Spine deformityPub Date : 2025-03-01Epub Date: 2024-11-09DOI: 10.1007/s43390-024-00999-5
Kiranpreet K Nagra, Jenna L Wisch, Ankush Thakur, Colson P Zucker, Na Cao, Mitchell Johnson Md, Don Li, Howard J Hillstrom, Benjamin N Groisser, Matthew E Cunningham, M Timothy Hresko, Ram Haddas, John S Blanco, Roger F Widmann, Jessica H Heyer
{"title":"Surface vs. skeleton: the relationship between surface topographic and radiographic measurements of shoulder symmetry in patients with scoliosis.","authors":"Kiranpreet K Nagra, Jenna L Wisch, Ankush Thakur, Colson P Zucker, Na Cao, Mitchell Johnson Md, Don Li, Howard J Hillstrom, Benjamin N Groisser, Matthew E Cunningham, M Timothy Hresko, Ram Haddas, John S Blanco, Roger F Widmann, Jessica H Heyer","doi":"10.1007/s43390-024-00999-5","DOIUrl":"10.1007/s43390-024-00999-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the relationship between existing radiographic measurements of shoulder asymmetry with novel surface topographic (ST) measurements, hypothesizing that these relationships will be weak.</p><p><strong>Methods: </strong>Data were gathered from a prospectively collected registry of patients who underwent ST scanning at a single tertiary care institution. Inclusion criteria were diagnosis of juvenile or adolescent idiopathic scoliosis, age 11-21, same-day ST and EOS radiographic evaluation. Twelve radiographic variables that evaluate shoulder height were measured, as well as curve magnitudes and vertebral axial rotation. ST data were collected using the 3dMDbody scanning system. Three ST measurements of shoulder symmetry were evaluated: ST-based AC angle (the angle between a line made between the surface of the AC joints and a line parallel to the ground), Shoulder Normal Asymmetry angle (the angle between the mirrored normals to the planes defined by the jugular notch, vertebral prominence, and AC joint), and Shoulder Volume Asymmetry Index (difference in volumes between the right and left shoulder). Univariate, followed by a stepwise multivariate linear regression was performed to evaluate the correlations of the radiographic measurements to the ST-based measurements. Correlation categories: weak (x < 0.4), moderate (0.4 ≤ x < 0.6), strong (0.6 ≤ x < 0.8), and very strong (x ≥ 0.8).</p><p><strong>Results: </strong>141 patients with idiopathic scoliosis were evaluated (65.2% female, mean age 15.1 years, mean BMI 20.5 kg/m<sup>2</sup>, with mean maximum curve 44.7 degrees). ST-based AC angle had moderate-to-strong correlations with several radiographic measurements, while ST-based Shoulder Normal Asymmetry angle and Shoulder Volume Asymmetry Index had weak or no correlation with individual radiographic measures. Multivariate models created using a combination of radiographic variables demonstrated a strongly positive correlation between radiographic variables and ST-based AC angle (R = 0.678) and moderately positive correlations with ST-based Shoulder Normal Asymmetry Angle (R = 0.488), and ST-based Shoulder Volume Asymmetry Index (R = 0.514).</p><p><strong>Conclusion: </strong>Radiographic measurements may be acceptable stand-ins for two-dimensional ST measurements such as AC angle, but not for more complex shoulder measurements based on three dimensions. This study demonstrates the inadequacy with which radiographic assessments evaluate shoulder height asymmetry and highlights the use of ST measurements.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"539-549"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627356","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}
Spine deformityPub Date : 2025-03-01Epub Date: 2024-11-19DOI: 10.1007/s43390-024-01008-5
Jennifer Hurry, John-David Brown, Ankita Bansal, Abdullah Al Amer, Oheneba Boachie-Adjei, Michael Vitale, Joshua Pahys, Scott Luhmann, Ron El-Hawary
{"title":"Magnetically controlled growing rods increase 3D true spine length in idiopathic early onset scoliosis patients: results from a multicenter study.","authors":"Jennifer Hurry, John-David Brown, Ankita Bansal, Abdullah Al Amer, Oheneba Boachie-Adjei, Michael Vitale, Joshua Pahys, Scott Luhmann, Ron El-Hawary","doi":"10.1007/s43390-024-01008-5","DOIUrl":"10.1007/s43390-024-01008-5","url":null,"abstract":"<p><strong>Purpose: </strong>To determine, at 2 year follow-up, 3D spine growth for idiopathic early onset scoliosis (iEOS) patients treated with magnetically controlled growing rods (MCGR).</p><p><strong>Methods: </strong>From an international EOS registry, patients with iEOS treated with MCGR were identified. Scoliosis, kyphosis, traditional coronal height, and 3D true spine length (3D-TSL) were measured pre-index surgery, post-index, and at 2 year follow-up.