Spine deformity最新文献

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Artificial intelligence automated measurements of spinopelvic parameters in adult spinal deformity-a systematic review. 人工智能自动测量成人脊柱畸形的脊柱骨盆参数-系统综述。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-05-23 DOI: 10.1007/s43390-025-01111-1
Anthony Bishara, Saarang Patel, Anmol Warman, Jacob Jo, Liam P Hughes, Jawad M Khalifeh, Tej D Azad
{"title":"Artificial intelligence automated measurements of spinopelvic parameters in adult spinal deformity-a systematic review.","authors":"Anthony Bishara, Saarang Patel, Anmol Warman, Jacob Jo, Liam P Hughes, Jawad M Khalifeh, Tej D Azad","doi":"10.1007/s43390-025-01111-1","DOIUrl":"10.1007/s43390-025-01111-1","url":null,"abstract":"<p><strong>Purpose: </strong>This review evaluates advances made in deep learning (DL) applications to automatic spinopelvic parameter estimation, comparing their accuracy to manual measurements performed by surgeons.</p><p><strong>Methods: </strong>The PubMed database was queried for studies on DL measurement of adult spinopelvic parameters between 2014 and 2024. Studies were excluded if they focused on pediatric patients, non-deformity-related conditions, non-human subjects, or if they lacked sufficient quantitative data comparing DL models to human measurements. Included studies were assessed based on model architecture, patient demographics, training, validation, testing methods, and sample sizes, as well as performance compared to manual methods.</p><p><strong>Results: </strong>Of 442 screened articles, 16 were included, with sample sizes ranging from 15 to 9,832 radiograph images and reporting interclass correlation coefficients (ICCs) of 0.56 to 1.00. Measurements of pelvic tilt, pelvic incidence, T4-T12 kyphosis, L1-L4 lordosis, and SVA showed consistently high ICCs (>0.80) and low mean absolute deviations (MADs <6°), with substantial number of studies reporting pelvic tilt achieving an excellent ICC of 0.90 or greater. In contrast, T1-T12 kyphosis and L4-S1 lordosis exhibited lower ICCs and higher measurement errors. Overall, most DL models demonstrated strong correlations (>0.80) with clinician measurements and minimal differences compared to manual references, except for T1-T12 kyphosis (average Pearson correlation: 0.68), L1-L4 lordosis (average Pearson correlation: 0.75), and L4-S1 lordosis (average Pearson correlation: 0.65).</p><p><strong>Conclusion: </strong>Novel computer vision algorithms show promising accuracy in measuring spinopelvic parameters, comparable to manual surgeon measurements. Future research should focus on external validation, additional imaging modalities, and the feasibility of integration in clinical settings to assess model reliability and predictive capacity.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1289-1304"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132998","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}
引用次数: 0
Racial disparities in pediatric spinal fusion surgery affect perioperative outcomes: a national multicenter study. 儿童脊柱融合手术的种族差异影响围手术期结果:一项全国多中心研究。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-06-06 DOI: 10.1007/s43390-025-01094-z
Alden H Newcomb, Haseeb E Goheer, Christopher G Hendrix, Amanda W Hayes, W Garret Burks, Jonathan J Carmouche
{"title":"Racial disparities in pediatric spinal fusion surgery affect perioperative outcomes: a national multicenter study.","authors":"Alden H Newcomb, Haseeb E Goheer, Christopher G Hendrix, Amanda W Hayes, W Garret Burks, Jonathan J Carmouche","doi":"10.1007/s43390-025-01094-z","DOIUrl":"10.1007/s43390-025-01094-z","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the effect of race and ethnic differences in perioperative outcomes and short-term complications in patients undergoing pediatric spinal fusion surgery.</p><p><strong>Methods: </strong>A retrospective cohort study was performed using prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP-Pediatric) Pediatric database merged with the Pediatric Spinal Fusion Procedure Targeted database from 2016 to 2022 to identify pediatric patients under 18 years who had undergone any spinal fusion procedure for scoliosis using Common Procedural Terminology codes. The study population was divided into four cohorts (1) White (2) Black (3) Asian and (4) Other or Unknown. One-way ANOVA for continuous variables and chi-square tests for categorical variables were used to identify differences in perioperative variables between the four groups. Multivariable logistic regression analysis assessed the effect of race on perioperative surgical and medical complications, extended hospital length of stay, and intensive care unit stay (ICU). Significance was defined as p < 0.05.