Spine deformity最新文献

{"title":"Correction: 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/s43390-025-01046-7","DOIUrl":"10.1007/s43390-025-01046-7","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1287"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024488","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":"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":"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":"1253-1261"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573985","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":"What can we learn from scoliosis in children with the 22q11.2 deletion syndrome? Prognostic factors at pre-adolescent age for fast progressive, mild and self-resolving forms during adolescence.","authors":"Sabrina Donzelli, Peter Lafranca, Marteen Van Smeden, René Castelein, Tom Schlösser","doi":"10.1007/s43390-025-01073-4","DOIUrl":"10.1007/s43390-025-01073-4","url":null,"abstract":"<p><strong>Introduction: </strong>Longitudinal data starting before adolescence and before curve onset, may elucidate prognostic factors for later scoliotic curve development. The aim is to predict the maximum curve acceleration (MCA; °/month) and the final curve progression in a cohort of 22q11.2DS subjects screened for scoliosis.</p><p><strong>Methods: </strong>Scoliosis screening starts immediately after 22q11.2DS diagnosis. A minimum of 2 years follow-up, two assessments, Risser 0, open triradiate cartilage at start, were the inclusion criteria. Risser ≥ 3 corresponded to skeletally matured. Linear and logistic binary mixed effect models accounting for patients nested into multiple measurement occasions were created to predict MCA during adolescence and progressors (progression to ≥ 30) versus non-progressors (no scoliosis or < 30 at last follow-up).</p><p><strong>Results: </strong>161 subjects (59% females) with a mean baseline age 8.7 ± 2.4 years, follow-up of 4.2 ± 2.4 years and having reached skeletal maturity. Ultimately, 19 subjects became progressors and 142 became non-progressors. Curve magnitude at baseline was 8.8 ± 5.9° (range 0-50), at final follow-up 11.6 ± 12.4 (0-77). The mean curve acceleration was + 0.1 ± 0.5°, respectively + 0.2 ± 0.5°for non-progressors vs progressors during the acceleration phase. A linear mixed model showed that the triradiate cartilage closure accelerates MCA by 2.6 when adjusted for age and female gender. In a logistic mixed model, when the triradiate cartilage closes, the OR of reaching the MCA before the next follow-up is increased by 4.60 (CI95% 2.34-8.90 p < 0.001). No evidence for prognostic value of Risser in all derivated models.</p><p><strong>Conclusion: </strong>We found no evidence for the parameters in the coronal, sagittal nor transverse plane before curve onset acting as prognostic factors for curve behavior. In the prediction model on a longitudinal database that starts in many patients before scoliosis, no clear radiographic discriminant for later progressive scoliosis could be identified. The closure of the triradiate cartilage resulted as the best sign of pubertal spurt onset and scoliosis acceleration.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1179-1187"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670980","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":"My orthopedic brace inventory (MOBI): a new, reliable, and valid questionnaire to identify barriers to brace adherence in adolescent idiopathic scoliosis treatment.","authors":"Omar Elsemen, Marie Beauséjour, Justin-Pierre Lorange, Samuel Sassine, Jean Théroux, Soraya Barchi, Julie Joncas, Sylvie Le May, Carole Fortin, Carl-Éric Aubin, Stefan Parent, Nikita Cobetto, Marie-Claire Ishimo, Hubert Labelle","doi":"10.1007/s43390-025-01074-3","DOIUrl":"10.1007/s43390-025-01074-3","url":null,"abstract":"<p><strong>Purpose: </strong>Full-time wearing of an orthopedic brace has demonstrated effectiveness in limiting curve progression in adolescents with idiopathic scoliosis. However, treatment adherence is challenging, with an average wearing time of 13 h/day. Despite this issue, barriers to brace adherence have rarely been studied. The aim of this study was to develop and validate a new instrument tool to evaluate factors influencing brace adherence.</p><p><strong>Methods: </strong>Our study followed the COnsensus-based Standards for the selection of health Measurement INnstruments criteria (COSMIN). A conceptual framework was initially defined, and experts elaborated, reviewed, and selected candidate items. We also investigated the MOBI's factorial structure and its psychometric properties.</p><p><strong>Results: </strong>The MOBI initial version included 32 items related to four conceptual barriers to adherence, namely social/emotional, treatment, patient, and health system/professional. The factorial analysis led to an 18-item inventory with an internal consistency of 0.85 with four better-defined barriers (treatment social/emotional support structure, patient's self-image and perception, treatment adverse effects, and treatment acceptability. The MOBI-18f correlates with the SRS-22 domain treatment satisfaction and pain and the SF-12 mental health. Patients with poor brace wear time and more severe scoliosis will score higher on the MOBI-18f questionnaire.