Spine deformity最新文献

{"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}

{"title":"Comparative analysis of thoracic structure and function using CT and dynamic MRI in pediatric thoracic insufficiency syndrome with and without neuromuscular disease.","authors":"Sara Hassani, Yubing Tong, Nima Broomand Lomer, Jayaram K Udupa, Caiyun Wu, Joseph M McDonough, Samantha Gogel, Oscar H Mayer, David M Biko, Patrick J Cahill, Jason B Anari, Drew A Torigian","doi":"10.1007/s43390-025-01095-y","DOIUrl":"10.1007/s43390-025-01095-y","url":null,"abstract":"<p><strong>Purpose: </strong>Thoracic insufficiency syndrome (TIS) impairs normal respiration and lung growth. In pediatric patients with or without neuromuscular disease (NMD), the relationship between thoracic structure and regional respiratory function remains understudied. We aimed to evaluate these interrelationships using dynamic magnetic resonance imaging (dMRI) and computed tomography (CT).</p><p><strong>Methods: </strong>This study included 25 pediatric TIS patients: 8 with NMD and 17 without NMD. Thoracic dMRI and CT images were analyzed to quantify intercostal muscle (ICM) volume, skeletal muscle (SM) volume, lung volumes at end-inspiration and end-expiration, chest wall excursion volume, and diaphragm excursion volume. Right-to-left volumetric symmetry ratios were compared using unpaired t-testing, and correlations between structural and functional parameters were assessed using Pearson correlation analysis.</p><p><strong>Results: </strong>Lung and muscle volumes were generally larger in the TIS-NMD compared to TIS non-NMD, reflecting age-related differences, although lung tidal volumes and diaphragmatic and chest wall excursion volumes were generally similar. The degree of asymmetry reflected by diaphragmatic respiratory function symmetry ratios exceeded that of chest wall symmetry ratios in both groups, with greater disparity in TIS-NMD (3.6 vs 1.8 in TIS-NMD compared to 2.8 vs 2.5 in TIS non-NMD). Correlation between thoracic SM volume and tidal volume was stronger than the correlation between ICM volume and tidal volume in both groups. TIS-NMD patients demonstrated unique compensatory dynamics, including a negative correlation between SM volume and diaphragmatic excursion volume.</p><p><strong>Conclusion: </strong>Distinct interrelationships exist between thoracic structure and function in TIS patients with and without NMD. These findings suggest that NMD significantly influences respiratory mechanics, emphasizing the role of SM and diaphragm interaction.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1507-1515"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032780","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":"Racial, ethnic and socioeconomic disparities in healthcare for adult spinal deformity patients.","authors":"Joseph E Nassar, Michael J Farias, Manjot Singh, Andrew Xu, Lama A Ammar, Mohammad Daher, Ashley Knebel, Bassel G Diebo, Alan H Daniels","doi":"10.1007/s43390-025-01118-8","DOIUrl":"10.1007/s43390-025-01118-8","url":null,"abstract":"<p><strong>Background: </strong>Racial and ethnic disparities in healthcare access remain underexplored among adult spinal deformity (ASD) patients in terms of cost related and non-cost related barriers to care.</p><p><strong>Methods: </strong>This cross-sectional study analyzed healthcare access and utilization survey data from the National Institutes of Health's All of Us Research Program (May 6th, 2018-January 30th, 2025). The participants included adults aged ≥ 40 years with spinal deformity enrolled online or through partner organizations across the US. The cost and non-cost barriers to health among ASD patients by race and ethnicity were reported. Multivariate logistic regressions were used to analyze the relationship between race and ethnicity and experiencing barriers to care.</p><p><strong>Results: </strong>This study included 7272 ASD patients of which 5635 were White (74.5%) (median age, 69 years [IQR, 60.0-75.0]), 535 Hispanic (7.4%) (60.0 years [51.0-68.0]), 538 (7.4%) Black (61.5 years [52.0-69.0]) and 564 (7.8%) of other race and ethnicity (65.0 years [55.0-74.0]) of whom 528 (7.3%) proceeded to undergo correction surgery. Compared to White patients, Black patients had higher odds of reporting delayed general care (adjusted odds ratio [aOR, 2.5; 95% CI 1.7-3.8), follow-up care (aOR, 1.6; 95% CI 1.1-2.3), and prescription filling (aOR, 1.5; 95% CI 1.1-1.9) due to cost. Non-cost barriers for Black patients included lack of transportation aOR, 3.2; 95% CI 2.3-4.3) while Hispanic patients had higher odds of reporting delayed care due to childcare (aOR, 2.9; 95% CI 1.5-5.5) and care to an adult (aOR, 1.8; 95% CI 1.0-3.3) responsibilities. Black and Hispanic patients had higher odds of placing importance on having a provider with a similar background (aOR, 2.4; 95% CI 1.9-3.0; aOR, 3.1, 95% CI 2.4-3.9) and of never having had such a provider (aOR, 4.6; 95% CI 3.2-6.6; aOR, 3.1, 95% CI 2.4-3.9), respectively. They also had higher odds of reporting delayed care due to provider background differences (aOR, 1.9, 95% CI 1.4-2.4; aOR, 1.6, 95% CI 1.2-2.2), respectively. Additionally, Hispanic patients had higher odds of reporting not being treated with respect by their provider (aOR, 1.6; 95% CI 1.0-2.5).