Spine deformity最新文献

{"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}

{"title":"Are we being forthright with the patients about vertebral body tethering? Quality, contemporaneity, and readability analysis of the online content about vertebral body tethering.","authors":"Rajul Gupta, Aakanksha Sriwastwa, Saral J Patel, Neal Taliwal, Alvin C Jones, Peter F Sturm, Viral V Jain","doi":"10.1007/s43390-025-01082-3","DOIUrl":"10.1007/s43390-025-01082-3","url":null,"abstract":"<p><strong>Purpose: </strong>The majority of patients refer to online patient education content before elective surgeries, including Vertebral Body Tethering (VBT). The purpose of this study was to evaluate the quality, contemporaneity, and readability of patient information web pages across different sources (teaching hospital, private HCF, commercial/news, and non-profit organization) on VBT.</p><p><strong>Methods: </strong>The search results from Google and Bing were analyzed using a systematic approach, excluding peer-reviewed articles, insurance policy documents, and videos. Forty-seven web pages were reviewed for quality based on preoperative, operative, and postoperative information, alongside compliance with Journal of American Medical Association (JAMA) benchmark criteria. The web page content was assessed using a contemporaneity score, which evaluated the inclusion of the latest research. Readability was assessed using the Flesch-Kincaid Grade level and Gunning-Fog Index.</p><p><strong>Results: </strong>The overall mean quality score, JAMA score, and contemporaneity scores were 7.63 (95% CI 6.63-8.64) out of 16, one (95% CI 0.68-1.32) out of four, and 0.61 (95% CI 0.33-0.9) out of five, respectively. The mean Flesch-Kincaid grade level and Gunning-Fog index were 11.7 (95% CI 10.88-12.55) and 14.94 (95% CI 14.12-15.75), respectively. Higher Quality scores also correlated with better Flesch-Kincaid and Gunning-Fox readability scores (Quality score-Flesch-Kincaid grade level: ρ = - 0.38, p = 0.0074; Quality score-Gunning-Fog index: ρ = - 0.354, p = 0.0161).</p><p><strong>Conclusion: </strong>Existing patient education material contains limited and fragmentary information, lacks essential details, does not reflect the current limitations of VBT, and is written at a much advanced reading level than recommended. The material requires thorough revision, given that VBT is a relatively new surgical procedure with evolving indications and outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1099-1106"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032064","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":"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":"Instrumentation using robotics coupled with navigation in pediatric spine deformity surgery: a technical report of sacropelvic instrumentation.","authors":"Craig Birch, Nicole Welch, Danielle Cook, Daniel Hedequist","doi":"10.1007/s43390-025-01047-6","DOIUrl":"10.1007/s43390-025-01047-6","url":null,"abstract":"<p><strong>Purpose: </strong>This technical report presents the intraoperative experience of using robotic-assisted navigation (RAN) for sacropelvic instrumentation in pediatric spine deformity surgery.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent surgery using RAN for sacropelvic instrumentation at a single institution from 2019 to 2022 was conducted. In cases with screw confirmation imaging, screws were evaluated using the Gertzbein and Robbins classification scale.</p><p><strong>Results: </strong>52 cases were included. Average age at surgery was 14.1 years and 67.3% of patients were female. The most common diagnosis was spondylolisthesis (48.1%). The average major curve in scoliosis cases was 77°. A Schanz pin in the posterior superior iliac spine was placed in 98.1% of surgeries compared to 1 case with a spinous process clamp. Intraoperative 3D imaging scans (Scan & Plan) were used for 69.2% of the robotic registrations to the patient and intraoperative fluoroscopy-CT scans were used for 30.8%. 644 total screws were placed, with 427 placed robotically. Specifically, in the sacral-pelvic region, 98 S1, 18 S2, 58 S2AI, and 5 iliac screws were placed using RAN (179 screws). In 17 cases with 139 total robotic screws, post-instrumentation intraoperative 3D imaging or postoperative CT scans were obtained. Of these screws, 99.3% (138/139; 95% CI = 95.5-99.96) were placed accurately (Grade A or Grade B). One S2AI screw had an anterior breach on intraoperative 3D imaging scan and was changed prior to closure. Loss of RAN registration was observed in 2 cases (3.8%). No cases required return to the operating room for screw malposition.</p><p><strong>Conclusion: </strong>This study highlights high screw accuracy with no neurologic compromise associated with the use of RAN technology.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1027-1032"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074998","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":"Assessing blood volume returned with use of intraoperative cell salvage in adult spinal deformity correction.","authors":"Katherine D Drexelius, Lindsey E Miller, Rebecca J DeCarlo, Trent A VanHorn, Michael A Bohl","doi":"10.1007/s43390-025-01055-6","DOIUrl":"10.1007/s43390-025-01055-6","url":null,"abstract":"<p><strong>Purpose: </strong>While multiple studies have evaluated the role of intraoperative red blood cell salvage (IOCS) in instrumented posterior spinal fusion as a method to reduce allogenic blood transfusion and its associated risks and cost, few studies have quantified the blood available for return to the patient when using IOCS. Given this paucity of data, the purpose of this study was to evaluate the relationship between estimated blood loss and cell saver volume returned.</p><p><strong>Methods: </strong>Patients aged 18 years or older who underwent elective spinal fusion for correction of deformity requiring six or more levels of fusion were included. Demographic data, surgical details, EBL as measured by cell saver, and cell saver blood volume returned were recorded.