year, pain while skiing, participation in pre- or postoperative physical therapy (PT), and satisfaction. Predictive factors for ability to RTS were evaluated. Scoliosis Research Society-22 (SRS-22) and Oswestry Disability Index (ODI) scores were collected at baseline, one year postoperatively, and final follow-up (FFU). Twenty six skiers from 2015-2023 were included (age 56.5 ± 15.2 years, BMI 23.8 ± 4.2 kg/m², female composition 85.6%, follow-up 5.3 ± 1.8 years). 42.3% (n = 11) patients returned to ski at an average of 2.6 ± 1.6 years. Patients who returned to ski maintained or improved their performance in the following metrics: 72.7% (n = 8) in self-assessed ski ability, 72.7% (n = 8) in slope difficulty comfort level, 63.6% (n = 7) in number of ski runs per day, 81.8% (n = 9) in number of days skied per year, and 81.8% (n = 9) in pain while skiing. Pain scores improved from baseline to FFU: VAS (7.1 ± 1.9 vs 1.8 ± 1.9; p < 0.01), SRS (71.8 ± 8.6 vs 89.9 ± 14.5; p < 0.01), ODI (30.8 ± 13.1 vs 13.4 ± 14.1; p < 0.01). Age, sex, BMI, surgical history, self-assessed ski ability, baseline pain scores and PT participation were not predictive of ability to RTS.</p><p><strong>Conclusion: </strong>This was the first in-depth analysis of RTS after corrective spine surgery. Almost half of the skiers returned to skiing after long-construct fusion to pelvis, and the majority reported similar or improved performance based on their slope ratings, runs skied per day, days skied per year, pain while skiing, and overall self-assessment. Mean pain and quality of life scores improved significantly for the whole group. ASD patients who RTS can reasonably expect equal or improved performance following spine surgery compared to their presurgical ability.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067827","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":"Sacral Alar-Iliac (SAI) screw diameter is not associated with pelvic fixation failure for neuromuscular scoliosis patients.","authors":"Tyler A Tetreault, Annika Y Myers, Jaqueline Valenzuela-Moss, Tishya A L Wren, Michael J Heffernan, Lindsay M Andras","doi":"10.1007/s43390-025-01044-9","DOIUrl":"https://doi.org/10.1007/s43390-025-01044-9","url":null,"abstract":"<p><strong>Purpose: </strong>Determine if Sacral Alar-Iliac (SAI) screw diameter is associated with pelvic fixation failure in pediatric patients with neuromuscular scoliosis (NMS) treated with posterior spinal fusion (PSF).</p><p><strong>Methods: </strong>NMS patients from a single institution who underwent PSF with bilateral SAI screw fixation from 2010 to 2021 were retrospectively reviewed. Clinical parameters, SAI screw sizes, and radiographic outcomes were analyzed. Patients with greater or less than two SAI screws, > 21 years old, or with < 2 years of radiographic follow-up were excluded.</p><p><strong>Results: </strong>142 patients had 284 SAI screws placed. Mean(± SD) age was 13.6 ± 2.7 years. Preoperative curve magnitude averaged 84.3 ± 29.1°. Mean patient weight was 36.4 ± 14.1kg and BMI was 18 ± 5.1. Radiographic follow-up averaged 4.6 ± 2.0 years. Most screws (234/284,82.4%) were < 8.5 mm and 7.5 mm screws were most frequently used (158/248,55.6%). Mean screw diameter was 7.4 ± 0.7 mm. Patients with greater age, weight, and BMI trended towards larger screws. Three patients had five screw complications (1 screw fracture and 4 set screw dislodgments). One screw fracture (1/284,0.4%;7.5 mm diameter) and contralateral set screw dislodgement occurred in a patient at 14 months but was not revised. One patient who had bilateral set screws dislodge 3 months after PSF underwent revision. The remaining patient was asymptomatic and was observed. Screw diameter was not associated with risk of postoperative complications (p = 0.245).</p><p><strong>Conclusion: </strong>SAI screw fracture is rare after PSF in pediatric patients with NMS. Contrary to pelvic fixation in adults, smaller diameter SAI screws, which may be optimal in patients with smaller anatomy, were not associated with increased risk of screw failure.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067831","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":"Congenital scoliosis presenting in teenage years outcomes without hemivertebra excision.","authors":"Vishal Sarwahi, Sayyida Hasan, Keshin Visahan, Effat Rahman, Katherine Eigo, Jesse Galina, Jeffrey Goldstein, Thomas J Dowling, Jordan Fakhoury, Yungtai Lo, Terry Amaral","doi":"10.1007/s43390-025-01039-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01039-6","url":null,"abstract":"<p><strong>Purpose: </strong>In congenital scoliosis, the surgical strategy approach of hemivertebra excision, with or without instrumentation and fusion, is a common approach to correction of scoliosis. However, hemivertebra excisions are technically challenging, with potential complications including spinal cord injury, nerve root injury and cerebrospinal fluid leak. The purpose of this study was to determine whether correction of congenital scoliosis can be achieved using a posterior instrumentation/fusion-only approach without the need for hemivertebra excision.