Spine deformity最新文献

{"title":"Quality of life and mental health in adolescents with idiopathic scoliosis undergoing brace treatment: a systematic review and pooled analysis of quantitative studies.","authors":"Ashita Nair, Katie Ridsdale, Nikki Totton, Lizzie Swaby, Matthew Bellamy, Carson Head, Adam Lloyd, Ashley Cole","doi":"10.1007/s43390-026-01549-x","DOIUrl":"https://doi.org/10.1007/s43390-026-01549-x","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent idiopathic scoliosis (AIS) is the most common paediatric spinal deformity. While bracing limits curve progression, its psychological and social effects remain unclear. This review and pooled analysis evaluate bracing's impact on quality of life (QoL) and mental health in AIS.</p><p><strong>Methods: </strong>Searches were conducted in MEDLINE, EMBASE and PsycINFO (Dec 2024). Quantitative studies involving AIS patients undergoing brace treatment were included. Primary outcomes were QoL scores and reported mental health impact, assessed using validated tools. Risk of bias was assessed. A narrative synthesis was completed, with a pooled analysis to show effect sizes.</p><p><strong>Results: </strong>The searches identified 78 studies. A narrative review of the QoL questionnaires in cross-sectional studies, cohort studies and comparisons of brace treatment versus observation in AIS patients found mild and often non-statistically significant reduction in psychological well-being, more social difficulties, impaired physical functioning, more discomfort and lower self-image. These changes were often transient, improving or stabilising during bracing and mostly resolving after brace treatment. Longer brace prescriptions (more hours per day) and bulkier brace designs were negative factors. Family support, brace adherence and bracing success seemed to have a positive effect. Studies comparing brace treatment with surgery found surgically treated patients had mild and often non-statistically significantly improved QoL, self-image and psychological well-being but reduced satisfaction. Most studies showed a moderate risk of bias. The review included a pooled analysis of 51 studies using SRS-22 (n = 4193) with an overall, mean SRS-22 score during bracing of 4.05 (95% CI: 3.96, 4.13). Comparing bracing with observation (8 studies, n = 2374) shows a small QoL difference favouring no bracing (pooled effect size: - 0.11; 95% CI: - 0.21, 0.00), with extreme heterogeneity (I2 = 83%).</p><p><strong>Conclusion: </strong>Bracing generally resulted in lower scores for psychological issues, physical and social function and self-image compared to no treatment. Overall pooled differences were small and braced patients retained good QoL. Long-term data suggest improvement after brace treatment completion. Given high heterogeneity and risk of bias, high-quality research is needed to better evaluate psychosocial outcomes during and after AIS bracing including confounding factors and factors that may improve QoL.</p><p><strong>Level of evidence: </strong>IV (systematic review of level IV studies).</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002566","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":"Postoperative thoracic kyphosis morphology following adult spinal deformity surgery: an analysis of fused and unfused segments.","authors":"Renaud Lafage, Jonathan C Elysee, Alan H Daniels, Bassel G Diebo, Leonard Chatelain, Christopher P Ames, Shay Bess, Themistocles Protopsaltis, Robert K Eastlack, Munish C Gupta, Richard Hostin, Khaled M Kebaish, Han Jo Kim, Eric O Klineberg, Gregory M Mundis, David O Okonkwo, Christopher I Shaffrey, Justin S Smith, Frank J Schwab, Virginie Lafage","doi":"10.1007/s43390-026-01546-0","DOIUrl":"https://doi.org/10.1007/s43390-026-01546-0","url":null,"abstract":"<p><strong>Introduction: </strong>Predicting post-operative changes in thoracic kyphosis (TK) remains challenging in adult spinal deformity (ASD) surgery. This study aimed to quantify both iatrogenic and reciprocal changes in TK following lumbar correction and assess their maintenance at 2-year follow-up.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 356 ASD patients treated with posterior instrumentation from T9-11 to the pelvis, with a minimum 2-year follow-up. TK values were compared with normative data. Multivariate analysis identified thoracolumbar parameters associated with reciprocal thoracic changes and proximal failure.</p><p><strong>Results: </strong>Pre-op TK (median 34°) was normal for 59.8% and hypokyphotic for 39.0% of patients. At 6 weeks, 79.1% of initially hypokyphotic patients normalized, while 11.3% of normokyphotic patients deteriorated. Postoperative TK increase correlated with lumbar lordosis gain (p<0.001), controlling for pre-op alignment and demographics (R²=0.40). Between 6 weeks and 2 years, 9.3% experienced TK decompensation >15°, and 9.6% required proximal extension for junctional issues-defined collectively as \"thoracic failures\" (17.4%). Independent predictors of failure included advanced age (OR 3.6), more proximal lumbar correction (OR 1.9), and pronounced early mid-thoracic kyphosis (OR 2.3).