Spine deformity最新文献

{"title":"Response to comments on \"Patient-perceived recovery after posterior spinal fusion: evaluating minimum clinically important difference (MCID) in adolescents with idiopathic scoliosis\".","authors":"Leila Mehraban Alvandi, J Nicholas Charla, Zachariah Samuel, Edina Gjonbalaj, Mohamed Said, Jorden Xavier, Carolyn Rachofsky, Morgan Roche, Priya Singh, Yungtai Lo, Jacob Schulz, Jaime A Gomez, Eric D Fornari","doi":"10.1007/s43390-026-01466-z","DOIUrl":"10.1007/s43390-026-01466-z","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1959-1960"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332911","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":"Consensus-based guidelines for research in bracing in idiopathic scoliosis by the SRS comprehensive care committee in collaboration with SOSORT.","authors":"Benjamin D Roye, Alexander M Park, Michael W Brown, Mehdi M Elfilali, Caglar Yilgor, Tom Schlösser, Sabrina Donzelli, Brian Smith, Stefano Negrini","doi":"10.1007/s43390-026-01349-3","DOIUrl":"10.1007/s43390-026-01349-3","url":null,"abstract":"<p><strong>Purpose: </strong>Significant variability exists in the current literature of bracing research and outcome reporting, highlighting the need to standardize study design and reporting practices to ensure cross-study consistency and comparability. The purpose of this study is to develop updated consensus-based recommendations for designing, reporting, and publishing bracing research in pediatric patients with idiopathic scoliosis.</p><p><strong>Methods: </strong>An anonymous Delphi process and a final in-person meeting using the nominal group technique (NGT) established consensus-based guidelines among a multidisciplinary group of bracing experts. Three consecutive, anonymous Delphi rounds were administered to 30 multidisciplinary bracing experts invited to participate in this study. An 80% agreement threshold was set throughout the survey process and final in-person meeting. Items that did not reach consensus were refined to incorporate feedback and redistributed in subsequent rounds to improve consensus. Items that met consensus across all the rounds were simplified to remove redundant items to develop the final list of guidelines.</p><p><strong>Results: </strong>Of the 30 experts invited to participate, response rates were 24 (80%), 25 (83%), and 23 (77%) across survey rounds and 22 participants in the final, in-person meeting. Expert consensus was reached on 121 items across 6 domains which were refined and consolidated into a final 28-item summary of consensus-based guidelines for research in bracing idiopathic scoliosis (Fig. 1).</p><p><strong>Conclusion: </strong>Detailed, consensus-based research guidelines for bracing treatment in patients with idiopathic scoliosis were successfully developed. It must be acknowledged that these best practice guidelines are for research purposes only and are not clinical recommendations.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1545-1555"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362128","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":"Efficacy of the spring distraction system for different etiologies of early onset scoliosis: evaluating an evolving treatment concept.","authors":"Casper S Tabeling, Isabelle E Blaauw, Hilde W Stempels, Tom P C Schlösser, Keita Ito, René M Castelein, Moyo C Kruyt, Justin V C Lemans","doi":"10.1007/s43390-026-01368-0","DOIUrl":"10.1007/s43390-026-01368-0","url":null,"abstract":"<p><strong>Purpose: </strong>Early onset scoliosis (EOS) is a challenging condition that often requires \"growth-friendly\" implants to control the curve and accommodate spinal growth, especially in young patients with severe curves. The spring distraction system (SDS) was developed to support growth without the need for repeated lengthenings. This prospective cohort study aimed to compare the performance of the SDS between patients with different EOS etiologies.