Spine deformity最新文献

{"title":"Impact of preoperative lumbosacral takeoff flexibility on postoperative correction following spinal fusion for adolescent idiopathic scoliosis: a new consideration for selective thoracic fusion.","authors":"Richard E Campbell, Theodore Rudic, Alexander Hafey, Elizabeth Driskill, Peter O Newton, Keith R Bachmann","doi":"10.1007/s43390-025-01063-6","DOIUrl":"10.1007/s43390-025-01063-6","url":null,"abstract":"<p><strong>Purpose: </strong>Nonselective fusion for adolescent idiopathic scoliosis results in greater correction of the Lumbosacral Takeoff Angle (LSTOA); however, there are patients selectively fused that still have considerable change in their LSTOA. We sought to identify the relationship between preoperative LSTOA flexibility and postoperative correction of the LSTOA.</p><p><strong>Methods: </strong>This was a retrospective analysis of Lenke 1-6, lumbar B and C modifier patients in the Harms Study Group with 2-year follow-up. Only patients with a lumbar Cobb angle ≥ 38 and ≤ 56 were included. The cases were divided into selective (SF: 177) and nonselective fusions (NSF: 324). Multivariate regression analysis was used to identify independent preoperative factors associated with postoperative LSTOA, and postoperative LSTOA correction in the NSF and SF groups.</p><p><strong>Results: </strong>The mean postoperative LSTOA correction was 6.1 ± 3.8, with 75 (15%) patients experiencing postoperative worsening of their LSTOA. Among other variables, larger LSTOA (p < 0.001) and smaller bending LSTOA correction (p < 0.001) were predictors of larger postoperative LSTOAs in both groups. Among other variables, larger LSTOA (p < 0.001), and larger bending LSTOA correction (p < 0.01) were predictors of greater LSOTA correction in both groups. Satisfactory LSTOA correction in the selective fusion group was associated with larger preoperative LSTOA (p < 0.001), larger bending LSTOA correction (p < 0.001), larger lumbar Cobb angle bending correction (p: 0.034), and smaller lumbar apex to LIV distance (p: 0.003).</p><p><strong>Conclusions: </strong>Preoperative static and bending LSTOA measurements may help surgeons decide between selective and non-selective fusion in patients with AIS.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626169","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":"Translation and validation of the Swedish version of the early-onset scoliosis 24-item questionnaire.","authors":"I Green-Petersen, T Cheng, S Blixt, P Gerdhem","doi":"10.1007/s43390-025-01064-5","DOIUrl":"https://doi.org/10.1007/s43390-025-01064-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to translate and validate the Early-Onset Scoliosis 24-Item Questionnaire (EOSQ-24) into Swedish.</p><p><strong>Methods: </strong>Following international guidelines, the EOSQ-24 was double forward translated by independent translators, reviewed by experts, and distributed to caregivers. A single back translation was performed, and the Swedish version was finalized. The Swedish EOSQ-24 was made available online for clinically active spinal surgeons to use during outpatient visits, where it was distributed to caregivers of early-onset scoliosis (EOS) patients aged 0-15 years. Internal consistency was assessed using Cronbach's alpha, item-total correlation, and analysis of floor and ceiling effects. Convergent validity was examined using the EuroQol-5D 3 level (EQ-5D) and the Scoliosis Research Society 22-Item Questionnaire revised (SRS-22r).</p><p><strong>Results: </strong>Responses from 140 caregivers were collected. Ceiling effects ranged from 21 to 74%, with no floor effects > 15%. Internal consistency was excellent (Cronbach's alpha = 0.9), except for two domains: \"General Health\" (0.6) and \"Pulmonary Function\" (0.4). The item-total correlation was poor for \"Pulmonary Function\". EOSQ-24 domains showed significant convergent validity with SRS-22r (Spearman's rho 0.5 to 0.8) and the EQ-5D (Spearman's rho -0.6 to -0.8). Stepwise regression showed lower scores for patients with neuromuscular scoliosis, indicating sensitivity for scoliosis etiology.</p><p><strong>Conclusion: </strong>The Swedish EOSQ-24 is a valid, disease-specific questionnaire with excellent internal consistency suitable for use in a clinical setting. Minor inconsistencies are not unique for the Swedish translation.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573985","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":"The impact of the social determinants of health on adolescent idiopathic scoliosis: a systematic review.","authors":"Rohit Paradkar, Ria Paradkar, Manjot Singh, Ashley Knebel, Mariah Balmaceno-Criss, Jinseong Kim, Joseph E Nassar, Michael J Farias, Bassel G Diebo, Alan H Daniels","doi":"10.1007/s43390-025-01065-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01065-4","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent idiopathic scoliosis (AIS) has been associated with significant physical and psychosocial burdens. Social determinants of health play a well-documented role in treatment and outcomes of various conditions, including AIS. As such, it is crucial to understand the multifaceted socioeconomic factors that may affect its prevalence and severity.