Spine deformity最新文献

{"title":"Long-term cancer risk in historic cohorts of patients with adolescent idiopathic scoliosis: a systematic review.","authors":"F D Højsager, L W Laursen, R Castelein, A Simony","doi":"10.1007/s43390-025-01176-y","DOIUrl":"https://doi.org/10.1007/s43390-025-01176-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term cancer risks associated with AIS, focusing on the roles of genetic predispositions and radiation exposure.</p><p><strong>Methods: </strong>A comprehensive systematic search was conducted on August 5, 2024, across PubMed, EMBASE, Scopus, Cochrane Libraries, and CINAHL, covering studies from 1947 onward. Human studies on patients with scoliosis diagnosed before age 20 were included. For cancer assessment, both risk, incidence and mortality were included. Studies were excluded if they focused solely on congenital or secondary scoliosis. Screening and quality assessment were conducted using Covidence. The first author performed the initial screening, while the first and second authors conducted full-text assessments and quality assessment collaboratively, with an agreement score of 0.83.</p><p><strong>Results: </strong>Seven studies from the USA, Australia, Denmark and The Netherlands were identified. Notable findings included elevated breast cancer risks among US cohorts, linked to historical radiographic practices that delivered higher radiation doses. None of the included studies assessed genetic etiologies of cancer. Risk of bias in the studies were generally attributed to selection bias and underreporting of characteristics and confounding variables. While most studies included either showed a tendency or a significant association towards an association between scoliosis and risk of cancer, it was mainly based on data before 1990 with exposure to radiation several orders of magnitude larger than modern standards. These changes could be a major factor in the risk of cancer identified in historical cohorts.</p><p><strong>Conclusion: </strong>This review highlights the importance of continued research, including the effect of modern examination techniques, such as EOS, MRI on rates of cancer in modern populations.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055696","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":"Bilateral anterior lumbar vertebral body tethering: a feasibility cohort study.","authors":"Alan A Stein, Amer F Samdani, Alexander J Schüpper, Sabrina Zeller, Zan A Naseer, Joshua M Pahys, Alejandro Quinonez, Emily Nice, Kaitlin Kirk, Steven W Hwang","doi":"10.1007/s43390-025-01175-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01175-z","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior vertebral body tethering (VBT) is a viable option for children with idiopathic scoliosis. Treating double major curves with bilateral VBT may allow patients to avoid spinal fusion while improving the coronal Cobb angle.</p><p><strong>Methods: </strong>A single center retrospective study was conducted to identify all patients who underwent bilateral VBT (lowest instrumented vertebra L3 or 4) with minimum 2-year follow-up. Clinical and radiographic parameters were collected, including complications and reoperations. Statistical analysis was performed utilizing Students' t-test.</p><p><strong>Results: </strong>Seventy-three patients (67 female, 91.8%) underwent bilateral VBT with mean follow-up of 4.2 ± 1.5 years. Preoperatively, all patients were skeletally immature (age 12.7 ± 1.2 years with a Sanders score of 3.3 ± 0.8 and Risser grade of 0.6 ± 0.8). The preoperative lumbar Cobb angle was 51.1° ± 7.9° which corrected to 20.7° ± 11.3° at most recent follow-up (p < 0.01) and the thoracic Cobb angle measured 52.3° ± 9.0° which corrected to 27.0° ± 11.3° (p < 0.01) at most recent follow-up. At latest follow-up, 51/73 (69.9%) had a thoracic Cobb angle <30°, 59/73 patients (80.8%) had a lumbar Cobb angle <30°, and 47/73 (64.4%) had both thoracic and lumbar Cobb angles <30°. 15 patients (20.5%) underwent 17 reoperations with overcorrection being the most common indication (8/17, 47.1%). Broken tethers led to reoperation in 3/17 instances (17.6%). Five patients (6.8%) eventually required posterior spinal fusion.</p><p><strong>Conclusions: </strong>Bilateral VBT is a safe procedure and may be a viable option for patients with double curves, with the majority of curves measuring <30° at most recent follow-up. Surgeons can use these data to help patients and parents make informed decisions regarding treatment options.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034171","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 fusion to the stable sagittal vertebra necessary to avoid distal junctional kyphosis in thoracic adolescent idiopathic scoliosis?","authors":"Lærke Ragborg, Martin Heegaard, Thomas Andersen, Rose-Marie Høi-Hansen, Martin Gehrchen, Benny Dahl, Søren Ohrt-Nissen","doi":"10.1007/s43390-025-01183-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01183-z","url":null,"abstract":"<p><strong>Study design: </strong>This is a retrospective single-center study.