</p><p><strong>Conclusion: </strong>In ASD surgery with Upper Instrumented Vertebra (UIV) between T9 and T11, changes in TK were largely proportional to lumbar correction, leading to normalization in most cases. However, age, the location of lumbar correction, and early post-operative thoracic shape independently predicted thoracic failure, highlighting the need for tailored alignment strategies.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002574","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 changing early onset scoliosis phenotype in spinal muscular atrophy: nusinersen treatment is associated with younger age, increased curve magnitude, and kyphosis at the time of index surgery.","authors":"Ian Hollyer, Talissa Generoso, Bill Young, Xochitl Bryson, Nicole Segovia, Marleni Albarran, Majella Vaughan, Amy Mcintosh, Brandon Ramo, Daniel Bouton, Brian Snyder, Michael Vitale, John Smith, Benjamin Roye, Patrick Cahill, Jaysson Brooks, Ron El-Hawary, Pediatric Spine Study Group, John S Vorhies","doi":"10.1007/s43390-026-01359-1","DOIUrl":"https://doi.org/10.1007/s43390-026-01359-1","url":null,"abstract":"<p><strong>Background: </strong>Nusinersen provides functional benefits to Spinal Muscular Atrophy (SMA) patients but does not affect the prevalence or progression of scoliosis. This study aims to characterize perioperative curve characteristics and patient demographics among patients with SMA undergoing surgical treatment for early onset scoliosis (EOS) in a period spanning the introduction of nusinersen, a disease-modifying therapy.</p><p><strong>Methods: </strong>This retrospective cohort study utilized a multicenter international pediatric spinal deformity database. Patients with SMA undergoing initial surgical treatment for scoliosis between 1996 and 2023 were included. Patients were stratified by exposure to nusinersen preoperatively. Preoperative clinical, radiographic characteristics, and first erect postoperative radiographic parameters were compared between groups.</p><p><strong>Results: </strong>A total of 210 patients were included, 37 with preoperative nusinersen exposure and 173 controls. Patients in the nusinersen group were younger at the time of intervention (6.5 vs. 7.6 years, p = 0.006) and had more spinal levels instrumented post-operatively (10.5 vs. 9.5, p = 0.033). Preoperative kyphosis (78° vs. 67°, p = 0.027) and major curve magnitude (83° vs. 75°, p = 0.030) were higher in the nusinersen group. Postoperative kyphosis was also greater in this group (48° vs 42°, p = 0.042). There was no difference in postoperative major curve magnitude or percent correction. The nusinersen group was more commonly treated with magnetically controlled growing rods. A contemporaneous subgroup analysis (post-2017) showed that patients treated with nusinersen were younger at the time of surgery, although no significant differences in preoperative curve characteristics were noted.</p><p><strong>Conclusion: </strong>Nusinersen exposure was associated with younger age at surgery, greater curve magnitude, and increased kyphosis. These findings highlight potential changes in the phenotype of surgical candidates with EOS and SMA among patients treated with Nusinersen.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991281","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":"Scheuermann's kyphosis carries higher perioperative risk than idiopathic scoliosis in adolescent patients undergoing posterior spinal fusion.","authors":"Vivien Chan, Justin L Reyes, Monerah Annaim, Mehdi Elfilali, Michael G Vitale, David L Skaggs, Zeeshan M Sardar","doi":"10.1007/s43390-026-01556-y","DOIUrl":"https://doi.org/10.1007/s43390-026-01556-y","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare perioperative outcomes between adolescents undergoing posterior spinal fusion for idiopathic scoliosis versus Scheuermann's kyphosis using a large clinical registry.</p><p><strong>Methods: </strong>This was a retrospective cohort study using the NSQIP Pediatric database years 2016-2024. Patients aged 10-17 years who underwent posterior spinal fusion for either idiopathic scoliosis (AIS) or Scheuermann's kyphosis (SK) were included. Perioperative outcomes of interest included operative time, length of stay, allogeneic transfusion, any adverse event, unplanned readmission, unplanned reoperation, and postoperative neurological injury. Outcomes were compared between the two etiologies using Student's t-test and Chi-square test. Multivariable regression analyses were performed adjusting for age, gender, ASA score, and number of fusion levels.