</p><p><strong>Results: </strong>138 consecutive patients were included in the study. Average EBL as measured by cell saver across 138 cases was 734 cc. Based on patients' height, weight, and sex, the average percentage of estimated circulating blood volume lost during surgery was 15.9%. Average EBL per level was 84.2 cc.; mean percentage of total blood volume lost per level was 1.8%. Average blood volume returned was 256 cc., resulting in an average 34.9% of blood loss returned to the patient via IOCS.</p><p><strong>Conclusions: </strong>On average, 34.9% of blood lost was subsequently transfused. While literature on this topic is very limited, this finding was similar to smaller cohorts that have examined IOCS autologous transfusion volumes. A better understanding of the available fraction of blood for return may allow providers to predict the need for allogenic blood transfusion or more clearly evaluate cost effectiveness of IOCS.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1223-1229"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441988","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":"Early reoperations do not adversely affect long-term pain and activity scores in adult deformity patients.","authors":"Erik Lewerenz, Sarthak Mohanty, Fthimnir M Hassan, Nathan J Lee, Justin K Scheer, Chun Wai Hung, Steven G Roth, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke","doi":"10.1007/s43390-025-01083-2","DOIUrl":"10.1007/s43390-025-01083-2","url":null,"abstract":"<p><strong>Purpose: </strong>To compare patient-reported outcomes (PROs) in adult spinal deformity (ASD) patients reoperated within six months of their index surgery to patients without readmissions/reoperations and note any similarities/dissimilarities in activity and pain outcomes.</p><p><strong>Methods: </strong>ASD patients who underwent spinal fusion at a single institution with minimum two years follow-up were included. Patients without readmissions/reoperations (No Reops) were compared to those requiring early reoperation resolved by six months post-index procedure (Early Reop) cohort. Outcomes included 2Y PROs, improvement, and MCID attainment. Question 22 from the SRS-22r, assessing likelihood of choosing the same treatment, was separately evaluated.</p><p><strong>Results: </strong>238 patients [211(89%) No Reops; 27(11%) Early Reop] were included. Early reoperations were associated with PJK/DJK (29.63%, n = 8), implant dislodgement (18.52%, n = 5), and pedicle/vertebral fracture (14.81%, n = 4). There was no difference in demographics, operative characteristics, baseline alignment, and preoperative PROs. PRO improvement was not significantly different for SRS Activity (p = 0.392), Pain (p = 0.291), Appearance (p = 0.179), Mental Health (p = 0.840), Satisfaction (p = 0.098), Total score (p = 0.152), and ODI (p = 0.564). MCID achievement was comparable for SRS Activity (p = 0.536), Pain (p = 0.115), Appearance (p = 0.269), Mental Health (p > 0.999), Satisfaction (p = 0.149), and ODI (p = 0.403). SRS total score MCID attainment was greater for No Reops Cohort (82% vs 70%, p = 0.048). In addition, a greater proportion of No Reop patients endorsed that they would choose the same operative management (86% vs 70%, p = 0.046) if they had to choose again.</p><p><strong>Conclusion: </strong>Early reoperations within 6 months after ASD surgery that addresses the reason for the revision surgery do not adversely affect two-year functional and pain outcomes. However, only 70% would choose the same treatment again vs 86% of those who didn't undergo a reoperation with greater SRS22r total score MCID attainment among the No Reop cohort.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1213-1222"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781134","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":"ChatGPT to answer frequently asked questions on scoliosis: comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s43390-025-01100-4","DOIUrl":"10.1007/s43390-025-01100-4","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1283"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013829","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":"Lumbosacral anatomy is unique in pediatric spondylolysis.","authors":"Ryan A Finkel, Nakul Narendran, Daniel Farivar, Paal Nilssen, Melodie F Metzger, David L Skaggs, Kenneth D Illingworth","doi":"10.1007/s43390-025-01084-1","DOIUrl":"10.1007/s43390-025-01084-1","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether patients with L5 spondylolysis have different lumbosacral anatomy compared to patients without L5 spondylolysis.</p><p><strong>Methods: </strong>Computed tomography (CT) scans of pediatric patients with isolated L5 spondylolysis were identified and matched 1:4 (age, sex, BMI) to patients without spondylolysis. Sagittal parameters assessed included sacral slope angle, sacral table angle, L4-S1 and L5-S1 Cobb angles, the horizontal angle of the L5 pars interarticularis, the distances between the L4 inferior articular process (IAP) and the S1 superior articular process (SAP) and their respective individual distances to the L5 pars. Coronal parameters assessed included the percent subluxation of L4 IAP below the facet joint.</p><p><strong>Results: </strong>1084 CT scans were reviewed. 32 patients with isolated L5 spondylolysis were identified and matched to 122 patients without spondylolysis. The horizontal angle of the L5 pars was greater in spondylolysis patients (142.5 ± 10.2 vs. 119.9 ± 5.9, p < 0.05). There was less distance (mm) between L4 IAP and S1 SAP (11.3 ± 3.9 vs. 14.7 ± 2.9, p < 0.05) and less distance (mm) from both L4 IAP (2.6 ± 1.7 vs. 5.4 ± 2.2, p < 0.05) and S1 SAP (0.7 ± 0.4 vs. 1.5 ± 0.7, p < 0.05), respectively, to the L5 pars in the spondylolysis group. Pearson's analyses revealed that a larger horizontal angle of the L5 pars was strongly associated with spondylolysis (0.59).</p><p><strong>Conclusion: </strong>Pediatric patients with L5 spondylolysis have a significantly more horizontal L5 pars that is closer to both the L4 IAP and S1 SAP.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1197-1204"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773342","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}