</p><p><strong>Methods: </strong>A comprehensive search of major bibliographic databases such as Medline, Embase, and Cochrane Library was conducted from inception to August 2024 for studies examining AIS in marginalized populations. Demographical and clinical outcomes data were extracted for quantitative and qualitative analyses.</p><p><strong>Results: </strong>Our initial search identified 479 articles, of which 14 met the eligibility criteria. The mean age was 14.1 years, 76.8% were females, 59.6% were White, and 73.6% had private insurance. Black adolescents with AIS presented with more severe forms of the condition that necessitated surgical management. Furthermore, lower socioeconomic status, along with residence in socioeconomically disadvantaged neighborhoods and enrollment in public insurance programs, often contributed to delayed clinical presentation, more severe curves at initial presentation, and delayed treatment.</p><p><strong>Conclusion: </strong>This systematic review revealed disparities in the diagnosis and management of AIS based on race, ethnicity, language, insurance status, and socioeconomic status. These disparities highlight the urgent need for a multifaceted approach to improve equity in AIS care. Addressing these challenges requires systemic reforms targeted towards enhancing access and treatment for marginalized populations. Focused interventions should consider the unique social determinants that contribute to these disparities, ultimately promoting a more equitable healthcare system for all adolescents affected by idiopathic scoliosis.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568084","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":"Building consensus: development of a best practice guideline (BPG) for avoiding errors in robotic-assisted spine surgery (RASS).","authors":"Michael G Vitale, Ritt R Givens, Matan S Malka, Kevin Lu, Thomas M Zervos, Joseph Lombardi, Zeeshan Sardar, Ronald Lehman, Lawrence Lenke, Rajiv Sethi, Stephen Lewis, Daniel Hedequist, Themistocles Protopsaltis, A Noelle Larson, Sheeraz Qureshi, Brandon Carlson, Terrence T Kim, David Skaggs","doi":"10.1007/s43390-025-01060-9","DOIUrl":"https://doi.org/10.1007/s43390-025-01060-9","url":null,"abstract":"<p><strong>Introduction: </strong>With the rapid increase in the use of robotic-assisted spine surgery (RASS), reports describing complications have inevitably emerged. This study builds on previous work done to identify, characterize, and classify potential sources of error in spine surgery performed with enabling technology in the operating room. The goal of this study is to leverage expert opinion to develop a set of best practice guidelines that can be employed to minimize complications and optimize patient safety, specifically as it relates to RASS.</p><p><strong>Methods: </strong>After assembling a group of attending spine surgeons experienced in the use of RASS across the country, formal consensus regarding the best practices was developed using the Delphi method and nominal group technique. After a review of the relevant literature and evidence, an initial survey of study group members (n=12) helped frame potential areas for investigation. Statements were subsequently edited, removed, or elaborated upon during four iterative rounds of live discussion with the opportunity for panelists to propose new guidelines at any point in the process. Respondents were able to suggest modifications and refine the statements until consensus, defined as ≥ 80% agreement, was achieved.</p><p><strong>Results: </strong>After a three-round iterative survey and video conference Delphi process, followed by an in-person meeting at the Summit for Safety in Spine Surgery, consensus was achieved on 27 best practice guideline statements. This BPG had the key focus areas of 1) general protocols, 2) screw planning/execution, 3) optimization of surgical technique, and 4) areas for robotic improvement. (available at https://safetyinspinesurgery.com/ ).</p><p><strong>Conclusion: </strong>This work provides expert insight into the best practices for minimizing errors in RASS with the presentation of 27 recommendations that can serve to reduce practice variability, optimize safety, and guide future research.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543374","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":"Novel radiological predictors for the progression of proximal junctional kyphosis in osteoporotic vertebral compression fracture with kyphosis following posterior corrective surgery.","authors":"Junyu Li, Yinghong Ma, Baitao Liu, Junjie Ma, Zhuoran Sun, Yongqiang Wang, Miao Yu, Weishi Li, Yan Zeng","doi":"10.1007/s43390-024-00983-z","DOIUrl":"10.1007/s43390-024-00983-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify the effect of some novel risk factors associated with L1 vertebrae and parameters closely related to the sagittal alignment for the occurrence of proximal junctional kyphosis (PJK) following surgery for patients with osteoporotic vertebral compression fractures (OVCF) kyphosis.