Spine deformity最新文献

{"title":"Novel radiological predictors for the progression of proximal junctional kyphosis in osteoporotic vertebral compression fracture with kyphosis following posterior corrective surgery.","authors":"Junyu Li, Yinghong Ma, Baitao Liu, Junjie Ma, Zhuoran Sun, Yongqiang Wang, Miao Yu, Weishi Li, Yan Zeng","doi":"10.1007/s43390-024-00983-z","DOIUrl":"https://doi.org/10.1007/s43390-024-00983-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify the effect of some novel risk factors associated with L1 vertebrae and parameters closely related to the sagittal alignment for the occurrence of proximal junctional kyphosis (PJK) following surgery for patients with osteoporotic vertebral compression fractures (OVCF) kyphosis.</p><p><strong>Methods: </strong>74 OVCF patients undergoing posterior corrective surgery between January 2008 and June 2021 with a minimum 2-year follow-up were included. These patients were divided into PJK and non-PJK groups. Spinopelvic parameters, including thoracolumbar slope (TLS) and the L1 plumb line (L1PL) were measured preoperatively, postoperatively, and at follow-up. Multivariate logistic analysis was performed on various risk factors and Global Alignment and Proportion (GAP) scores. Associations between novel parameters and PJK were analyzed using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>PJK was identified in 28.4% of patients. The mean age and follow-up were 63.45 years and 38.17 months, respectively. There was no difference between the PJK and the non-PJK groups in baseline demographics, pre-operative and immediate post-operative pelvic incidence-lumbar lordosis mismatch. Multiple comparisons showed that the proportion of PJK in the severely disproportioned group(the group with the highest GAP scores) and that of the other two groups with lower GAP scores were statistically different (P < 0.001). Potential risk factors for PJK included preoperative thoracic kyphosis (TK) (P < 0.001), TLS (P = 0.016), postoperative TLS (P < 0.001), and L1PL (P < 0.001). Postoperative TLS and L1PL were respectively independent risk factors for PJK, with the cut-off values set at 8.6° and 10.4 mm to predict the occurrence of PJK.</p><p><strong>Conclusions: </strong>TLS and L1PL can be used to predict the occurrence of PJK in patients undergoing surgery for OVCF and are crucial for preventing the progression of PJK. Achieving a proportionate GAP Score postoperatively seems to be a viable option as higher GAP scores were associated with higher rates of PJK.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564309","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":"Influence of slippage reduction and correction of lumbosacral kyphosis by single-level posterior lumbar interbody fusion on spinal alignment in patients with dysplastic spondylolisthesis.","authors":"Kazuki Takeda, Satoshi Suzuki, Masahiro Ozaki, Yohei Takahashi, Osahiko Tsuji, Narihito Nagoshi, Mitsuru Yagi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1007/s43390-024-00917-9","DOIUrl":"10.1007/s43390-024-00917-9","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the influence of slippage reduction and correction of lumbosacral kyphosis by L5-S1 single-level posterior lumbar interbody fusion (PLIF) on spinal alignment and clinical outcomes including postoperative complications in patients with dysplastic spondylolisthesis (DS).</p><p><strong>Methods: </strong>Twenty consecutive patients with symptomatic and severe DS who underwent L5-S1 single-level PLIF with a minimum of 2 years of follow-up after surgery were included. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores for low back and leg pain obtained on preoperative and postoperative examinations. Postoperative instrumentation failure and L5 radiculopathy were also evaluated. The preoperative and postoperative spinopelvic parameters were measured.</p><p><strong>Results: </strong>The JOA score significantly improved from 21.5 ± 4.8 (preoperative) to 27.0 ± 2.5 (postoperative), with a mean recovery rate of 75.0% ± 30.4%. The VAS score for low back pain significantly improved from 44.5 ± 30.1 (preoperative) to 11.5 ± 15.9 (postoperative), and that for leg pain significantly improved from 31.0 ± 33.2 (preoperative) to 5.0 ± 10.2 (postoperative). The slip percentage (% slip) significantly improved from 59.6% ± 13.5% (preoperative) to 25.2% ± 15.0% (postoperative). The lumbosacral angle (LSA) significantly improved from 12.3° ± 9.5° (preoperative) to 1.0° ± 4.9° (postoperative). L5-S1 PLIF led to significant improvement of lumbar lordosis (from 52.0° ± 15.9° to 59.7° ± 8.0°) and pelvic incidence - lumbar lordosis mismatch (from 23.9° ± 20.6° to 13.3° ± 10.0°). Correction of lumbosacral kyphosis had a significant positive correlation with postoperative pelvic tilt (PT) (r = 0.50, P = 0.02), while postoperative % slip did not have a significant correlation with postoperative PT.