</p><p><strong>Conclusions: </strong>Racial and ethnic disparities significantly impact ASD patients with Hispanic and Black patients facing higher rates of cost and non-cost barriers to care. The healthcare practitioners especially those specializing in ASD play a crucial role in recognizing and addressing these disparities to improve healthcare access and outcomes across racial and ethnic groups.</p><p><strong>Level of evidence: </strong>Prognostic Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1539-1546"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174782","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":"Comparative meta-analysis of vertebral body tethering and posterior spinal fusion in patients with idiopathic scoliosis. Evaluation of radiographic, perioperative, clinical, patient-reported outcomes, and complication rates.","authors":"Stavros Stamiris, Cornelius Sofos, Athanasios Sarridimitriou, Panagiotis Kakoulidis, Panagiotis Christidis, Dimitrios Stamiris, Elissavet Anestiadou, Angeliki Cheva, Christiana Chatzianestiadou, Pavlos Christodoulou, Christos Karampalis","doi":"10.1007/s43390-025-01113-z","DOIUrl":"10.1007/s43390-025-01113-z","url":null,"abstract":"<p><strong>Background: </strong>Although posterior spinal fusion (PSF) is considered the gold standard for the treatment of idiopathic scoliosis, it has been associated with several limitations. Vertebral body tethering (VBT) offers a motion-preserving alternative, with growing evidence supporting its clinical efficacy.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Cochrane, Web of Science and Scopus databases was performed to identify comparative studies between VBT and PSF in patients with idiopathic scoliosis. Primary outcomes included major curve correction and postoperative major and minor curve angles. Secondary outcomes included radiographic parameters (shoulder height difference, spinal height gain, coronal balance, thoracic kyphosis, lumbar lordosis), perioperative metrics [length of stay (LOS), estimated blood loss (EBL), operative time, instrumented levels], patient-reported outcomes [Scoliosis Research Society-22 Questionnaire (SRS-22)], complication and revision rates.</p><p><strong>Results: </strong>Seventeen studies met the inclusion criteria. VBT patients required shorter instrumentations (p < 0.00001). PSF achieved lower postoperative major (p < 0.00001) and minor curve angles (p = 0.00001), better coronal balance (p = 0.005) and superior major curve correction from baseline (p < 0.00001), but with questionable clinical significance. VBT demonstrated greater lumbar flexion capacity (p < 0.00001), superior shoulder balance (p < 0.00001) and better outcomes in SRS-22 pain (p = 0.02), satisfaction (p = 0.03) and function (p = 0.02) at two-year follow-up. VBT also had shorter operation times (p = 0.0007), less blood loss (p < 0.00001), but higher complication (p = 0.0002) and revision rates (p < 0.00001). No difference detected in lumbar lordosis (p = 0.08), thoracic kyphosis (p = 0.15), SRS-22 self-image (p = 0.20) and total (p = 0.12), lumbar side bending (p = 0.81), axial rotation (p = 0.43) and hospital stay (p = 0.7).</p><p><strong>Conclusions: </strong>PSF demonstrates superior coronal spinal alignment, along with lower complication and revision rates. In contrast, VBT offers better preservation of spinal motion, improved shoulder balance, enhanced early quality of life, and reduced blood loss and operative time, while requiring shorter instrumentations. Treatment decisions should be individualized, taking into account patient-specific factors. Long-term outcome data are needed to guide clinical practice.