</p><p><strong>Results: </strong>A total of 31,637 patients were included (AIS: 31,120, mean age 14.5 years; SK: 517, mean age 15.7 years). SK patients had significantly longer operative time (AIS: 276.4 min vs. SK: 306.4 min, p<0.001) and length of stay (AIS: 3.4 days vs. SK: 3.8 days, p = 0.03). SK patients had significantly higher rates of any adverse event (AIS: 1.6% vs. SK: 3.7%, p<0.001), unplanned reoperation (AIS: 1.3% vs. SK: 3.5%, p<0.001), unplanned readmission (AIS: 1.7% vs. SK: 5.6%, p<0.001), and postoperative neurological injury (AIS: 0.3% vs. SK: 1.4%, p<0.001). SK patients had a significantly lower rate of allogeneic transfusion (AIS: 10.9% vs. SK: 5.6%, p<0.001). On multivariable regression analysis, SK patients had higher odds of any adverse event (OR 1.72, p = 0.03), readmission (OR 2.24, p<0.001), reoperation (OR 1.88, p = 0.01), and postoperative neurological injury (OR 3.56, p = 0.002), as well as decreased odds of allogeneic transfusion (OR 0.44, p<0.001). Etiology was not independently associated with operative time or length of stay after adjustment.</p><p><strong>Conclusion: </strong>Adolescents undergoing posterior spinal fusion for Scheuermann's kyphosis experience significantly higher rates of perioperative complications, readmissions, reoperations, and neurological injury compared with those treated for idiopathic scoliosis. These findings highlight important differences in perioperative risk between pathologies and underscore the need for tailored preoperative counseling, risk stratification, and perioperative planning for patients with Scheuermann's kyphosis.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978006","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":"Operative management of traumatic sacral fractures and in-hospital mortality: a national analysis.","authors":"Samer Salman, Rohan Phadke, Nathan J Lee","doi":"10.1007/s43390-026-01551-3","DOIUrl":"https://doi.org/10.1007/s43390-026-01551-3","url":null,"abstract":"<p><strong>Purpose: </strong>Sacral fractures cause substantial morbidity and mortality, yet prior studies have focused on fixation strategy and functional outcomes rather than survival. In the largest cohort to date, we evaluated factors associated with lower in-hospital mortality following operative management among adults with sacral fractures.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the National Trauma Data Bank (2017-2022). Adults with sacral fractures were identified by ICD-10-CM codes. We balanced baseline differences using overlap weighting, stabilized inverse probability weighting, and 1:1 propensity score matching, confirmed by multivariable logistic regression, with prespecified subgroup and sensitivity analyses.</p><p><strong>Results: </strong>Among 105,649 adults with sacral fractures, median age was 57 years, 54.3% were female, and in-hospital mortality was 5.4%. Overall, 22.7% underwent operative management. Crude mortality was lower in operative than nonoperative patients (2.9% vs. 6.2%, p<0.001). After overlap weighting, surgery remained associated with lower mortality (OR 0.37), with consistent findings across matched (OR 0.33), stabilized weighting (OR 0.39), and multivariable analyses (aOR 0.23; all p<0.001). The association persisted across nine sensitivity analyses (aOR range 0.19-0.25). Benefit was present across all fracture zones, with the greatest effect in Zone III (aOR 0.14 vs. Zone I aOR 0.28, Zone II aOR 0.20). Older adults also benefited (aOR 0.32). Operative use increased modestly from 21.2% to 23.0% over the study period.</p><p><strong>Conclusions: </strong>Operative management was associated with lower in-hospital mortality in the largest sacral fracture cohort studied to date. Fewer than one in four patients underwent surgery, supporting reassessment of operative thresholds, particularly for higher-zone injuries, through prospective validation.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971363","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":"In reply to the letter to the editor regarding \"National mental health burden in adults with spinal deformity: a propensity-matched analysis using the All of Us Research Program\".","authors":"Tanmay S Mehta, Manjot Singh, Michael J Farias, Joseph E Nassar, Nicolas L Carayannopoulos, Zvipo M Chisango, Alan H Daniels, Bassel G Diebo","doi":"10.1007/s43390-026-01555-z","DOIUrl":"https://doi.org/10.1007/s43390-026-01555-z","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971377","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":"Thoracic compensation after pediatric lumbar spinal fusion: adaptations in the sagittal plane.","authors":"Eshan S Sane, Jake H Goldfarb, Christian E Wright, Nicholas C Speller, Gabriel G Boebel, Ling Chen, Simon Y Tang, Michael P Kelly, Blake K Montgomery","doi":"10.1007/s43390-026-01545-1","DOIUrl":"10.1007/s43390-026-01545-1","url":null,"abstract":"<p><strong>Purpose: </strong>Sagittal plane changes after isolated lumbar fusion for pediatric idiopathic scoliosis are under-reported in current literature. Understanding how the thoracic spine compensates after this surgery will help optimize surgical technique. This study aims to determine the thoracic compensation and the change in other sagittal plane variables after lumbar fusion.