</p><p><strong>Purpose: </strong>The purpose is to investigate the incidence of distal junctional kyphosis (DJK) when fused proximal to the stable sagittal vertebra (SSV) in adolescent idiopathic scoliosis (AIS) patients undergoing selective thoracic fusion.</p><p><strong>Methods: </strong>We retrospectively reviewed a consecutive cohort of surgically treated AIS patients with Lenke 1-2 A/B curves between 2011 and 2022 with a minimum of 2 years of follow-up. The SSV was defined as the vertebra bisected by the posterior sacral vertical line on long-standing sagittal radiographs. All patients underwent posterior pedicle screw instrumentation, and the decision of fusion level was at the surgeons' discretion. Distal junctional kyphosis was defined as ≥10° angulation between the lower instrumented vertebra (LIV) and the vertebra below the LIV (LIV + 1). Patients were stratified into Fusion proximal of SSV (Prox-SSV) and fusion including SSV (Incl-SSV). Multivariable backward regression was performed to identify predictors for DJK.</p><p><strong>Results: </strong>A total of 196 patients were included, with 80 in the Prox-SSV group. The overall DJK rate was 3.6% (7/196), occurring in 6.3% (5/80) in the Prox-SSV group and 1.7% (2/116) in the Incl-SSV group, respectively (p = 0.125). Fusion proximal of SSV did not significantly increase DJK risk (Univariate OR 7.98, 95% CI 0.87-66.6; excluded in multivariable regression). Using SSV for LIV selection would extend the fusion by one level in 63.8%, two in 25.0%, and three in 11.2% of patients.</p><p><strong>Conclusion: </strong>The overall risk of DJK is small in thoracic curves and fusion proximal to the SSV did not significantly increase the risk of DJK. Standardized use of SSV as LIV would result in a substantial extension of the fusion area with questionable benefits to the patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024178","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 Scolioscope: a home detection tool for measuring axial trunk rotation in scoliosis-a validation study.","authors":"Julia H E Holleman, Hanneke M van West, Thomas Q M Vu, Max Reijman, Joost P H J Rutges","doi":"10.1007/s43390-025-01174-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01174-0","url":null,"abstract":"<p><strong>Purpose: </strong>Screening for adolescent idiopathic scoliosis (AIS) using the Adam Forward Bending Test (AFBT) remains controversial, resulting in the discontinuation of scoliosis screening in the Netherlands. This study aims to validate the Scolioscope, a simplified version of the Scoliometer, for detecting scoliosis in a home setting.</p><p><strong>Methods: </strong>A validation study was conducted at the orthopedic outpatient clinic of Erasmus Medical Center Sophia Children's Hospital in Rotterdam, the Netherlands. Patients aged 9-18 years with or without AIS and capable of performing the AFBT were included. The Scolioscope measurement of the parents was compared with the Scoliometer measured by an orthopedic surgeon. After unsatisfactory results with the initial Scolioscope version, a revised version was developed and tested.</p><p><strong>Results: </strong>Among 100 patients included in the study, 79 had scoliosis. The revised version of the Scolioscope demonstrated a positive predictive value of 97%, a negative predictive value of 89%, sensitivity of 94%, and specificity of 94%. Parental measurements showed no variation, with an intra-observer reliability kappa value of 1.</p><p><strong>Conclusion: </strong>The Scolioscope demonstrates high diagnostic accuracy and precision, making it suitable for use in at-home scoliosis screening programs.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024194","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":"Surgical invasiveness, reoperation, and preoperative depression are predictive of super-utilization in adult spinal deformity surgery.","authors":"Pratibha Nayak, Richard Hostin, Jeffrey L Gum, Breton Line, Shay Bess, Lawrence G Lenke, Renaud Lafage, Justin S Smith, Bassel Diebo, Virginie Lafage, Eric Klineberg, Han Jo Kim, Peter Passias, Khal Kebaish, Robert Eastlack, Alan H Daniels, Gregory M Mundis, Themistocles S Protopsaltis, D Kojo Hamilton, Munish Gupta, Frank J Schwab, Christopher I Shaffrey, Christopher P Ames","doi":"10.1007/s43390-025-01167-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01167-z","url":null,"abstract":"<p><strong>Purpose: </strong>A subset of adult spinal deformity (ASD) patients undergoing corrective surgery receive a disproportionate level of medical resources and incur greater costs. We examined the characteristics of such super-utilizers of health care resources among ASD patients.