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1399-1420"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249406","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":"The impact of a multi-disciplinary care pathway on intensive care unit and total hospital length of stay in high-risk neuromuscular scoliosis patients who require posterior spinal fusion: a quality improvement study.","authors":"Lorena V Floccari, Bryce Pember, Kenzie D Lundqvist, Matthew B Holloway, Richard P Steiner, Michael T Bigham, Kenneth T Bono, Todd F Ritzman","doi":"10.1007/s43390-025-01112-0","DOIUrl":"10.1007/s43390-025-01112-0","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to establish a multi-disciplinary consensus-based standardized perioperative care pathway for high-risk neuromuscular scoliosis (NMS) patients requiring posterior spinal fusion (PSF) and to compare patient outcomes before and after its implementation.</p><p><strong>Methods: </strong>A retrospective comparative cohort study was performed at a freestanding children's hospital in the United States. A multi-disciplinary team reviewed published evidence and developed a consensus-based standardized perioperative pathway that was implemented in May 2018. Pre-pathway (1/2014-4/2018) NMS patients with complex multi-system involvement who underwent PSF were compared to post-pathway (5/2018-12/2023) patients in demographics, radiographic characteristics, surgical variables, disposition, length of stay (LOS), and complications.</p><p><strong>Results: </strong>Ninety-one patients were included (30 pre-pathway, 61 post-pathway). There were no significant differences in patient demographics or curve characteristics. Central venous catheters were used more often in the pre-pathway group (50.0% vs 27.9%, p = 0.039). The post-pathway group had longer mean fusion length (14.4 vs 15.3 levels, p = 0.015), greater frequency of pelvic instrumentation (43.3% vs 73.8%, p = 0.005), and a longer mean operative time (316 vs 357 min, p = 0.032). The post-pathway group had a significantly shorter median intensive care unit (ICU) LOS (2.5 vs 2.0 nights, p = 0.017) and a significantly shorter median hospital LOS (7.5 vs 5.0 days, p < 0.001). There were no statistically significant differences in early complications.</p><p><strong>Conclusion: </strong>After implementation of a comprehensive multi-disciplinary pathway for high-risk scoliosis patients, patients had a 20% shorter median ICU LOS and a 33% shorter median hospital LOS despite more complex surgeries. Both groups had a similar incidence of early postoperative complications.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1529-1537"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144542163","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 value of another centimeter: assessing the impact of magnetically controlled growing rod replacement in thoracic height gain and scoliosis correction.","authors":"Yusuke Hori, David Fralinger, Brett Shannon, Ali Asma, Norihiro Isogai, Luiz Carlos Almeida da Silva, Kacey L McGinnes, Kenneth J Rogers, W G Stuart Mackenzie, Peter G Gabos, William G Mackenzie, Suken A Shah","doi":"10.1007/s43390-025-01101-3","DOIUrl":"10.1007/s43390-025-01101-3","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetically controlled growing rods (MCGR) enable scoliosis correction and height gain with minimum surgeries; however, the risk of extension failure increases with repeated lengthening, potentially necessitating rod replacement. This study aimed to investigate the benefits of replacing MCGR for additional lengthening before definitive fusion compared with direct transition to fusion without replacement.</p><p><strong>Methods: </strong>This single-center retrospective study included patients with early-onset scoliosis who were treated with MCGR and underwent definitive fusion. Achieved rod length, T1-T12 height gain, and major curve correction were compared between patients with and without MCGR replacement. Additionally, achieved length of first and second rods was compared among patients who underwent MCGR replacement.</p><p><strong>Results: </strong>Of 39 patients (56% female) meeting inclusion criteria, 13 underwent MCGR replacement. Patients who had replacement achieved greater total lengthening (37 vs. 20 mm, P < 0.001) over a longer period (6.2 vs. 3.5 years, P < 0.001). The replacement group also showed higher T1-T12 height gain after definitive fusion than the control group (61 vs. 47 mm, P = 0.011), although most height gains occurred during the index surgery. In contrast, the major curve correction rate was significantly lower in the replacement group (51% vs. 65%, P = 0.033). The initial MCGR achieved more lengthening than the secondary in 11/13 replacement patients.</p><p><strong>Conclusions: </strong>MCGR replacement leads to additional lengthening and T1-T12 height gain but is associated with diminished scoliosis correction. These findings question the value of the modest 14-mm increase in thoracic height from MCGR replacement considering the decreased deformity correction and the additional time and cost.