</p><p><strong>Results: </strong>135 participants, mean age 8.1 years (2.7-15.6) were included. Scoliosis improved from 71° pre-index to 41° post-index (p < 0.001) and remained constant at 2 years (43°, p = 0.58). Kyphosis improved from 49° to 36° (p < 0.001); then increased by 2 years to 42° (p = 0.002). Traditional T1-S1 height, which reflects both spine growth and changes in deformity, increased from pre-index to post-index (274 mm vs. 310 mm; p < 0.001), and again at 2 years (332 mm, p < 0.001). As 3D-TSL reflects growth of the spine, independent of changes in deformity, as expected it did not change perioperatively (335 mm vs. 339 mm, p = 0.83), but significantly changed by 2 years (367 mm; p < 0.001). Participants < 5 years at surgery increased 22 mm (8.2%), 5-10 years increased 26 mm (7.8%), and > 10 increased 41 mm (11.0%). For instrumented levels, mean vertebral growth was 1.3 mm/level for < 5 years, 1.4 mm/level for 5-10 years, and 2.2 mm/level for > 10 years.</p><p><strong>Conclusions: </strong>As kyphosis increased over time, these out of the coronal plane changes justify the use of 3D-TSL for this cohort of patients. For idiopathic EOS patients treated with MCGR, 3D spine length increased by 28 mm during the 2 year post-operative period.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"639-645"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676643","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":"Factors associated with rod fracture following surgery for adult spinal deformity: a single-center retrospective study.","authors":"Hiroki Konuma, Junya Katayanagi, Takahiro Iida, Shingo Morishita, Tomoyuki Tanaka, Tsukasa Yanase, Tetsuya Jinno, Hiroyuki Inose","doi":"10.1007/s43390-024-00985-x","DOIUrl":"10.1007/s43390-024-00985-x","url":null,"abstract":"<p><strong>Purpose: </strong>Adult spinal deformity (ASD) has a significant impact on trunk balance and quality of life in the elderly. Postoperative rod fractures pose significant challenges, but the mechanisms of their occurrence are underexplored compared to other complications such as proximal junctional kyphosis. This study investigated factors associated with rod fracture in patients with ASD.</p><p><strong>Methods: </strong>A retrospective single-center study analyzed 110 adult patients who underwent spinal deformity correction between 2012 and 2020. Comparative analysis and univariate and multivariate Cox regression analyses were employed to identify factors associated with rod fracture.</p><p><strong>Results: </strong>In this study, rod fracture occurred in 14.5% of patients. The rod fracture group exhibited a larger change in lumbar lordosis (LL), a higher proportion of patients with pre-operatively existing (pre-existing) vertebral fractures, and a greater percentage of patients with a rod diameter of 6 mm or less compared to the non-rod fracture group. Univariate Cox regression analysis revealed that rod fracture was associated with pre-existing vertebral fracture, LL change, preoperative sagittal vertical axis, and preoperative pelvic tilt. Multivariate Cox regression analysis identified pre-existing vertebral fractures and the amount of LL change as independent factors associated with rod fractures.</p><p><strong>Conclusion: </strong>Pre-existing vertebral fractures and the magnitude of lumbar lordosis correction are independent risk factors for rod fracture following ASD surgery. Surgeons should consider these factors during preoperative planning to reduce the risk of postoperative rod fracture.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"481-487"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142474253","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}
Spine deformityPub Date : 2025-03-01Epub Date: 2024-10-29DOI: 10.1007/s43390-024-00991-z
Sassan Keshavarzi, Griffin Harris, Subaraman Ramchandran, Noah Gabor, Jeffrey Spardy, Thomas Errico, John Ragheb, Stephen George
{"title":"Role of spinal MRI for pre-operative work up in patients with adolescent idiopathic scoliosis: a retrospective case study and narrative review.","authors":"Sassan Keshavarzi, Griffin Harris, Subaraman Ramchandran, Noah Gabor, Jeffrey Spardy, Thomas Errico, John Ragheb, Stephen George","doi":"10.1007/s43390-024-00991-z","DOIUrl":"10.1007/s43390-024-00991-z","url":null,"abstract":"<p><strong>Introduction: </strong>There remains variability in the acquisition of whole-spine MRI prior to surgical correction in patients with adolescent idiopathic scoliosis (AIS). In this study, we take a retrospective look at the clinical impact of uniformly obtaining spinal MRI on all patients with a diagnosis of AIS.