</p><p><strong>Conclusions: </strong>L5-S1 PLIF for DS provided good clinical outcomes. Correction of lumbosacral kyphosis had a positive impact on regaining ideal spinopelvic balance and may be beneficial in the setting of treating DS.</p><p><strong>Level of evidence iv: </strong></p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1761-1772"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459299","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":"Deep learning classification of pediatric spinal radiographs for use in large scale imaging registries.","authors":"Kellen L Mulford, Christina M Regan, Julia E Todderud, Charles P Nolte, Zachariah Pinter, Connie Chang-Chien, Shi Yan, Cody Wyles, Bardia Khosravi, Pouria Rouzrokh, Hilal Maradit Kremers, A Noelle Larson","doi":"10.1007/s43390-024-00933-9","DOIUrl":"10.1007/s43390-024-00933-9","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to develop and apply an algorithm that automatically classifies spine radiographs of pediatric scoliosis patients.</p><p><strong>Methods: </strong>Anterior-posterior (AP) and lateral spine radiographs were extracted from the institutional picture archive for patients with scoliosis. Overall, there were 7777 AP images and 5621 lateral images. Radiographs were manually classified into ten categories: two preoperative and three postoperative categories each for AP and lateral images. The images were split into training, validation, and testing sets (70:15:15 proportional split). A deep learning classifier using the EfficientNet B6 architecture was trained on the spine training set. Hyperparameters and model architecture were tuned against the performance of the models in the validation set.</p><p><strong>Results: </strong>The trained classifiers had an overall accuracy on the test set of 1.00 on 1166 AP images and 1.00 on 843 lateral images. Precision ranged from 0.98 to 1.00 in the AP images, and from 0.91 to 1.00 on the lateral images. Lower performance was observed on classes with fewer than 100 images in the dataset. Final performance metrics were calculated on the assigned test set, including accuracy, precision, recall, and F1 score (the harmonic mean of precision and recall).</p><p><strong>Conclusions: </strong>A deep learning convolutional neural network classifier was trained to a high degree of accuracy to distinguish between 10 categories pre- and postoperative spine radiographs of patients with scoliosis. Observed performance was higher in more prevalent categories. These models represent an important step in developing an automatic system for data ingestion into large, labeled imaging registries.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1607-1614"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749012","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":"Prognosticating accelerated deterioration in skeletally mature adolescent idiopathic scoliosis curves of 40-50° using uniplanar radiographic measures of axial rotation.","authors":"Graham Ka-Hon Shea, Samuel Yan-Lik Ng, Changmeng Zhang, Guodong Wang","doi":"10.1007/s43390-024-00949-1","DOIUrl":"10.1007/s43390-024-00949-1","url":null,"abstract":"<p><strong>Purpose: </strong>The management of adolescent idiopathic scoliosis (AIS) curves between 40 and 50° is controversial. Here, we investigated the prognostic significance of simple radiographic rotational parameters to identify curves of this magnitude with accelerated deterioration following skeletal maturity.</p><p><strong>Methods: </strong>Seventy-three patients were identified with AIS and Cobb angles of the major curve between 40 and 50° at skeletal maturity. We defined fast progressive curves as those increasing by ≥ 2° per year after skeletal maturity. From the apical vertebra of the major curve upon presentation and skeletal maturity, we determined the modified Nash-Moe index (×100), and from thoracic major curves, the Rib Index. T tests were performed to compare fast-progressive curves with those that deteriorated by < 2° per year. Receiver operator characteristic (ROC) curves were plotted to establish optimal cutoffs, sensitivity, and specificity measures for rotational parameters.