</p><p><strong>Methods: </strong> 35 patients with congenital scoliosis and hemivertebra operated between 2007 and 2024 were matched to 35 AIS patients by BMI, levels fused, and preoperative Cobb. Wilcoxon rank-sum tests, chi-square tests, and Fisher's Exact tests were utilized.</p><p><strong>Results: </strong>Age (p = 0.22), BMI (p = 0.25) and preoperative Cobb (p = 0.79) were similar between hemivertebra and AIS patients. Cobb correction (HV: 71.8% vs. AIS: 70.4%; p = 0.92) and EBL (500 cc vs. 400 cc; p = 1.0) were similar. Operative time (310.0 min vs. 242.0 min; p < 0.001) and length of stay (7.0 days vs. 5.0 days; p < 0.001) were statistically different. Patients operated on after 2018, when the Rapid Recovery Protocol was implemented, had a similar length of stay (4.5 vs. 5.0; p = 0.92). Patients in both cohorts had similar SRS-22 scores.</p><p><strong>Conclusion: </strong> Choosing fusion levels in congenital patients, on similar principles to AIS, leads to avoidance of hemivertebra excision, including lumbosacral hemivertebrae. This approach is safer than hemivertebra excision and has similar, or better, curve correction than previously reported.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060638","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":"Analysis of scoliosis rod deformation after cutting with a surgical rod cutter.","authors":"James Egan, Collin T Erickson, Kierstin Bennett, Grace E Tideman, Richard M Schwend, Elizabeth A Friis, John T Anderson","doi":"10.1007/s43390-025-01053-8","DOIUrl":"https://doi.org/10.1007/s43390-025-01053-8","url":null,"abstract":"<p><strong>Purpose: </strong>Scoliosis is a complex multi-dimensional deformity of the spine that is common in children and adults. Of the various treatments for scoliosis, one is posterior spinal fusion with instrumentation. The rods typically used are composed of titanium or cobalt-chrome. Rods are cut during surgery, which causes rods to be deformed on the cut end. Inducing rod deformation raises concerns about deformed end influencing the stability of the rod-tulip-set screw interface. This study examines rod deformation from the rod cutter.</p><p><strong>Methods: </strong>This study was performed using photogrammetry, a technique allowing the creation of three-dimensional (3D) models from photographs. Rod materials included titanium (Ti) and cobalt chrome (CoCr). Three different diameters, 4.75 mm, 5.5 mm, and 6.0 mm, were analyzed for each rod material. Five rods of each material and diameter were used for these groups, totaling 30 rods for the study. Photogrammetry was used to create a 3D rendering of the cut end of the rods. The parameters measured included local angle of deformation at each mm away from the cut, as well as roundness of the cross section. Means and standard deviations were taken for each measurement. A two-way ANOVA analysis and a Tukey post-hoc analysis were used for statistical analysis.</p><p><strong>Results: </strong>Five rods in each rod group resulted in the analysis of 30 rods. Deformation from the rod cutter resulted in more angular deformation in the CoCr rods than the Ti rods. The CoCr rods also had lower cross-sectional roundness measurements. The 6.0-mm rods had significantly more angular deformation as well as lower roundness measurements compared to the smaller diameter rods. The 4.75-mm and 5.5-mm diameter Ti rods showed deformation up to 4 mm from the cut end, while the 6.0-mm Ti rods, and all the CoCr rods, showed deformation 5 mm from the cut end.</p><p><strong>Conclusions: </strong>The data from this study offer information about the amount of deformation present at the cut end of spinal rods. There was a difference in the angle of deformation as well as roundness along the length of the rod's cut end. Placing the deformed portion of the rods within a screw tulip theoretically increases the risk of failure of the rod-screw interface. Based on these data, to decrease the risk of construct failure, we recommend leaving at least 4 mm of rod between the cut end in 4.75 mm and 5.5-mm Ti rods, and 5 mm in CoCr rods and 6.0-mm Ti rods.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067823","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}