</p><p><strong>Methods: </strong>Three hundred thirty four patients with presumed AIS who underwent surgery between 2017 and 2022 were identified; 283 of these patients who were asymptomatic and had a preoperative MRI in the database were included. We investigated radiographic, demographic, and clinical risk factors for the presence of neural axis anomalies. Radiologists' reports were reviewed to determine the level of the conus medullaris and the presence of any intra-spinal dysraphisms. The utility of known risk factors for neural axis anomalies and the utility of MRI identifying anomalies on clinical decision-making, intra-operative neuromonitoring (IONM) alerts, and postoperative neurologic insult in asymptomatic AIS patients were investigated.</p><p><strong>Results: </strong>There were 283 patients with a mean age of 14.1 years, 67 males (22.6%) and 26 (9.2%) left-sided thoracic curves. MRI identified nine patients with central cord dilations, four patients with low cerebellar tonsils, four patients with Chiari Malformations, five patients with low-lying conus, one patient with a tethered cord, and five patients with arachnoid cysts. Six (2.1%) of the 283 patients underwent a neurosurgical intervention and 3 (50%) of the 6 went on to have IONM alerts. Eighteen (6.4%) of the 283 patients had IONM alerts and 5 (28%) of the 18 had neural axis anomalies. None of the patients with IONM alerts had a permanent neurologic deficit post-operatively.</p><p><strong>Conclusion: </strong>In asymptomatic patients presumed to have AIS, 9.9% had a neuro-axis anomaly, 2.1% needed a neurosurgical intervention, and 6.4% of the patients had an IONM alert. We did not find known risk factors for identifying neural axis anomalies to have statistically significant application in asymptomatic AIS patients. Presence of neuroaxis anomalies increased the chance of having IONM alerts, however, we were unable to demonstrate if neurosurgical interventions in these patients with anomalies were preventative for IONM alerts or have statistically significant protection against clinical complications.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"509-518"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547240","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}
Spine deformityPub Date : 2025-03-01Epub Date: 2024-11-05DOI: 10.1007/s43390-024-01000-z
Peng Dou, Xuan Li, Haobo Jin, Boning Ma, Ming Jin, Yi Xu
{"title":"Research trends of biomechanics in scoliosis from 1999 to 2023: a bibliometric analysis.","authors":"Peng Dou, Xuan Li, Haobo Jin, Boning Ma, Ming Jin, Yi Xu","doi":"10.1007/s43390-024-01000-z","DOIUrl":"10.1007/s43390-024-01000-z","url":null,"abstract":"<p><strong>Objective: </strong>Despite the abundance of research on the biomechanics of scoliosis, there is a lack of a comprehensive bibliometric analysis. This study utilizes bibliometric methods to elucidate the research trends and hotspots within this domain.</p><p><strong>Methods: </strong>The data for this study were obtained from the Web of Science Core Collection and then analyzed using the open-source Bibliometrix R package and Citespace.</p><p><strong>Results: </strong>The analysis encompassed 410 publications published from 1999 to 2023. There is a sustained increase in the number of publications within the field. Utilizing citation analysis and keyword analysis, the study identified key research focuses. Burst keyword analysis identified 19 keywords.</p><p><strong>Conclusions: </strong>The period from 1999 to 2023 has witnessed significant research attention on the biomechanics of scoliosis. The demographic shift towards an aging population has recently increased interest in ASD. Proximal biomechanical changes and transitional zones in PJK and PJF are hotspots in research, offering emerging scholars in this discipline valuable opportunities for exploration.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"391-403"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583941","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}
Spine deformityPub Date : 2025-03-01Epub Date: 2024-12-01DOI: 10.1007/s43390-024-01010-x
Joel D Turtle, Jwalant S Mehta, Stefan Parent, Grace X Xiong, Jason Py Cheung, Michelle C Welborn, Alex R Vaccaro, Patrick J Cahill, Ferran Pellisé, Serena S Hu