</p><p><strong>Results: </strong>The average duration of follow-up post was 11.8 ± 7.3 years. Thirteen out of seventy-three patients were fast progressors. The modified Nash-Moe index was similar between groups at presentation (p = 0.477) but significantly higher in fast progressors than non-fast progressors at maturity for major thoracic curves (25.40 ± 6.60 vs. 19.20 ± 4.40, p < 0.001). Rib Index values were also higher among fast progressors at skeletal maturity (2.50 ± 0.90 vs. 1.80 ± 0.60, p = 0.026). An ROC curve for a modified Nash-Moe index of 0.235 for thoracic curves achieved an area under the curve (AUC) of 0.76 for discriminating fast progressors. A threshold of 1.915 for Rib Index at maturity achieved an AUC of 0.72 for discriminating fast progressors. In combining both rotational parameters, an AUC of 0.81 was achieved.</p><p><strong>Conclusion: </strong>These simple rotational parameters may be useful to predict fast progression in 40-50° AIS curves following skeletal maturity indicated for early fusion, but further validation upon larger cohorts and non-thoracic major curves is required.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1729-1734"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983175","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":"Axial rod slip at the end-of-construct screw in scoliosis surgery: relevance, occurrence and prevention.","authors":"T P Schlösser, I Blaauw, M R van der Valk, Guido van Solinge, C Faber, M C Kruyt","doi":"10.1007/s43390-024-00925-9","DOIUrl":"10.1007/s43390-024-00925-9","url":null,"abstract":"<p><strong>Purpose: </strong>Despite standardized biomechanical tests for spinal implants, we recently recognized pedicle screw failure to maintain the rod fixated as a clinical concern in scoliosis surgery. This occurrence study investigates the risk and magnitude of axial rod slip (ARS), its relation with technique and preventive measures.</p><p><strong>Methods: </strong>Retrospective multicenter review of all primary scoliosis cases (2018-2020) with > 1 year FU from three centers, instrumented with uniplanar screws and 5.5 mm CoCr rods (Mesa 2, Stryker Corporation, Kalamazoo, MI, USA). ARS was defined as > 1 mm change in residual distal rod length from the screw in the lowest instrumented vertebra (LIV) and assessed by two independent observers. Slip distance, direction, relation to distal screw density and time of observation were recorded, as well as the effect of ARS on caudal curve increase. To prevent slip, more recent patients were instrumented with a different end-of-construct screw (Reline, NuVasive Inc. San Diego, CA, USA) and analyzed for comparison.</p><p><strong>Results: </strong>ARS risk was 27% (56/205) with a distance of 3.6 ± 2.2 mm, predominantly convex. 42% occurred before 4 months, the rest before 1 year. The caudal curve substantially increased three times more often in patients with ARS. Interobserver reliability was high and slip was in the expected direction. ARS was unrelated to distal screw density. Remarkable variation in ARS rates (53%, 31%, 13%) existed between the centers, while there was no difference in mean screw density (≈1.3 screws/level) or curve correction (≈60%). Revision surgery for ARS was required in 2.9% (6/207). Using the different end-of-construct screw, ARS risk was only 2% (1/56) and no revisions were required.</p><p><strong>Conclusion: </strong>This study demonstrates the prevalence of axial rod slip at the end of construct in scoliosis surgery and its clinical relevance. While minimal ARS can be subclinical, ARS should not be mistaken for adding on. The most severe ARS predominantly occurred convex at the high-loaded distal screw when L3 was the LIV. Longer constructs (LIV L3 or L4) have a higher risk of ARS. The minimal risk of ARS with another end-of-construct screw underscores the influence of screw type on ARS occurrence in our series. Further research is essential to refine techniques and enhance patient outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1699-1707"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009405","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":"Correction: Anterior vertebral body tethering shows clinically comparable shoulder balance outcomes to posterior spinal fusion.","authors":"James Meyers, Lily Eaker, Amer Samdani, Firoz Miyanji, Michael Herrera, Ashley Wilczek, Ahmet Alanay, Caglar Yilgor, Daniel Hoernschemeyer, Suken Shah, Peter Newton, Baron Lonner","doi":"10.1007/s43390-024-00934-8","DOIUrl":"10.1007/s43390-024-00934-8","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1855"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996404","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":"Cross-cultural adaptation, reliability and validity of the Greek version of the Spinal Appearance Questionnaire (SAQ) in patients with adolescent idiopathic scoliosis.","authors":"Marianna Oikonomaki, George Kelalis, Apostolos Z Skouras, Spiros Sotiropoulos, George Georgoudis, Theodoros Grivas","doi":"10.1007/s43390-024-00907-x","DOIUrl":"10.1007/s43390-024-00907-x","url":null,"abstract":"<p><strong>Purpose: </strong>The Spinal Appearance Questionnaire (SAQ) is a widely validated tool for assessing perceptions of spinal deformity in adolescent idiopathic scoliosis (AIS) patients. This study aimed to develop and validate a Greek version of the SAQ (GR-SAQ).