</p><p><strong>Methods: </strong>This prospective, multicenter study analyzed data from ASD patients with > 4 levels of spinal fusion and a minimum 2-year follow-up. Index and total episode-of-care (EOC) costs in 2022 US dollars were calculated using average itemized direct costs obtained from administrative hospital records. Patients with total 2-year EOC cost > 90th percentile were considered super-utilizers, the characteristics of which we identified through a multivariate generalized logistic model.</p><p><strong>Results: </strong>Of 1299 eligible patients, mean age was 60 years, 73% were female and 92% were Caucasian. Super-utilizers were older (+2.1 years; p = 0.012), had greater depression (34.2 vs 25.7%; p = 0.03), increased frailty (p = 0.009) comorbidities (p = 0.005), higher reoperation rates (54.4 vs 15.0%; p < 0.001), hospital length of stay (+ 3 days; p < 0.0001), higher surgical invasiveness (+28.6; p < 0.001), more vertebrae fused (+ 3; p < 0.0001); interbody fusions (80 vs 55%; p < 0.0001), bone morphogenetic protein (BMP) use (87.3 vs 69.4%; p = 0.0001), operative time (+91 min; p < 0.0001), and blood loss (+620 mL; p < 0.0001) compared to other ASD patients. Index cost was 65% (p < 0.0001), and cost/quality-adjusted life-year was three times higher among super-utilizers.</p><p><strong>Conclusion: </strong>ASD patients with depression who undergo more complex or revision spinal surgical procedures are more likely to be super-utilizers. Identifying likely super-utilizers within the ASD population may enable targeted interventions and preoperative planning to reduce unnecessary costs, while improving patient outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006537","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":"Letter to the editor about ' Evaluation of Google and ChatGPT responses to common patient questions about scoliosis'.","authors":"Sezgin Bahadır Tekin","doi":"10.1007/s43390-025-01182-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01182-0","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001430","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":"Three cases of revision surgery for exacerbated deformity due to long-term neglect after failed corrective fixation of adolescent idiopathic scoliosis.","authors":"Shimei Tanida","doi":"10.1007/s43390-025-01180-2","DOIUrl":"10.1007/s43390-025-01180-2","url":null,"abstract":"<p><strong>Purpose: </strong>Implant-related complications can occur after the surgery for adolescent idiopathic scoliosis (AIS) and remain untreated for long periods until they become painful enough for intervention. This can result in a rigid deformity with vertebral fusion and disc degeneration within the scoliotic curve. This report aimed to emphasize the importance of early revision surgery illustrated in three unique cases.</p><p><strong>Case description: </strong>The cases presented were as follows: a 48-year-old female who had experienced implant failure following posterior corrective fixation left untreated for 25 years; a 32-year-old female who had experienced implant failure following anterior corrective fixation left untreated for 16 years; and a 23-year-old male who had experienced pseudarthrosis following posterior corrective fixation and had been left untreated for 5 years following implant removal. All patients exhibited vertebral fusion and disc degeneration within the exacerbated major thoracolumbar/lumbar scoliotic curve as well as kyphotic deformity because of prolonged neglect after implant failure. In all cases, surgery required an anteroposterior combined procedure with anterior intervertebral release, posterior fusion mass osteotomy, and asymmetric pedicle subtraction osteotomy.</p><p><strong>Conclusion: </strong>When implant failure occurs after AIS surgery, early surgical intervention can enable less extensive revision with reduced risk before stiffness and fusion of the bone mass develop. Regular long-term follow-up is therefore essential for early detection of implant failure. Moreover, when recommending revision surgery, it is critical to intervene at an appropriate time, ensuring that patients fully understand both the risks and benefits, including the psychological burden of residual deformity.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967790","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":"Correction: My orthopedic brace inventory (MOBI): a new, reliable, and valid questionnaire to identify barriers to brace adherence in adolescent idiopathic scoliosis treatment.","authors":"Omar Elsemin, 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/s43390-025-01181-1","DOIUrl":"https://doi.org/10.1007/s43390-025-01181-1","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967784","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":"Effects of intraoperative topical hemostatic agents on chest tube output and thoracic complications following vertebral body tethering.","authors":"Hans K Nugraha, Jack W Sample, Brett F Curran, D Dean Potter, Todd A Milbrandt, A Noelle Larson","doi":"10.1007/s43390-025-01089-w","DOIUrl":"10.1007/s43390-025-01089-w","url":null,"abstract":"<p><strong>Purpose: </strong>Vertebral body tethering (VBT) is an emerging treatment option for idiopathic scoliosis, but routinely requires intraoperative placement of a chest tube (CT). Topical thrombin and injectable collagen have routinely been used as a hemostatic agent, but data are lacking on its use in VBT. Thus, we aim to investigate the impact of the topical hemostatic use on CT output and duration, and the subsequent rate of clinically-significant hemothorax and effusion after VBT.