</p><p><strong>Methods: </strong>We analyzed all SDS patients with a minimum of two-year follow-up. We measured curve correction, sagittal parameters, spinal growth, complications and unplanned return to the OR (UPROR) and compared these outcomes between different etiological groups. Differences between pre- and postoperative were compared with a mixed repeated-measures ANOVA. Differences between postoperative and later follow-up were compared using linear mixed models. Complications and UPROR rates were compared with a Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Sixty-four patients were included (14 congenital, 41 neuromuscular, and 9 idiopathic). Mean age at surgery was 8.4 ± 1.7 years. Follow-up was 3.7 ± 1.4 years. Correction was maintained for congenital and neuromuscular patients. In idiopathic patients, Cobb angle increased during follow-up (3.6°/year). T1-S1 growth was 7.4 mm/year (idiopathic), 8.9 mm/year (congenital), and 9.8 mm/year (neuromuscular). Fifty-nine complications occurred (mostly implant-related), corresponding to a complication rate of 0.22/patient/year (congenital), 0.26/patient/year (neuromuscular) and 0.27/patient/year (idiopathic). Forty-two UPRORs were recorded, corresponding to an UPROR rate of 0.19/patient/year (congenital), 0.20/patient/year (neuromuscular) and 0.07/patient/year (idiopathic).</p><p><strong>Conclusion: </strong>The SDS performs well across EOS etiologies in terms of curve correction, spinal growth, and complication/UPROR rates. Idiopathic patients had less sustained correction. Complication rates were comparable, idiopathic patients had the lowest UPROR rate.</p><p><strong>Trial registration: </strong>GRADS study (NL55705.041.16). BiPOWR study (NCT04021784).</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1921-1933"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144491","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":"Vertebral pelvic angles accurately predict risk of proximal junctional kyphosis following long-segment fusion for adult spinal deformity.","authors":"Michael W Fields, Justin K Scheer, Matthew Weintraub, Juan Baltazar, Fthimnir Hassan, Omar Taha, Anastasia M Ferraro, Erik Lewerenz, Matthew J Cooney, Joseph M Lombardi, Zeeshan M Sardar, Lawrence G Lenke, Ronald A Lehman","doi":"10.1007/s43390-026-01382-2","DOIUrl":"10.1007/s43390-026-01382-2","url":null,"abstract":"<p><strong>Purpose: </strong>VPAs quantify the spatial relationship of each vertebra to the pelvis and are independent of patient positioning, making them a valuable tool for preoperative planning and intraoperative assessment of sagittal alignment. Given the biomechanical relevance of vertebral pelvic angles (VPAs), their role in predicting proximal junctional kyphosis (PJK) warrants further investigation. We hypothesized that malalignment of VPAs is associated with an increased risk of developing PJK following long-segment fusion for adult spinal deformity (ASD).</p><p><strong>Methods: </strong>ASD patients ≥ 18 years undergoing ≥ 5-level posterior spinal instrumentation and fusion (PSIF) to the pelvis from 2015 to 2022 were included. VPAs (C2PA, T1PA, T4PA, T10PA, L1PA) were measured on standardized radiographs preoperatively and immediately postoperatively. PJK was defined radiographically by two criteria: (1) a postoperative proximal junctional sagittal Cobb angle ≥ 10°, and (2) an increase of ≥ 10° compared to the preoperative angle between the UIV and UIV + 2. Associations between VPA changes, published alignment thresholds (L1PA = PI × 0.5 - 19° ± 2°; T4-L1PA mismatch = - 3° to + 1°), and PJK were assessed using ROC analysis and logistic regression.</p><p><strong>Results: </strong>A total of 266 patients (mean age: 57.5 ± 12.5 years; 74.8% female; mean follow-up: 24.6 ± 13.7 months) were included. Forty-five patients (16.9%) developed PJK, of which 37.8% were symptomatic. VPAs correlated most strongly with pelvic tilt (r up to 0.766). In the overall cohort, mean postoperative VPA values and changes were not significantly different between PJK and no-PJK groups. However, in a subgroup with UIV ≥ T5 (n = 174), patients with PJK demonstrated greater corrections in C2PA (14.3° vs. 8.0°, p < 0.001), T1PA (14.6° vs. 9.0°, p = 0.005), T4PA (12.9° vs. 8.3°, p = 0.016), T10PA (10.1° vs. 6.2°, p = 0.004), and L1PA (8.3° vs. 5.4°, p = 0.006). ROC demonstrated C2PA change held the highest predictive value for PJK (AUC = 0.64), followed by L1PA change (AUC = 0.62). Adherence to the published L1PA threshold and optimizing T4-L1PA mismatch to near neutral was protective against PJK in this cohort.</p><p><strong>Conclusion: </strong>Our results demonstrate that greater magnitude correction of VPAs from baseline, particularly C2PA and L1PA, was associated with an increased risk of PJK in longer constructs with a UIV proximal to T5. Furthermore, this study is consistent with prior work suggesting that L1PA and T4-L1 mismatch may be useful parameters when assessing sagittal alignment in relation to PJK risk.