</p><p><strong>Conclusion: </strong>The MOBI-18f is a reliable and valid measure of patients' adherence to brace treatment. This questionnaire can be used to develop interprofessional adherence support intervention in AIS patients undergoing brace treatment.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1075-1084"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670978","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":"Smartphone-based surface topography app accurately detects clinically significant scoliosis.","authors":"Matthew S Rohde, Marleni Albarran, Anthony A Catanzano, Elizabeth J Sachs, Hiba Naz, Amishi Jobanputra, Jacob Ribet, Kali Tileston, John S Vorhies","doi":"10.1007/s43390-025-01062-7","DOIUrl":"10.1007/s43390-025-01062-7","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was twofold: (1) to validate the predictive capabilities of the Scoliosis Assessment App using ST technology against X-ray \"ground truth\" in patients being evaluated for clinically significant scoliosis; and (2) to compare the diagnostic accuracy of the App versus the commonly used scoliometer tool.</p><p><strong>Methods: </strong>A multicenter, prospective validation study was conducted among patients with known or suspected scoliosis. The App determined an Asymmetry Index to predict the likelihood of clinically significant disease (MCM ≥ 20°) as determined by X-ray. Outcomes included the sensitivity, specificity, and area under the receiver operating characteristic curve (ROC AUC) associated with the Apps prediction of clinically significant disease.</p><p><strong>Results: </strong>Fifty-five patients were evaluated with a mean age of 13.6 ± 2.1 years. The App correctly classified 91% (50/55) of the patients compared to 69% (38/55) for the scoliometer. The sensitivity of the App was 96.4% (89.6-100% CI) versus 50% (28.1-71.9% CI) for the scoliometer (P < 0.05), while the specificity values were 85.2% (71.8-98.9% CI) and 88.9% (74.4-100% CI), respectively. ROC analysis indicated a statistically significant difference in accuracy (AUC) in favor of the App (95% versus 71%; P = 0.015).</p><p><strong>Conclusion: </strong>The Scoliosis Assessment App using ST technology offers an accurate, accessible, and non-ionizing method of detecting clinically significant scoliosis, suggesting that the App can be used for detection and monitoring as an alternative to radiography and as a replacement for scoliometer without diminishing the standard of care. Further studies are required to assess variations of sensitivity in a large cohort of patients and clinical utility as an alternative to radiographs.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1051-1057"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765068","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":"Where does the tether break in vertebral body tethering cases? Clinical insights from revision cases after tether breakage.","authors":"Mahmoud Alkharsawi, Alice Baroncini, Dong-Gune Chang, Miguel Pishnamaz, Per David Trobisch","doi":"10.1007/s43390-025-01048-5","DOIUrl":"10.1007/s43390-025-01048-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the sites where the tether breaks in vertebral body tethering (VBT) cases.</p><p><strong>Methods: </strong>Intraoperative evaluation of broken tethers in patients who had anterior revision.</p><p><strong>Inclusion criteria: </strong>anterior revision of VBT cases with explantation of the full implant and photo documentation. Eight patients met the inclusion criteria. The primary variable of interest was the location of tether breakage in relation to the vertebral curve and the tether-screw interface. Another variable of interest was to evaluate the difference in breakage rates between anterior and posterior tethers in double tether cases.</p><p><strong>Results: </strong>Sixty tethers bridging the intervertebral disc within this cohort of eight patients were found. Seven implants were removed from thoracolumbar curves and one implant from a thoracic curve. We identified 32 tether breakages. Double tethers were used in six patients. In these six cases, 15 breakages were found in the posterior tether and 13 in the anterior tether. Four cases (50%) exhibited breakages at the apex, eight cases (100%) at the lowest instrumented vertebra (LIV), and five cases (63%) at the uppermost-instrumented vertebra (UIV). Five tether breakages (in three cases with double tether) were observed at the screw sites, while the remaining 27 exhibited cord breakages near the intervertebral discs. In double tether systems, statistical analysis did not reveal any significant difference in breakage rates between anterior and posterior tethers.</p><p><strong>Conclusions: </strong>In VBT cases, the tether breaks mostly at the level of the intervertebral disc, adjacent to the lowest instrumented vertebra.</p><p><strong>Level of evidence: </strong>Level IV (Case series with no comparison group).</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1107-1114"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053339","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":"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":"979-986"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","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}