</p><p><strong>Results: </strong>A total of 39,666 pediatric spinal fusion patients were identified between 2016 and 2022, of which 25, 521 were White, 6007 were Black, 1342 were Asian, and 6796 were unknown or other. Black and Asian patients experienced significantly higher rates of postoperative medical complications at 75.70 and 74.52%, compared with 69.03% for White patients (p < 0.001). Both Black [OR: 1.383, 95% CI (1.292-1.481)] and Asian [OR: 1.320, 95% CI (1.157-1.509)] patients had an independently increased risk for medical complications, whereas only Black patients had an increased risk for ICU stay [OR: 1.222, 95% CI (1.143-1.306)] complications following a multivariate logistic regression analysis (p < 0.001).</p><p><strong>Conclusions: </strong>This study provides evidence of racial disparities in outcomes after pediatric spine surgery, even after controlling for demographic and health factors. Pediatric Black and Asian patients undergoing pediatric spinal fusion have a significantly higher risk of postoperative medical complications compared with White patients. These findings emphasize the need to focus on identifying the root cause and ways to reduce racial disparities in pediatric spine surgery. The present study brings awareness to the disparity in the pediatric spine population and is useful as we work towards the reduction in such disparities and their root causes.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1359-1366"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235098","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}
引用次数: 0
Management of early-onset scoliosis: modern Luque trolley technique led to fewer reoperations within 3 years than other growth-friendly techniques, a prospective cohort study with matched historical controls. 早发性脊柱侧凸的治疗:一项具有匹配历史对照的前瞻性队列研究表明,现代Luque手推车技术在3年内比其他生长友好技术导致更少的再手术。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-05-28 DOI: 10.1007/s43390-025-01102-2
Romain Dayer, Michael Grevitt, Lee Breakwell, WaiWeng Yoon, Maio Chen, Tiara Ratz, Tina Szocik, Yaner Y Zhu, Jean Ouellet
{"title":"Management of early-onset scoliosis: modern Luque trolley technique led to fewer reoperations within 3 years than other growth-friendly techniques, a prospective cohort study with matched historical controls.","authors":"Romain Dayer, Michael Grevitt, Lee Breakwell, WaiWeng Yoon, Maio Chen, Tiara Ratz, Tina Szocik, Yaner Y Zhu, Jean Ouellet","doi":"10.1007/s43390-025-01102-2","DOIUrl":"10.1007/s43390-025-01102-2","url":null,"abstract":"<p><strong>Purpose: </strong>Management of early-onset scoliosis (EOS) remains challenging with high reoperation rates. The modern Luque trolley technique (MLT) was developed to reduce open lengthening and complications. This study aimed to compare the reoperation rates between the MLT and other growth-friendly surgical techniques.</p><p><strong>Methods: </strong>Prospective EOS patients were recruited and treated with MLT; matched historical controls were selected from the Pediatric Spine Study Group (PSSG) database. The primary objective was to test if within 3 years of surgery MLT patients would have fewer reoperations. Secondary outcomes were growth, curve correction, and quality of life using the 24-item early-onset scoliosis questionnaire (EOSQ-24). Safety analysis was performed for the MLT patients.</p><p><strong>Results: </strong>MLT (N = 18) and control patients (N = 43) had similar baseline age, body measurements, etiology, Cobb angle, and spinal length. Within 3 years of surgery, 1/18 MLT patients required a reoperation compared with 30/43 controls, conditional Poisson regression rate ratio = 0.02 (95% CI 0; 0.12) (P < 0.001). The median time to first reoperation was MLT, 5.4 years and control, 0.8 years. The MLT achieved the same curve correction as the controls at 3 years. The total spinal growth (T1-S1) was similar between the groups, although the thoracic spinal growth (T1-T12) was less in the MLT group. No difference was observed in standing heights and EOSQ-24 scores. Within 3 years, 2 MLT patients had recurrence of deformity (risk = 11.1%, 95% CI 1.4; 34.7) and 1 had implant loosening (risk = 5.6%, 95% CI 0.1; 27.3).</p><p><strong>Conclusion: </strong>MLT patients had fewer reoperations within 3 years than control patients and a low risk of implant failure.</p><p><strong>Levels of evidence: </strong>Level II.</p><p><strong>Trial registration number: </strong>NCT01672749. Date of registration: 2012-08-24.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1611-1624"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174779","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}
引用次数: 0
Complications in vertebral body tethering: what are the short term effects on patient reported outcomes? 椎体系扎术的并发症:对患者报告结果的短期影响是什么?