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1687-1694"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779798","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":"Effect of mixing dissimilar metals on serum metal ion levels following spinal deformity surgery.","authors":"Jennifer C Urquhart, Vahagn Karapetyan, Firoz Miyanji, Omar Siddiqi, Karim Kantar, Timothy Carey, Christopher S Bailey, Ravi Ghag, Brent Lanting, Supriya Singh, Parham Rasoulinejad","doi":"10.1007/s43390-026-01363-5","DOIUrl":"10.1007/s43390-026-01363-5","url":null,"abstract":"<p><strong>Purpose: </strong>The increased use of hybrid spinal implants combining dissimilar metals raises concerns for galvanic corrosion, which can affect metal ion release and implant longevity. This study examines the variation in post-fusion metal ion concentrations among different hybrid implant constructs.</p><p><strong>Methods: </strong>In this prospective multicenter observational study, patients undergoing elective surgery for idiopathic or neuromuscular scoliosis received either cobalt-chromium (CoCr/Ti) or stainless steel (SS/Ti) rods with titanium screw implants. Blood metal ion concentrations were measured preoperatively and at 3, 12 and 24 months. Longitudinal data were analyzed using linear mixed-effects models adjusted for repeated measures.</p><p><strong>Results: </strong>A total of 37 patients were enrolled in the CoCr/Ti group and 35 in the SS/Ti group, with a majority of females (68% in CoCr/Ti vs. 71% in SS/Ti). There were no significant differences between the groups in age, BMI, number of rod attachments or rod surface area. Chromium (Cr) levels initially increased then plateaued, remaining consistently higher in the SS/Ti group, and significantly above baseline at 24 months. Cobalt (Co) concentrations also initially increased in both groups, but were higher in CoCr/Ti. Titanium (Ti) levels increased in both groups but continued to show a positive trajectory in CoCr/Ti at 24 months. Higher titanium concentrations also correlated with the number of rod attachments and instrument-related complications in CoCr/Ti but not the SS/Ti group.</p><p><strong>Conclusions: </strong>With consideration of the different material properties in hybrid implant components, our findings suggest that differences in surface hardness appear to be more pertinent to metallic wear than galvanic corrosion.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1587-1598"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699684","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":"Sagittal balance dynamics during gait in patients with degenerative spine disease.","authors":"Armand Dominik Škapin, Janez Vodičar, Matej Supej, Nina Verdel, Miha Vodičar","doi":"10.1007/s43390-026-01347-5","DOIUrl":"10.1007/s43390-026-01347-5","url":null,"abstract":"<p><strong>Study design: </strong>Observational Case-Control Study.</p><p><strong>Purpose: </strong>To evaluate the dynamics of sagittal balance during gait in patients with degenerative spine disease compared with matched controls.</p><p><strong>Methods: </strong>33 patients with pathological sagittal balance parameters on standing radiographs and 31 matched controls underwent three-dimensional motion capture analysis during a six-minute walking assessment. Data were collected across five phases: pre-walk, initial-walk, mid-walk, end-walk, and post-walk. Spino-pelvic (pelvic angle, lumbar lordosis, thoracic kyphosis) and sagittal balance parameters (sagittal trunk shift and angle, global tilt), as well as lower limb joint angles were assessed.</p><p><strong>Results: </strong>The greatest decrease in sagittal balance occurred during the transition from standing to walking, with significantly larger changes observed in the study group (C7-L5-sagittal trunk shift increasing from 69.1 ± 50.6 mm to 138.7 ± 51.9 mm) compared to controls (increase from 20.9 ± 18.8 mm to 69.2 ± 19.7 mm; p = 0.020). The decrease was primarily due to increased thoracic kyphosis and, in some cases, reduced pelvic retroversion. During continued walking, sagittal balance remained stable at the group level, with only a subgroup in both groups demonstrating a notable decrease. No significant differences in changes during walking were found between groups. After walking, parameters largely returned close to baseline in a standing position, indicating an almost complete recovery of sagittal balance.