</p><p><strong>Methods: </strong>This was an IRB approved retrospective study that included patients if they were between 11 and 18 with idiopathic scoliosis with lumbar major patterns that underwent isolated thoracolumbar/lumbar fusion. Spinal radiographs were reviewed at 3 timepoints: pre-operative, 6 weeks post-operative, and long-term (at or greater than 2 years) post-operative to assess sagittal plane parameters. Linear mixed effect model, regression analysis with Pearson's correlation coefficient, and Fisher exact analyses were used to identify differences across these timepoints for quantitative and categorical variables.</p><p><strong>Results: </strong>45 patients met inclusion criteria. The median age was 15 (range 11-18) and average follow up was 4.04 years. There were 38 female and 7 male patients. The thoracic spine became more kyphotic after surgery (M diff. pre-op to 2 years T5-T10 = 4.7°, p < 0.05). Additionally, 22% developed radiographic proximal junctional kyphosis at 2 years. The lumbar segments became increasingly more lordotic after surgery (M diff. L1-S1 pre-op to 2 years = - 5.6°, p < 0.05). Lower pre-operative sagittal thoracic curvature was significantly associated with increased post-operative thoracic kyphosis (T5-T10 pre- to 2-year post-op r = - 0.31, p = 0.04). Lower pre-operative sagittal lumbar curvature was also significantly associated with increased post-operative lumbar lordosis kyphosis (L1-S1 pre- to 2-year post-op r = - 0.4, p = 0.01). Age, BMI, and number of fused segments did not correlate significantly with thoracic or lumbar change post-operatively.</p><p><strong>Conclusions: </strong>Isolated lumbar fusion for pediatric idiopathic scoliosis is associated with increasing thoracic kyphosis. Additionally, the lumbar spine became more lordotic after surgery. These effects became pronounced in patients with low sagittal plane pre-operative curvature. Anticipating these adaptations will help guide surgical planning to optimize the sagittal plane.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971346","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":"Pediatric spine surgeons report high perceived patient mental health burden and limited screening in scoliosis care.","authors":"Matthew Weintraub, Omar Taha, Julia Rakin, Amber Mizerik, Mehdi M Elfilali, Benjamin D Roye, Michael G Vitale","doi":"10.1007/s43390-026-01550-4","DOIUrl":"https://doi.org/10.1007/s43390-026-01550-4","url":null,"abstract":"<p><strong>Background: </strong>Adolescents seeking treatment for scoliosis often present with comorbid mental health concerns. Yet, standardized screening, evaluation, and care protocols remain lacking. This study examines pediatric orthopedic providers' perceptions of patient mental health burden and screening practices in spine deformity care.</p><p><strong>Methods: </strong>Fifty-four pediatric spine surgeons from a multi-center AIS registry were anonymously surveyed. Closed-ended responses were tallied, and sentiment analysis was applied to open-ended responses.</p><p><strong>Results: </strong>Twenty-eight surgeons (52%) responded, most with over ten years of experience in high-volume practices. Many estimated that up to half of their patients face mental health challenges, noting a slight increase in burden. Despite this, only 12 (42%) reported structured screening (e.g., SRS, PROMIS) and 6 (21%) used informal methods (observations, conversations). Among the 16 (57%) screening, PROMIS and depression/suicide screens were most common. Few reported reliable follow-up: only 2 (7%) indicated their teams \"probably\" follow up on low scores, while 11 (39%) felt follow-up was unlikely. Most (64%) believed they were not adequately addressing concerns. Referrals were typically prompted by positive screens or observations, but barriers, like limited provider availability, access issues, and insurance constraints, often hindered them. When made, referrals were usually directed in-house.</p><p><strong>Conclusion: </strong>Significant gaps exist in addressing mental health in pediatric scoliosis care. While providers report to recognize the burden, few conduct routine screenings, and follow-up and referrals remain inconsistent. Findings highlight the need for standardized protocols and improved access to mental health resources within scoliosis care.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971403","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":"Beyond the curve: long-term lived experiences and psychological outcomes of spinal fusion in adolescents with scoliosis.","authors":"Edward M Barksdale, Christian E Wright, Nicholas Speller, Lucas Budd, Gabriel Boebel, Josh Marino, Simon Y Tang, Kirsten Brouillet, Brian A Kelly, Keith Bridwell, Blake K Montgomery","doi":"10.1007/s43390-026-01544-2","DOIUrl":"10.1007/s43390-026-01544-2","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior spinal fusion (PSF) surgery is the standard treatment for severe adolescent idiopathic scoliosis (AIS) and is effective in both preventing further progression of scoliosis and correcting spinal deformity. However, adolescents may face psychological and social challenges following surgery that are not captured by traditional clinical outcome measures. This study aimed to explore the long-term psychological impacts that spinal fusion surgery may have on adolescents by identifying factors, such as self-image, emotional well-being, and social functioning, that influence recovery and adjustment post-surgery.