</p><p><strong>Methods: </strong>Retrospective review was conducted on patients who underwent VBT at a single institution between 2015 and 2024. Patients were grouped to whether they were treated with FDA-approved, topically applied recombinant thrombin and injectable collagen intraoperatively. We hypothesized that there would be fewer thoracic and chest tube complications in the topical hemostatic group based on their 90-day perioperative outcomes.</p><p><strong>Results: </strong>Out of 190 patients who underwent VBT, 92 received thrombin and injectable collagen intraoperatively while 98 did not. Mean age at surgery was 13 (range 9-17) years. Adjusting for chest tube size and number of instrumented levels, regression analysis showed significant decrease in CT output, CT duration, and the odds of developing clinically significant pleural effusion with the use of intraoperative topical hemostatic agents. Two cases of in-hospital hemothorax were found in the non-topical hemostatic group and none in the group with topical hemostatic.</p><p><strong>Conclusions: </strong>Applying topical thrombin and injectable collagen during surgery decreases CT output and duration following VBT, as well as the odds of developing clinically significant pleural effusion. This may serve as an alternative to the use of 24-h intravenous hemostatic agent such as tranexamic acid.</p><p><strong>Level of evidence: </strong>Level III-Retrospective Cohort Study.</p><p><strong>Level of evidence: </strong>Level III-Retrospective Cohort Study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1441-1445"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812190","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 roommate: does double-occupancy rooming impact recovery from pediatric spinal fusion surgery?","authors":"Alexa P Bosco, Margaret L Sullivan, Daniel Gabriel, Shanika De Silva, Daniel J Hedequist, Michael T Hresko, Craig M Birch, Grant D Hogue","doi":"10.1007/s43390-025-01093-0","DOIUrl":"10.1007/s43390-025-01093-0","url":null,"abstract":"<p><strong>Purpose: </strong>Single occupancy inpatient recovery rooms are perceived by health care professionals to positively influence patients' experience, while double rooms are associated with higher noise levels, sleep disturbances, and a lack of privacy. These differing physical environments may manifest in differing length of stay, pain scores, and opioid use. When bed space is scarce, identifying ideal populations for double occupancy rooming is important. This study aims to assess how inpatient room assignment impacts recovery time, opioid consumption, and patient reported pain for adolescent idiopathic scoliosis (AIS) patients undergoing a posterior spinal fusion (PSF).</p><p><strong>Methods: </strong>A retrospective cohort study of AIS patients who underwent PSF from 2011 to 2017 at a single center was conducted. Demographics and baseline radiographic measurements were summarized using appropriate statistics. Intraoperative and postoperative outcomes, as well as numerical ranking scale (NRS) pain scores and total daily opioid administration, were compared across room types using t tests, Wilcoxon rank sum tests, Chi-squared tests, or Fisher's exact tests, as appropriate. GEE models were constructed to examine the influence of room type and days since surgery on outcomes.</p><p><strong>Results: </strong>The cohort included 635 patients: 448 (71%) assigned to a double room and 187 (29%) to a single room. The mean age was 15 ± 2 years and 83% of patients were female. Length of hospital stay, complication rates, 2-year outcomes, inpatient pain scores, and daily opioid usage did not significantly differ between room types (all p > 0.05). Adjusted GEE models revealed no significant associations between room type and pain scores (p = 0.9) or between room type and total opioid dosage (p = 0.95).</p><p><strong>Conclusion: </strong>When bed space is scarce, double occupancy rooming for pediatric patients after PSF surgery for AIS can serve as a relief valve to continue elective practices without compromising post-operative outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1455-1463"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998125","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}