</p><p><strong>Level of evidence: </strong>Retrospective Cohort, Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1595-1604"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094722","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":"Patient education strategies in pediatric orthopaedics: using ChatGPT to answer frequently asked questions on scoliosis.","authors":"Brigitte Lieu, Ethan Crawford, Logan Laubach, Teja Yeramosu, Chester Sharps, Joanna Horstmann, Victoria Kuester","doi":"10.1007/s43390-025-01087-y","DOIUrl":"10.1007/s43390-025-01087-y","url":null,"abstract":"<p><strong>Purpose: </strong>Patients increasingly rely on online resources to better understand their health conditions. ChatGPT could satisfy the demand for reliable and accessible online health education resources, yet few studies have applied this to pediatric orthopaedic counseling. This study quantifies the accuracy and comprehensibility of ChatGPT responses to frequently asked questions (FAQs) regarding scoliosis.</p><p><strong>Methods: </strong>Twelve FAQs regarding scoliosis were compiled following a literature review, and ChatGPT Version 3.5 was utilized to answer them. The responses were analyzed for accuracy and clarity using the Mika et al. scoring system and modified DISCERN score in collaboration with two fellowship-trained pediatric orthopaedic surgeons. Readability was assessed using several published educational-level indices.</p><p><strong>Results: </strong>The ChatGPT responses received a Mika et al. average of 2.4 (satisfactory requiring minimal to moderate clarification) and an averaged mean DISCERN score of 45.9. The estimated reading level necessary for comprehension ranged from 11^th grade to college graduate.</p><p><strong>Conclusions: </strong>When prompted with 12 scoliosis FAQs, ChatGPT produces responses of satisfactory accuracy but require further clarification and are written at an inappropriately high reading level for the scoliosis patient population. Future research should explore strategies to verify the reliability of AI services for counseling on other pediatric orthopaedic conditions.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1377-1389"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788711","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":"Predictive factors for osteoporosis in adult spinal deformity patients.","authors":"Hiroki Konuma, Junya Katayanagi, Takahiro Iida, Shingo Morishita, Tomoyuki Tanaka, Tsukasa Yanase, Tetsuya Jinno, Hiroyuki Inose","doi":"10.1007/s43390-025-01088-x","DOIUrl":"10.1007/s43390-025-01088-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify predictive factors for femoral bone mineral density (BMD) in adult patients with spinal deformity and to establish cutoff values for detecting osteoporosis using preoperative computed tomography (CT) scans.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 90 patients with adult spinal deformity (ASD) who underwent preoperative bone density testing. Key parameters such as age, body mass index (BMI), and Hounsfield unit (HU) values from various vertebral levels were analyzed. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD T-score, and HU values were measured at C2, C7, T8, T9, L1, L2, and L3.</p><p><strong>Results: </strong>Multivariate regression analyses identified BMI and HU at C2 as independent predictors of femoral T-score. The following predictive equation was developed: femoral T-score = - 5.178 + 0.053 × BMI + 0.006 × C2 HU (R² = 0.50). The formula derived from these variables explained 50% of the variance in femoral T-score. Receiver operating characteristic analysis identified cutoff values for predicting osteoporosis as 281 for C2 HU and 22.9 for BMI. The areas under the curve were 0.751 and 0.638, respectively.</p><p><strong>Conclusion: </strong>These findings suggest that HU values from preoperative CT scans can serve as reliable indicators of femoral T-score, offering an alternative to DXA in cases where DXA is unavailable or inaccurate due to factors like severe spinal degeneration. This approach could enhance the preoperative assessment of osteoporosis in ASD patients by facilitating more targeted use of DXA and improving overall clinical decision-making.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1563-1571"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032547","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":"Evaluation of paraspinal muscles in adolescent idiopathic scoliosis: a study based on shear wave elastography.","authors":"Haoyang Zhang, Xin Ye, Yingsen Pan, Yi Shen, Yan Chen, Ge Cai, Jiaying He, Xiang Zhou, Xiaoming Ying","doi":"10.1007/s43390-025-01110-2","DOIUrl":"10.1007/s43390-025-01110-2","url":null,"abstract":"<p><strong>Study design: </strong>Prospective study.