{"title":"Guidelines for returning to activity after spinal deformity surgery.","authors":"Joel D Turtle, Jwalant S Mehta, Stefan Parent, Grace X Xiong, Jason Py Cheung, Michelle C Welborn, Alex R Vaccaro, Patrick J Cahill, Ferran Pellisé, Serena S Hu","doi":"10.1007/s43390-024-01010-x","DOIUrl":"10.1007/s43390-024-01010-x","url":null,"abstract":"<p><p>Returning to activity after spinal deformity surgery is vital for patient recovery and long-term health, yet there is significant variability in postoperative protocols among surgeons worldwide. This paper aims to define guidelines for returning to activity across diverse patient groups: early onset scoliosis (EOS), adolescent idiopathic scoliosis (AIS), young adults, adult spinal deformity (ASD), elite athletes, and general sports participants. This paper provides guidelines to foster a unified approach to postoperative care, improving outcomes and ensuring patients can safely and effectively resume their activities. This paper represents the proceedings of an SRS educational CME webinar. A summary of recommendations for each patient group is included aiming to enhance surgeon practice and patient care through standardized postoperative protocols.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"383-390"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772053","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}
Spine deformityPub Date : 2025-03-01Epub Date: 2024-10-22DOI: 10.1007/s43390-024-00988-8
Yinyu Fang, Zhen Tian, Weibiao Li, Dongyue Li, Jie Li, Zongshan Hu, Yong Qiu, Zezhang Zhu, Zhen Liu
{"title":"Gut microbiota alterations in adolescent idiopathic scoliosis: a comparison study with healthy control and congenital scoliosis.","authors":"Yinyu Fang, Zhen Tian, Weibiao Li, Dongyue Li, Jie Li, Zongshan Hu, Yong Qiu, Zezhang Zhu, Zhen Liu","doi":"10.1007/s43390-024-00988-8","DOIUrl":"10.1007/s43390-024-00988-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the composition of GM isolated from individuals with AIS or congenital scoliosis (CS) and age-matched control (Ctr).</p><p><strong>Methods: </strong>A total of 48 patients with AIS, 24 patients with CS, and 31 healthy individuals were recruited as the discovery cohort, and 9 pairs of siblings where one was affected by AIS were recruited as the validation cohort. The GM profile was determined with 16S rRNA sequencing, and the alpha-diversity and beta-diversity metrics were performed with Mothur. Linear discriminant analysis (LDA) analysis was performed to identify the enriched species.</p><p><strong>Results: </strong>The α diversity (Chao1 index) was significantly lower in AIS patients with low BMI (< 18.5) than those with normal BMI. The PcoA analysis showed a trend of clustering of GM in AIS compared to that in Ctr and CS groups (r<sup>2</sup> = 0.0553, p = 0.001). METASTAT analysis showed Cellulomonadaceae was significantly enriched in AIS groups compared to CS and Ctr. LDA analysis showed 9 enriched species in AIS patients. Compared to Ctr, two species including Hungatella genus and Bacteroides fragilis were significantly enriched, while the Firmicutes versus Bacteroidetes (F/B) ratio and the Ruminococcus genus were significantly decreased in AIS but not CS groups. The significantly reduced F/B ratio and Ruminococcus genus in AIS were replicated in the validation cohort.</p><p><strong>Conclusions: </strong>Our study elucidated an association between low BMI and GM diversity in AIS patients. The reduced F/B ratio and Ruminococcus genus in AIS patients were identified and validated in 9 pairs of AIS patients and their unaffected siblings. Our pilot results may help understand the anthropometric discrepancy in these patients and support a possible role of GM in the pathogenesis of AIS.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"497-507"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507401","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}
Spine deformityPub Date : 2025-03-01Epub Date: 2024-11-04DOI: 10.1007/s43390-024-01001-y
Tristan Langlais, Claudio Vergari, Nicolas Mainard, Xavier du Cluzel, Matthieu Baudoux, Laurent Gajny, Kariman Abelin-Genevois, Jean Claude Bernard, Zongshan Hu, Jack Chun Yiu Cheng, Winnie Chiu Wing Chu, Ayman Assi, Mohamad Karam, Ismat Ghanem, Tito Bassani, Fabio Galbusera, Luca Maria Sconfienza, Marco Brayda-Bruno, Isabelle Courtois, Eric Ebermeyer, Raphael Vialle, Jean Dubousset, Wafa Skalli
{"title":"3D external shape analysis and barycentremetry can provide early signs of progression in adolescent idiopathic scoliosis.","authors":"Tristan Langlais, Claudio Vergari, Nicolas Mainard, Xavier du Cluzel, Matthieu Baudoux, Laurent Gajny, Kariman Abelin-Genevois, Jean Claude Bernard, Zongshan Hu, Jack Chun Yiu Cheng, Winnie Chiu Wing Chu, Ayman Assi, Mohamad Karam, Ismat Ghanem, Tito Bassani, Fabio Galbusera, Luca Maria Sconfienza, Marco Brayda-Bruno, Isabelle Courtois, Eric Ebermeyer, Raphael Vialle, Jean Dubousset, Wafa Skalli","doi":"10.1007/s43390-024-01001-y","DOIUrl":"10.1007/s43390-024-01001-y","url":null,"abstract":"<p><strong>Purpose: </strong>Our objective was to analysis the barycentremetry, obtained from the external envelope reconstruction of biplanar radiographs, in adolescent idiopathic scoliosis (AIS) and to determine whether assessing would help predict the distinction between progressive and stable AIS at the early stage.