</p><p><strong>Methods: </strong>A cross-cultural adaptation of the SAQ following international guidelines was performed. Internal consistency and test-retest reliability were evaluated. Convergent validity was assessed by correlating the GR-SAQ with the Appearance domain of Scoliosis Research Society-22 (SRS-22) and the Cobb angle with the Trunk Shift domain of GR-SAQ. Divergent validity was examined through the relationship between GR-SAQ, patient characteristics, and clinical measures including Cobb angle, DIERS Formetric 4D angle, and scoliometer readings.</p><p><strong>Results: </strong>The study included 61 AIS patients (52 females, 13.91 ± 2.57 years, 25.33 ± 10.14° Cobb angle). GR-SAQ exhibited good internal consistency (Cronbach's α = 0.794) and excellent test-retest reliability (ICC = 0.931, 95%CI: 0.880-0.960). Correlations between GR-SAQ and SRS-22 showed a low-to-moderate negative correlation (r = -0.351, p = 0.006). The Trunk Shift domain moderately correlated with the Cobb Angle (r = 0.393, p = 0.002). Divergent validity analyses did not demonstrate statistical significance (p > 0.05).</p><p><strong>Conclusion: </strong>The GR-SAQ is a valid and reliable tool for evaluating spinal deformity perception in Greek AIS patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1623-1629"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237302","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":"Predicting brace holiday eligibility in juvenile idiopathic scoliosis.","authors":"Julianna Lee, Nathan Chaclas, Lucas Hauth, David VanEenenaam, Vineet Desai, John M Flynn","doi":"10.1007/s43390-024-00924-w","DOIUrl":"10.1007/s43390-024-00924-w","url":null,"abstract":"<p><strong>Purpose: </strong>The psychological effects of scoliosis bracing can be difficult, and thus clinicians sometimes recommend a brace holiday when the curve corrects to less than 25°. However, the clinical indications for taking a break from the brace before reaching maturity have yet to be described. We hypothesized there would be a relationship between brace holiday eligibility and degree of curve at presentation, change in curve magnitude while bracing, and level of bracing compliance.</p><p><strong>Methods: </strong>A retrospective cohort study at a single institution was performed from 2016 to 2022. Objective brace compliance I-button data were collected on patients aged 3-9 years old. Patients with other etiologies besides idiopathic scoliosis before the age of 10 were excluded. Binary logistic regression was performed to determine the effect of significant variables on the likelihood of brace holiday.</p><p><strong>Results: </strong>Fifty-six patients met inclusion criteria. Of these, 20 were able to get a brace holiday. Patients with higher brace compliance and larger in-brace curve correction were more likely to get a brace holiday (P = 0.015, 0.004). Patients with higher BMIs and larger curves at initial presentation were less likely to get a brace holiday (P = 0.002, 0.014).</p><p><strong>Conclusion: </strong>Compliant brace wearers with good in-brace correction are most likely to be eligible for a brace holiday. While some elements remain immutable, others are modifiable, such as bracing compliance. Understanding how outcomes differ between patients who do and do not take a brace holiday will be crucial to elucidating if the psychological benefit of taking a break from the brace can be justified.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1683-1687"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559639","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":"Proximal foundation anchor variations and their correlation with unplanned return to the operating room (UPROR) in children with EOS treated with magnetically controlled growing rods (MCGR).","authors":"Fernando Rios, Hazem B Elsebaie, Bahar Shahidi, Robert Ames, Bailee Monjazeb, William Kerr, Joshua M Pahys, Steven W Hwang, Amer F Samdani, Lindsay M Andras, Matthew E Oetgen, Peter O Newton, Burt Yaszay, Gregory M Mundis, Behrooz A Akbarnia","doi":"10.1007/s43390-024-00921-z","DOIUrl":"10.1007/s43390-024-00921-z","url":null,"abstract":"<p><strong>Introduction: </strong>The evolution of MCGR technique has led to modifications in the configuration of the proximal construct to decrease the incidence of implant-related complications (IRC) and revision surgeries. However, there is no data characterizing the performance of the most used configurations reducing the risk of complications.