</p><p><strong>Purpose: </strong>To explore the application and potential clinical value of shear wave elastography (SWE) in assessing the biomechanical properties of paraspinal muscles in adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>This study screened 30 AIS who visited our hospital between January 1, 2023, and January 4, 2024. Shear wave elastography (SWE) was used to measure the Young's modulus of the paraspinal muscles while the patients were seated in a neutral posture. The biomechanical properties of the paraspinal muscles were analyzed, and their correlation with the degree of scoliosis was explored.</p><p><strong>Results: </strong>The Young's modulus values of the bilateral erector spinae, quadratus lumborum, and psoas major muscles in AIS showed significant differences (P < 0.05). A significant correlation was found between the difference in Young's modulus values of the paraspinal muscles and the Cobb angle (P < 0.05). Specifically, the erector spinae had a negative correlation with the Cobb angle (r = - 0.410, P = 0.024), while the psoas major and quadratus lumborum had positive correlations (r = 0.852, P = 0.024; r = 0.419, P = 0.021).</p><p><strong>Conclusion: </strong>The results show that in AIS, the stiffness of the erector spinae is higher on the convex side, while the psoas major and quadratus lumborum are stiffer on the concave side. The Cobb angle positively correlates with the stiffness of the psoas major and quadratus lumborum, and negatively with the erector spinae. SWE effectively evaluates paraspinal muscle properties in AIS, aiding scoliosis diagnosis and assessment.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1391-1397"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143489","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":"Can postoperative changes in pelvic incidence occur after adult spine deformity surgery? When do they occur, and what factors influence them? A systematic review with pooled analysis.","authors":"Marco Manzetti, Alberto Ruffilli, Giovanni Viroli, Matteo Traversari, Marco Ialuna, Chiara Ricci Petitoni, Cesare Faldini","doi":"10.1007/s43390-025-01103-1","DOIUrl":"10.1007/s43390-025-01103-1","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic incidence (PI) is traditionally considered a constant anatomic parameter in adult spinal deformity (ASD) surgery. However, emerging evidence suggests that PI may change postoperatively, potentially influencing sagittal balance and mechanical complications. This study aims to systematically review the literature on postoperative PI variations in ASD patients, identifying potential radiologic and surgical predictors.</p><p><strong>Methods: </strong>Papers describing postoperative PI changes in ASD patients were included in the analysis. The rate of PI changes, in different subgroups of patients was considered for outcome measure. Meta-analyses were performed to determine the prevalence and factors influencing PI changes.</p><p><strong>Results: </strong>Thirteen studies (1055 patients) met the inclusion criteria. All included studies assessed spinopelvic parameters using standing full-spine X-rays, except for one that used full-body standing X-rays, demonstrating moderatehigh reproducibility in PI measurement (ICC: 0.71-0.96). While the mean absolute PI value remained stable postoperatively, 46.3% of patients experienced significant changes (> 5°). Factors associated with PI variations included fusion area, pelvic fixation type, preoperative sagittal imbalance, and extreme PI values. Sacropelvic fixation reduced PI instability, whereas prolonged anterior imbalance and compensatory pelvic retroversion increased the likelihood of PI shifts. Long-term follow-ups indicated that PI changes could not recover or increase in patients without sacropelvic fixation and in patients with higher preoperative PI values if they experience a decrease in PI postoperatively.</p><p><strong>Conclusion: </strong>The current literature challenges the traditional belief that PI is a static parameter in ASD surgery, particularly in severely imbalanced patients or those with extreme PI values. Acknowledging that PI may change under certain preoperative conditions could help optimize postoperative sagittal realignment in selected groups of ASD patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1327-1344"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981288","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}