</p><p><strong>Methods: </strong>74 OVCF patients undergoing posterior corrective surgery between January 2008 and June 2021 with a minimum 2-year follow-up were included. These patients were divided into PJK and non-PJK groups. Spinopelvic parameters, including thoracolumbar slope (TLS) and the L1 plumb line (L1PL) were measured preoperatively, postoperatively, and at follow-up. Multivariate logistic analysis was performed on various risk factors and Global Alignment and Proportion (GAP) scores. Associations between novel parameters and PJK were analyzed using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>PJK was identified in 28.4% of patients. The mean age and follow-up were 63.45 years and 38.17 months, respectively. There was no difference between the PJK and the non-PJK groups in baseline demographics, pre-operative and immediate post-operative pelvic incidence-lumbar lordosis mismatch. Multiple comparisons showed that the proportion of PJK in the severely disproportioned group(the group with the highest GAP scores) and that of the other two groups with lower GAP scores were statistically different (P < 0.001). Potential risk factors for PJK included preoperative thoracic kyphosis (TK) (P < 0.001), TLS (P = 0.016), postoperative TLS (P < 0.001), and L1PL (P < 0.001). Postoperative TLS and L1PL were respectively independent risk factors for PJK, with the cut-off values set at 8.6° and 10.4 mm to predict the occurrence of PJK.</p><p><strong>Conclusions: </strong>TLS and L1PL can be used to predict the occurrence of PJK in patients undergoing surgery for OVCF and are crucial for preventing the progression of PJK. Achieving a proportionate GAP Score postoperatively seems to be a viable option as higher GAP scores were associated with higher rates of PJK.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"469-480"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564309","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":"Human spinal height growth: a description of normal spine growth patterns and adult spine height prediction from a longitudinal cohort.","authors":"James O Sanders, Sarah E Obudzinski, Lauren E Karbach, Xing Qiu, Raymond W Liu","doi":"10.1007/s43390-024-01011-w","DOIUrl":"10.1007/s43390-024-01011-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study describes spinal growth and predicts future growth by standardizing timing relative to the growth spurt.</p><p><strong>Methods: </strong>From a longitudinal cohort of normal, healthy children followed through their growth, we identified those who completed their growth and compared spinal heights to chronological age and timing relative to the growth spurt. Anthropometrics and radiographs were correlated to identify heights to C1, T1, and S1 using three separate methods with validation performed by comparing to heights predicted by pelvic width. Heights and spinal lengths were normalized to percentages of adult lengths, and multipliers of growth remaining determined for both age and timing relative to PHV_90% (peak height velocity defined by achieving 90% of final height) as adult length divided by current spine length. The age at PHV_90% is termed Peak Growth Age (PGA)_90%.</p><p><strong>Results: </strong>Fifty-four subjects completed their growth at the study terminus (35f, 19 m). We identified multipliers allowing calculations of adult spine length based on the child's current timing relative to peak growth. At PHV_90%, children were 90% adult total height and 87% adult spine height. During childhood, spinal growth is 1.55 ± 0.21 cm/yr in girls, 1.14 ± 0.23 cm/yr in boys increasing to 1.75 ± 0.11 cm/yr in girls and 2 ± 0.11 cm/yr in boys during the growth spurt.</p><p><strong>Conclusion: </strong>This study identifies multipliers of spinal growth determination and identifies their values relative to the adolescent growth spurt timing which is known to be closely related to skeletal maturity. Timing compared to the PGA_90% provides reliable predictions of final spine length for both sexes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"519-528"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710669","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":"Mobile device-based 3D scanning is superior to scoliometer in assessment of adolescent idiopathic scoliosis.","authors":"Yousi Oquendo, Ian Hollyer, Clayton Maschhoff, Christian Calderon, Malcolm DeBaun, Joanna Langner, Nadine Javier, Xochitl Bryson, Ann Richey, Hiba Naz, Kali Tileston, Michael Gardner, John S Vorhies","doi":"10.1007/s43390-024-01007-6","DOIUrl":"10.1007/s43390-024-01007-6","url":null,"abstract":"<p><strong>Purpose: </strong>Screening for adolescent idiopathic scoliosis (AIS) currently relies on clinical evaluations by trained practitioners, most commonly using a scoliometer. Modern structured light 3D scanning can generate high-quality 3D representations of surface anatomy using a mobile device. We hypothesized that a mobile-based 3D scanning system would provide accurate deformity assessments compared to a scoliometer.