{"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":"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":"1041-1049"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","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":"Are abnormal preoperative hematological screening tests associated with allogeneic transfusion in idiopathic scoliosis surgery?","authors":"Vivien Chan, Suhas Etigunta, Armaan K Malhotra, Geoffrey Shumilak, David E Lebel, Kenneth D Illingworth, David L Skaggs","doi":"10.1007/s43390-025-01078-z","DOIUrl":"10.1007/s43390-025-01078-z","url":null,"abstract":"<p><strong>Purpose: </strong>Previous studies have suggested routine preoperative laboratory assessment may be unnecessary or excessive. The primary aim of this study was to determine the association between abnormal preoperative laboratory screening tests on allogeneic transfusion in pediatric patients receiving posterior spinal fusion for idiopathic scoliosis correction.</p><p><strong>Methods: </strong>The NSQIP Pediatric database for years 2016-2022 was used. Patients who were (1) < 18 years old, (2) received posterior arthrodesis for idiopathic scoliosis correction, and (3) had recorded preoperative laboratory tests were included in this study. Preoperative bloodwork values of interest were hematocrit, albumin, platelet count, international normalized ratio (INR), and partial thromboplastin time (PTT). Descriptive statistics were used to characterize patient demographics, surgical metrics, and preoperative laboratory values. Rate of allogeneic transfusion was stratified by laboratory value cut-offs and compared using G-test. Standardized cut-offs were used to define abnormal values. A multivariable logistic regression analysis was used to assess the impact of abnormal bloodwork values on rate of allogeneic transfusion.</p><p><strong>Results: </strong>There were 6057 patients included in this study. The mean age was 13.8 years. There were 13.6% that received allogeneic transfusion. The mean transfusion volume was 62.1 mL. Patients with abnormal preoperative INR (13.1% vs. 20.0%; p < 0.001), hematocrit < 35 (12.4% vs. 25.9%; p < 0.001), and albumin < 3.4 (13.4% vs. 25.8%; p = 0.004) had higher rates of transfusion. In the multivariable logistic regression analysis, INR > 1.2 (OR 1.4, p = 0.023) and hematocrit < 35 (OR 2.3, p < 0.001) were significantly associated with higher odds of allogeneic transfusion.</p><p><strong>Conclusion: </strong>Preoperative INR and hematocrit values can aid in risk stratification for allogeneic transfusion requirements. PTT and platelet count did not significantly impact perioperative transfusion rates or volumes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1127-1134"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674114","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":"Breast asymmetry in idiopathic scoliosis (IS) patients with structural thoracic curve: a computed tomography (CT) morphometric analysis and assessment of patients' perceptions using the Breast-Q™ questionnaire.","authors":"Chris Yin Wei Chan, Siti Mariam Mohamad, Heng Keat Tan, Chee Kidd Chiu, Mun Keong Kwan","doi":"10.1007/s43390-025-01080-5","DOIUrl":"10.1007/s43390-025-01080-5","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify the breast computed tomography (CT) parameters in IS patients. Patients' perceptions of their breast appearance before/after scoliosis surgery were also assessed with Breast-Q™ questionnaire.</p><p><strong>Outcome measure: </strong>Concave/convex side breast volume difference (BVD), computed tomographic external breast appearance parameters (extraversion angle (EA), coverage angle (CA), axial breast height (ABH), nipple-to-sternum distance (NSD), thoracic rib cage parameter (inclination angle (IA)), and Breast Satisfaction and Psychosocial Well Being domains of Breast-Q Q™ questionnaires.</p><p><strong>Methods: </strong>This was a prospective study of 50 IS patients recruited between June 2017 and December 2018 who had pre-operative CT scans available for review. Pre-operative radiological parameters as stated above were evaluated. Breast volume difference (BVD) was calculated using the formula: 100 * {(CC BV - CV BV)/[(CC BV + CV BV)/2]}. Breast-Q™ questionnaires were administered pre-operative and post-operatively. The percentage of patients who achieved the minimal clinically important difference (MCID) was reported.</p><p><strong>Results: </strong>Thirty-three patients (66%) had significant BVD with the concave side larger in 52.0% of patients. BVD had significant correlation with ABH, NSD, CA, and EA. There was no significant correlation between pre-operative Cobb angle with BVD and IA. There was also no significant correlation between Tanner stage and the radiological parameters. Breast satisfaction and psychosocial well-being domains improved after surgery and the satisfaction with breast domain minimal clinically important difference (MCID) was achieved in 83.7% of patients, while the psychosocial well-being domain reached the MCID in 75.5% of patients (p < 0.001).</p><p><strong>Conclusion: </strong>Scoliosis led to significant breast asymmetry among patients with smaller volume on the convex side. Changes in breast volume (BV) contributed significantly towards the external breast appearance. Patient's breast satisfaction and psychosocial well-being improved post-operatively and, in the majority, MCID was achieved.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1115-1126"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788708","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}