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with AIS patients who underwent PSF with primarily pedicle screw constructs with at least 10 years of follow-up. A grounded-theory approach to qualitative analysis identified key themes within each interview to structure an in-depth exploration of the patient experience after PSF.</p><p><strong>Results: </strong>Thirteen participants completed qualitative interviews (12 female; mean follow-up: 16.5 years, range 12 - 23 years). Thematic analysis identified key domains that influenced patient experiences before and after surgical treatment, including perceived long-term success, the role of reliable support systems (such as family and medical teams), and ongoing challenges related to insecurity, limited flexibility, and activity restrictions. 12 participants reported satisfaction with their surgical care and would elect to undergo surgery again. 11 participants described an improved self-image postoperatively, though individual reasons varied. Notably, all five participants who underwent bracing prior to surgery expressed significant dissatisfaction with their bracing experience. Additionally, three of the female patients noted trouble obtaining epidurals during pregnancy as a negative side-effect of PSF surgery.</p><p><strong>Conclusion: </strong>Most patients who underwent PSF for AIS reported a positive experience and improved self-image post-surgery. Essential themes within this cohort include transparent communication and strong support from both families and the medical team, which promote an adolescent patient's long-term recovery and adjustment post-surgery. Understanding the themes that impact a patient's experience of PSF can inform shared decision-making and guide future research in AIS long-term outcomes.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930924","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":"State-of-the-art review in AI and digital technologies for spine deformity.","authors":"Caroline Constant, A Noelle Larson, Carl-Eric Aubin","doi":"10.1007/s43390-026-01533-5","DOIUrl":"https://doi.org/10.1007/s43390-026-01533-5","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence (AI) and digital technologies are increasingly being used across the continuum of spinal deformity care, from screening and diagnosis to surgical planning, intraoperative assistance, and postoperative follow-up. This State-of-the-Art Review provides a clinically oriented synthesis of current applications, summarizes the available evidence supporting their use, and discusses the requirements for safe and effective clinical translation.</p><p><strong>Methods: </strong>Peer-reviewed literature published primarily within the past five years was reviewed, with earlier studies included when considered fundamental to the development or clinical understanding of the field. Applications were organized according to their role in screening and diagnosis, deformity assessment, prediction and decision support, preoperative planning, intraoperative technologies, postoperative follow-up, and clinical workflow support. Emphasis was placed on the maturity of available evidence, validation strategies, and potential clinical utility.</p><p><strong>Results: </strong>Published studies describe a rapidly expanding range of applications, including automated radiographic measurements, radiation-free screening approaches, automated deformity classification, prediction of curve progression and postoperative outcomes, preoperative planning, patient-specific physics-based biomechanical simulations, remote monitoring technologies, and natural language processing-based clinical tools. The strongest evidence currently supports automated image analysis, selected predictive models, and specific planning technologies. However, many systems remain at the proof-of-concept stage and have been developed using retrospective single-centre datasets. Although technical performance is often promising, independent multicentre validation, prospective evaluation, assessment of clinical impact, and demonstration of integration within routine workflows remain limited for many applications.</p><p><strong>Conclusion: </strong>AI and digital technologies have the potential to improve the consistency, efficiency, and personalization of spinal deformity care. Nevertheless, most current applications should be considered decision-support tools rather than autonomous systems. Future progress will depend not only on algorithmic performance but also on rigorous validation, transparent reporting, prospective clinical evaluation, and risk-informed assessment frameworks that align the level of evidence with the intended clinical role and potential impact of each technology.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913344","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}