</p><p><strong>Conclusions: </strong>Compensatory mechanisms for maintaining sagittal balance are significantly more effective in a standing position than during walking. While sagittal balance remains stable in most patients during short-term walking, a notable decrease occurred in several individuals. Therefore, further research is needed to identify prognostic factors associated with a decrease in sagittal balance during walking.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1671-1685"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594422","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":"Does pelvic fixation impact reoperation outcomes for neuromuscular scoliosis surgery? A 10-year matched cohort analysis.","authors":"Suhas K Etigunta, Vivien Chan, Adeesya Gausper, Andy Liu, Christopher Mikhail, Alexander Tuchman, Kenneth D Illingworth, David L Skaggs","doi":"10.1007/s43390-026-01352-8","DOIUrl":"10.1007/s43390-026-01352-8","url":null,"abstract":"<p><strong>Purpose: </strong>To report revision surgery rates in neuromuscular scoliosis (NMS) patients undergoing posterior spinal fusion with or without pelvic fixation.</p><p><strong>Methods: </strong>The PearlDiver database identified patients who underwent posterior spinal fusion for NMS from 2015 to 2021. Two cohorts-patients with pelvic fixation and those without-were matched for age, gender, number of levels fused, and wheelchair use. Primary outcomes were rates of subsequent posterior spinal fusion and instrumentation, and spinal wound debridement. Secondary outcome assessed subsequent posterior spinal fusion rates after further matching for wound debridement status.</p><p><strong>Results: </strong>A total of 952 patients (476 with pelvic fixation, 476 without) were analyzed. The 10-year rate of subsequent posterior spinal fusion was similar between the two groups (6.9% pelvic fixation vs. 7.1% no pelvic fixation, p > 0.05). Subsequent posterior spinal fusion was more common in the early postoperative period (< 1 year). Wound debridement was more frequent in the pelvic fixation cohort at 10 years (10.5% vs. 6.1%, p < 0.05), with a higher proportion requiring early intervention within the first two months postoperatively.</p><p><strong>Conclusion: </strong>No significant difference was found in subsequent posterior spinal fusion rates between the pelvic fixation group and no pelvic fixation group. The pelvic fixation group exhibited higher rates of spinal wound debridement in the early postoperative period. Our results suggest that the addition of pelvic fixation may not be necessary in every case to reduce the rates of instrumentation revision or failure. These findings represent associations within matched cohorts and provide comparative outcome data rather than guidance for individual patient decision-making.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1863-1869"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646468","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":"Comment on \"patient-perceived recovery after posterior spinal fusion: evaluating minimum clinically important difference (MCID) in adolescents with idiopathic scoliosis\".","authors":"Deepti M Sati, Vanashri Dhananjay Shinde, Chhaya Agarwal","doi":"10.1007/s43390-026-01415-w","DOIUrl":"10.1007/s43390-026-01415-w","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1957-1958"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933386","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":"Intraoperative neurophysiological monitoring changes during surgical correction of pediatric neuromuscular scoliosis: a single-institution report.","authors":"Mo Chen, Sara J Morgan, Aaron Patterson, Salma Noor, Daniel J Miller, Zack D Thompson, Eduardo C Beauchamp, Walter H Truong, Tenner J Guillaume, Joseph H Perra, Allysa Kimber, Timothy Feyma","doi":"10.1007/s43390-026-01366-2","DOIUrl":"10.1007/s43390-026-01366-2","url":null,"abstract":"<p><strong>Purpose: </strong>Intraoperative neurophysiological monitoring (IONM) is a tool that can improve safety during spinal surgery. Patients with neuromuscular scoliosis (NMS) have inherent neural axis or primary muscle pathology that may present challenges to neuromonitoring. An understanding of IONM event rates, patterns, and outcomes would better prepare surgeons to counsel patients and families.