</p><p><strong>Methods: </strong>Between August 2020 and June 2022, patients 10-18 years being evaluated for AIS in our clinic with a scoliosis radiograph obtained within 30 days of clinic evaluation and no history of spinal surgery were enrolled. Patients had 3D scans taken in the upright and forward bend positions, and the largest angle of trunk rotation (ATR) was measured by a scoliometer. Image processing software was used to analyze trunk shift (TS), coronal balance (CB), and clavicle angle (CL) in the upright position and the largest ATR in the forward bend position. 3D and scoliometer measurements were correlated to major curve magnitude. Multiple logistic regression models were created based on 3D and scoliometer measurements, controlling for demographic covariates.</p><p><strong>Results: </strong>Two hundred and fifty-eight patients were included in this study. Mean coronal major curve magnitude was 25.7° (range 0-100), and 59% had a thoracic major curve. There were good-to-excellent correlations between 3D and radiographic measures of TS, CB, and CL (r = 0.79, rs = 0.80, and r = 0.64, respectively, p < 0.001). Correlations between 3D and radiographic measures of largest lumbar and thoracic ATR also demonstrated good correlations (r = 0.64 for both, p < 0.001). Using Akaike's Information Criterion (AIC), a multivariable logistic regression model based on 3D scanning outperformed a scoliometer model.</p><p><strong>Conclusions: </strong>Mobile device-based 3D scanning of TS, CB, and TS identifies clinically relevant scoliotic deformity and is more predictive of radiographic curve magnitude than scoliometer in this population. This new modality may facilitate scoliosis screening by decreasing the need for trained personnel or dedicated equipment and clinical space to perform screening tests.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"529-537"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814208","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":"Compensatory thoracic curve correction in lumbar anterior vertebral body tether (VBT) versus lumbar posterior spinal fusion (PSF).","authors":"Jennifer M Bauer, Suken A Shah, Jaysson Brooks, Baron Lonner, Amer Samdani, Firoz Miyanji, Peter Newton, Burt Yaszay","doi":"10.1007/s43390-024-00994-w","DOIUrl":"10.1007/s43390-024-00994-w","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior vertebral body tethering (VBT) is a non-fusion surgical option for skeletally immature patients with idiopathic scoliosis. Prior studies demonstrated compensatory correction of the thoracic curve after lumbar posterior spinal fusion (PSF); however, no studies have examined thoracic curve correction after lumbar VBT.</p><p><strong>Methods: </strong>Patients with Lenke 5 + 6 lumbar scoliosis who underwent VBT and at least 2 years' follow-up were compared to matched lumbar PSF patients. Groups were compared for major lumbar (L) and compensatory thoracic (T) curve correction, coronal/sagittal balance, and complications.</p><p><strong>Results: </strong>24 AVBT and 24 PSF patients were matched 1:1 for skeletal maturity and curve flexibility. There were no significant differences between VBT and PSF for average pre-operative or 2 year post-operative major L or compensatory T curves. Average final L curve correction was 50% VBT and 60% PSF (p = 0.08); average T curve correction was 17% VBT and 20% PSF (p = 0.18). Compared to pre-operative flexibility radiographs, the final post-op thoracic curves were 6° (VBT) and 5° (PSF) larger. PSF had better coronal balance by average of 17 mm (p < 0.0001). There were seven (24%) reoperations in the VBT group: two overcorrections relaxed, two T adding-on (extended to T by PSF-1, VBT-1), one broken tether converted to PSF. There was one (4%) reoperation in the PSF group (10-year post-op extension).</p><p><strong>Conclusion: </strong>Compensatory thoracic correction was achieved to a similar degree for lumbar VBT and PSF patients. There was little change in thoracic curve magnitude over time, and, on average, the correction did not reach the pre-operative flexibility curve measurement. There was better coronal balance by PSF, and a higher rate of re-operation in VBT patients.