</p><p><strong>Methods: </strong>487 patients were identified from an international multicenter EOS database.</p><p><strong>Inclusion criteria: </strong>EOS patients, primary dual MCGR, complete radiographs, and minimum of 2-year follow-up. 76 patients had incomplete X-rays, 5 had apical fusions, and 18 had inconclusive complications, leaving 388 patients for review. A digital spine template was created to document UIV; number of levels; number, type, and location of anchors; as well as implant configuration. First available postoperative and latest follow-up radiographs were reviewed by two senior surgeons and two spine fellows. UPROR due to IRC was defined as any change in proximal anchors between the postoperative and final follow-up radiographs.</p><p><strong>Results: </strong>The most common proximal construct configuration: UIV at T2 (50.0%) with 17.5% UPROR, followed by T3 (34.0%) with 12.1% UPROR; number of levels was three (57.1%) with 16.8% UPROR and two (26.0%) with 17.0% UPROR; number of proximal anchors was six (49.9%) with 14.1% UPROR and four (27.0%) with 18.3% UPROR. The most common anchors were all screws (42.0%) with 9.9% UPROR, and all hooks (26.4%) with 31.4% UPROR (P < 0.001). The construct with the lowest rate of UPROR was a UIV at T2, with six anchors (all screws) across three levels (42 cases), with 0% UPROR. Other construct combinations that yielded 0% UPROR rates were UIV of T3, six anchors (all screws) across three levels (25 cases), and a UIV of T3 with six anchors (screws and hooks) across three3 levels (9 cases).</p><p><strong>Conclusion: </strong>Proximal anchor configuration impacts the incidence of UPROR due to IRC in MCGR. UIV at T2 and T3 compared to T4, and the use of all screws or combination of screws and hooks compared to all hooks were associated with a lower UPROR rate. The most common construct configuration was T2 UIV, three levels, six anchors, and all screws. The use of a combination of six anchors (screws or screws and hooks) across three levels with a UIV at T2 or T3 was associated with a lower UPROR rate. Additional research is needed to further evaluate the variables contributing to configuration selection and their association with IRC.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1831-1839"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601730","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":"Maturation of the vertebral ring apophysis is delayed in girls with adolescent idiopathic scoliosis compared to the normal population.","authors":"Lorenzo Costa, Agnes van Lange, Peter R Seevinck, Winnie Chu, Ludvig Vavruch, Moyo C Kruyt, René M Castelein, Tom P C Schlosser","doi":"10.1007/s43390-024-00908-w","DOIUrl":"10.1007/s43390-024-00908-w","url":null,"abstract":"<p><strong>Purpose: </strong>The ring apophysis is a secondary ossification center on both sides of each vertebral body, to which the annulus of the intervertebral disc inserts. Recently, its pattern of ossification and fusion to the vertebral body was described for the normal growing spine. The aim of the present study was to investigate the ossification and fusion of the ring apophysis in patients with adolescent idiopathic scoliosis (AIS) and compare it to the normal growing population.</p><p><strong>Methods: </strong>Ring apophysis maturation along the entire thoracic and lumbar spine was analyzed on CT scans of 99 female, pre-operative AIS patients and compared to 134 CT scans of non-scoliotic girls, aged 12 to 20.</p><p><strong>Results: </strong>The ring apophysis maturation in AIS patients was delayed at all spinal levels in AIS patients compared to non-scoliotic controls. Ossification starts at T4-T11 at age 12, followed by T1-T5 and L3-S1 at age 15. The fusion process in AIS patients continues longer in the midthoracic region as compared to the other regions and as compared to non-scoliotic controls, with many incomplete fusions still at age 20.</p><p><strong>Conclusion: </strong>The ring apophysis maturation in AIS is delayed compared to that in the normal population and lasts longer in the mid/low thoracic spine. Delayed maturation of the spine's most important stabilizer, while the body's dimensions continue to increase, could be part of the patho-mechanism of AIS.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1631-1637"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288558","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}