</p><p><strong>Methods: </strong>IONM data from pediatric spine deformity correction procedures in patients with neuromuscular scoliosis at a single quaternary care center between 2012 and 2022 were reviewed to determine cases with monitorable IONM data as well as cases with IONM events. Surgical data and radiographic measures were compared between cases with and without lower extremity IONM events.</p><p><strong>Results: </strong>443 surgical cases were reviewed with 404 (91.2%) monitorable. Of monitorable cases, 37 (9.2%) cases had an IONM event. There were 363 (82.0%) cases were monitorable from the lower extremities, and of these, there were 27 (7.4%) cases had IONM events. One case (1/363 = 0.3%) had clinically identifiable post-surgical neurological complications. Statistical comparisons revealed more blood loss (p = 0.0473) and a trend toward more severe deformity angular ratio (p = 0.07) in cases with lower extremity intraoperative IONM events than those without.</p><p><strong>Conclusion: </strong>This study provides an estimate of IONM events and clinically identifiable neurological injury for children with neuromuscular scoliosis. These rates were similar to those reported in studies of other populations of children with spine deformity which supports the feasibility of IONM. Our data suggest that lower extremity IONM events tend to happen in more severe spine deformity cases.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1881-1890"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699671","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":"Comparison of postoperative infection risk with and without topical vancomycin in adult posterior spinal fusion: a propensity-matched cohort study of 126,910 patients.","authors":"Haad A Arif, Devan Devkumar, Hesham Tanbour, Michael J Conklin, Steven M Theiss","doi":"10.1007/s43390-026-01378-y","DOIUrl":"10.1007/s43390-026-01378-y","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical site infections (SSIs) are the third most common complication following spine surgery. The effect of topical vancomycin in addition to perioperative systemic cefazolin remains uncertain. This study sought to investigate the effect of topical vancomycin administration on 90-day postoperative infection risk following adult posterior spinal fusion (PSF).</p><p><strong>Methods: </strong>The TriNetX Global Collaborative database was queried to identify adult patients undergoing PSF. Patients were stratified into two cohorts based on documented administration of topical vancomycin and systemic cefazolin (topical cohort) versus systemic cefazolin alone (control cohort). Patients underwent 1:1 propensity matching based on demographics and relevant comorbidities. The primary outcomes of interest included 90-day rates of infection-related complications. Subgroup analyses were performed to identify the influence of neuromuscular scoliosis, PSF with osteotomies, pelvic fixation, or fusion of greater than six levels on infection rates. Infectious complication rates were also compared between patients receiving topical vancomycin with and without topical gentamicin or tobramycin.</p><p><strong>Results: </strong>After propensity matching, 63,455 patients were included in each cohort. Patients in the topical cohort demonstrated comparable rates of overall infection (3.0% vs. 3.1%, p = 0.794), superficial surgical site infection (SSI) (0.9% vs. 0.8%, p = 0.151), deep SSI (0.6% vs. 0.6%, p = 0.070) and all other infectious complications when compared to the control cohort. Subgroup analysis revealed decreased rate of deep SSI when using topical gentamicin or tobramycin with vancomycin versus topical vancomycin alone (0.7% vs. 1.7%, p = 0.019). No other between-group differences were observed.</p><p><strong>Conclusion: </strong>This study found no significant difference in 90-day postoperative infectious complications following PSF when topical vancomycin was added to standard systemic cefazolin prophylaxis compared to cefazolin prophylaxis alone. Vancomycin with the addition of gentamicin or tobramycin, however, was associated with decreased rates of deep SSI.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1629-1637"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780304","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}