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"581-586"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627420","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":"Healthcare disparities in adult and pediatric spinal deformity: a state of the art review.","authors":"Lancelot Benn, Tarek Yamout, Mauro Costa Morais Tavares Junior, Adwin Denasty, Laurel C Blakemore, Serena S Hu, Qusai Hammouri, Joe Minchew, Isaac Karikari, Joseph Osorio, Olavo Biraghi Letaif, Addisu Mesfin","doi":"10.1007/s43390-024-01012-9","DOIUrl":"10.1007/s43390-024-01012-9","url":null,"abstract":"<p><strong>Purpose: </strong>A health disparity refers to a greater disease burden or negative health outcomes influenced by social, economic, and environmental factors. Numerous studies in the surgical literature show that social drivers of health affect health outcomes. Similar disparities may affect treatment and outcomes of spine deformity patients. This study aims to review existing literature on healthcare disparities in patients with spinal deformities.</p><p><strong>Methods: </strong>A comprehensive search of articles from 1/2002 to 7/2024 in two databases included keywords and Medical Subject Heading terms: \"health disparities,\" \"scoliosis,\" \"social determinant of health,\" \"disparities,\" \"spine deformity,\" and \"race\". The 22 studies that met the inclusion criteria were U.S.-based, English-language, peer-reviewed research covering all age groups. Exclusion criteria excluded studies unrelated to spinal deformity and case reports.</p><p><strong>Results: </strong>The search resulted in 22 potential articles investigating health care disparities in spinal deformity patients. Black patients were noted to present with disease progression compared to White patients. Females have a longer length of stay (LOS) than males. The Black and Hispanic patients had longer LOS than Whites. The privately insured patients were more likely to receive timely care than Medicaid recipients.</p><p><strong>Conclusion: </strong>The consensus across much of the literature reviewed indicate that surgeon volume, hospital volume, sex/gender, race/ethnicity, socioeconomic status, and insurance status impact patient outcomes in adult and pediatric spinal deformity. Prospective studies and solutions to address these disparities are needed.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"373-381"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732513","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":"Zones where reduced implant density leads to correction loss after scoliosis surgery for Lenke 1A adolescent idiopathic scoliosis: a multicenter study.","authors":"Kaho Yanagisawa, Hiroki Oba, Tetsuro Ohba, Tomohiro Banno, Shoji Seki, Masashi Uehara, Shota Ikegami, Tetsuhiko Mimura, Terue Hatakenaka, Yoshinari Miyaoka, Daisuke Kurogochi, Takuma Fukuzawa, Michihiko Koseki, Yoshiharu Kawaguchi, Hirotaka Haro, Yukihiro Matsuyama, Jun Takahashi","doi":"10.1007/s43390-024-01005-8","DOIUrl":"10.1007/s43390-024-01005-8","url":null,"abstract":"<p><strong>Purpose: </strong>Investigate zones where implant density should not be reduced in posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) Lenke type 1A curves.</p><p><strong>Methods: </strong>126 consecutive patients (118 female and 8 male; mean age: 15.1 ± 2.2 years) with Lenke type 1A AIS who underwent PSF using pedicle screw constructs were included. Correction loss which was calculated using immediately postoperative and 2-year postoperative Cobb angle. Implant density was assessed by dividing the instrumented levels into four zones each on the concave and convex sides. The risk factors for significant correction loss were examined using logistic regression analysis. For convex apical zone, correction loss was compared among the three groups of low (0-59%), medium (60-99%), and high (100%) implant density.</p><p><strong>Results: </strong>Multivariate analysis revealed the apical zone of the convex side (Odds ratio [OR] 1.27; 95% confidence interval [CI] 1.01-1.59; P = 0.04) and the peri-apical zone of the convex side (OR 1.33; 95% CI 1.11-1.59; P = 0.002) as independent predictors of significant correction loss. In the convex apical zone, the median (interquartile range) correction loss of the low implant density, medium implant density, and high implant-density groups was 4.8° (1.5°), 5.3° (0.8°), and 2.2° (0.3°), respectively. The median difference was 2.6° (P = 0.048) between the low implant density and high implant-density group and 3.1° (P < 0.001) between the medium implant density and high implant-density group.</p><p><strong>Conclusion: </strong>In PSF for AIS Lenke 1A, low implant density in the convex apical zones were significant factors affecting correction loss at 2 years postoperatively. However, the difference in correction loss between groups may not be large enough to consider clinically meaningful. Prospective studies of longer term outcomes are needed to determine whether these results are clinically important.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"587-594"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627375","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}