</p><p><strong>Methods: </strong>A retrospective study with a multicentre cohort of 205 AIS was conducted. All AIS underwent a biplanar X-ray between 2013 and 2020. Inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the barycentremetry parameters were computed, i.e., the center of mass position at the apex and the axial torque at the apex, the upper and lower junction. A severity index, helping to distinguish stable and progressive AIS, was computed on the first radiograph, and weighted according to these parameters. A clinical and radiographic monitoring determined if AIS were classified such a stable or progressive scoliosis.</p><p><strong>Results: </strong>One hundred and sixty-two AIS were included (i.e., 87 were classified as stable and 75 as progressive). The apex center of mass position was different between the stable and progressive AIS groups (6 mm, SD = 4 mm for the whole cohort; 5 mm, SD = 4 mm for stable AIS versus 7 mm, SD = 4 mm for progressive AIS; p = 0.02). In AIS thoracic, the specificity and positive predictive value of the severity index increased by 19% and 16%, respectively, by adding the apex vertebral axial torque.</p><p><strong>Conclusion: </strong>Early assessment of the external envelope from biplanar X-ray reconstruction of idiopathic scoliosis showed that the apex centre of mass position was significantly different between progressive and stable scoliosis. The inclusion of the axial torque of the apex vertebra in the severity index is promising to help the clinician distinguish between stable and progressive thoracic AIS at an early stage.</p><p><strong>Level of evidence: </strong>II - Prognostic studies.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"551-560"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569319","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}
Spine deformityPub Date : 2025-03-01Epub Date: 2024-11-07DOI: 10.1007/s43390-024-01003-w
Mert Marcel Dagli, Connor A Wathen, Joshua L Golubovsky, Yohannes Ghenbot, John D Arena, Gabrielle Santangelo, Jonathan Heintz, Zarina S Ali, William C Welch, Jang W Yoon, Vincent Arlet, Ali K Ozturk
{"title":"Preoperative anemia is associated with increased length of stay in adult spinal deformity surgery: evaluation of a large single-center patient cohort and future suggestions for patient optimization.","authors":"Mert Marcel Dagli, Connor A Wathen, Joshua L Golubovsky, Yohannes Ghenbot, John D Arena, Gabrielle Santangelo, Jonathan Heintz, Zarina S Ali, William C Welch, Jang W Yoon, Vincent Arlet, Ali K Ozturk","doi":"10.1007/s43390-024-01003-w","DOIUrl":"10.1007/s43390-024-01003-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the relationship of preoperative hemoglobin levels as an independent prognostic factor for hospital and intensive care unit (ICU) length of stay (LOS) in patients undergoing surgery for adult spinal deformity (ASD), with the intent of determining whether there exists a correlation and enhancing patient preoperative optimization protocols.</p><p><strong>Methods: </strong>The authors reviewed consecutive patients who underwent elective thoracolumbosacral posterior spinal fusion (PSF) involving six or more vertebrae for ASD from January 1, 2013, to December 13, 2021, with a minimum follow-up period of two years. This study primarily investigated the association of preoperative hemoglobin levels with hospital and ICU LOS. To analyze the data, both unadjusted and adjusted generalized linear models (GLM), incorporating cubic splines for non-linear variables, were applied.</p><p><strong>Results: </strong>A total of 598 patients were included. GLMs for hospital and ICU LOS demonstrated nonlinear relationships with preoperative hemoglobin levels. Specifically, hospital LOS decreased with increasing preoperative hemoglobin until a significance threshold of 13.5 g/dl. Similarly, ICU LOS significantly decreased with increasing preoperative hemoglobin until 13.0 g/dl. Lower preoperative hemoglobin was associated with more perioperative transfusions, less likely discharge to home, and greater risk of reoperation.</p><p><strong>Conclusions: </strong>Preoperative anemia is an independent non-linear risk factor that significantly affects LOS, disposition, and outcomes after surgery for ASD. These findings advocate for a systemic preoperative approach and highlight the need for future research to improve postoperative outcomes and reduce hospital resource utilization.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"625-637"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606614","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}