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-07-10 DOI: 10.1007/s43390-025-01107-x
Katherine D Sborov, Mansi Agarwal, Michael J Heffernan, Jason B Anari, Benjamin Roye, Stefan Parent, Firoz Miyanji, Selina C Poon
{"title":"Complications in vertebral body tethering: what are the short term effects on patient reported outcomes?","authors":"Katherine D Sborov, Mansi Agarwal, Michael J Heffernan, Jason B Anari, Benjamin Roye, Stefan Parent, Firoz Miyanji, Selina C Poon","doi":"10.1007/s43390-025-01107-x","DOIUrl":"10.1007/s43390-025-01107-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Vertebral body tethering (VBT) has continued to gain popularity for the treatment of idiopathic scoliosis (IS); however, complication and reoperation rates have been reported as high as 25%. There is a paucity of data on the clinical and long-term outcomes of VBT. The purpose of this study is to determine how complications from VBT effect patient quality of life (QOL) up to three years after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort study, the patients were identified via an analysis of multi-center electronic medical record data from the Pediatric Spine Study Group (PSSG). All patients who underwent VBT for IS were included. The dataset was screened to include only patients who had patient reported outcome data documented both before and after surgery. Patient demographics, surgery dates, complications, Early Onset Scoliosis Questionnaire (EOSQ) scores, and Scoliosis Research Society (SRS) scores were collected. Complications were classified using the modified Clavien-Dindo-Sink (mCDS) complication classification system. The analysis of QOL after surgery was determined comparing survey scores of patients with and without any complication over time. Additional analysis was similarly performed comparing patients with no or mild complications, defined as mCDS grade I and II, to those with severe complications, defined as mCDS grade IIIA or above.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study consisted of 339 total surveys from 81 patients with EOSQ data and 293 total surveys from 101 patients with SRS data. Among the 81 patients with EOSQ data, 15 patients experienced a complication, with eight patients suffering a severe complication. Among the 101 patients with SRS data, 42 patients experienced a complication, and 22 patients suffered a severe complication. When comparing patients with a complication to those with without a complication, patients with complications had significantly lower total EOSQ scores at 2, 2.5, and 3 years after surgery (p = 0.009, 0.001, and &lt; 0.001 respectively); however, there was no difference in total SRS scores at any time point. In comparing patients with severe complications to pts with mild complications/no complication, patients with severe complications had significantly worse total EOSQ at 2, 2.5, and 3 years after surgery (p = 0.018, 0.002, & &lt; 0.001) and SRS scores at 2, 2.5, and 3 years after surgery (p = 0.040, 0.018, 0.010).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with any complication from VBT had worse EOSQ scores at 2 years after surgery. Severe complications (mCDS &gt; IIIA) following VBT manifest with decreasing EOSQ and SRS scores over time and become statistically significant at 2 years and beyond. The magnitude of difference in EOSQ and SRS scores between the groups also increases over time. Longer-term follow-up will ascertain whether these poorer QOL outcomes persist at time points greater than 3 years. Long-term follow up will be importan","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1431-1440"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601419","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}
引用次数: 0
Development and validation of a pediatric spine surgical invasiveness index. 小儿脊柱外科侵袭性指数的建立与验证。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-05-13 DOI: 10.1007/s43390-025-01106-y
Vivien Chan, Adeesya Gausper, Andrew Chan-Tai-Kong, Andy M Liu, Suhas Etigunta, Justin K Scheer, Lindsay M Andras, David L Skaggs
{"title":"Development and validation of a pediatric spine surgical invasiveness index.","authors":"Vivien Chan, Adeesya Gausper, Andrew Chan-Tai-Kong, Andy M Liu, Suhas Etigunta, Justin K Scheer, Lindsay M Andras, David L Skaggs","doi":"10.1007/s43390-025-01106-y","DOIUrl":"10.1007/s43390-025-01106-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Surgical invasiveness indices have been used in adult spine surgery to characterize the invasiveness of complex procedures and for risk stratification. This has not been studied in the pediatric population. The purpose of this study was to develop and validate a surgical invasiveness index for pediatric spinal deformity surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The National Surgical Quality Improvement Program (NSQIP) Pediatric database was queried between the years 2016-2022. Patients were included if they were &lt;18 years of age, received posterior or anterior-posterior spinal fusion surgery, and had a diagnosis of spinal deformity. The study cohort was divided into a derivation cohort and a validation cohort. A multivariable linear regression analysis was performed to identify surgical components associated with operative time. Surgical components of interest included number of posterior fusion levels, number of anterior fusion levels, pelvic instrumentation, posterior column osteotomies, three-column osteotomies, and prior spinal deformity surgery. Statistically significant variables were used to establish a pediatric spinal deformity surgical invasiveness index. The score was assessed and validated using linear and logistic regression analysis and receiver operating characteristic curve analysis on operative time and allogeneic transfusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 37,658 patients included (Derivation cohort: 26,372; Validation cohort: 11,286). In the linear regression analysis, more posterior fusion levels (7-12 levels: 0.54, p&lt;0.001;&gt;12 levels: 1.40, p&lt;0.001), anterior fusion 1-3 levels (2.42, p&lt;0.001), anterior fusion ≥4 levels (2.93, p&lt;0.001), pelvic instrumentation (0.79, p&lt;0.001), and previous spinal deformity surgery (0.44, p&lt;0.001) were associated with longer operative time. Each level of posterior column osteotomy (0.13, p&lt;0.001) and three-column osteotomy (0.61, p&lt;0.001) were associated with increased operative time. Points were assigned to each surgical component: 7-12 posterior fusion levels (4 pts), &gt;12 posterior fusion levels (11 pts), anterior fusion 1-3 levels (19 pts), anterior fusion ≥4 levels (23 pts), pelvic instrumentation (6 pts), previous spinal deformity surgery (3 pts), posterior column osteotomy (1 pt per level), and three-column osteotomy (5 pts per level). In the derivation cohort, each point was associated with an increase in operative time by 0.13 hours (R&lt;sup&gt;2&lt;/sup&gt;=0.16, p&lt;0.001). In the validation cohort, each point was associated with an increase in operative time by 0.12 hours (R&lt;sup&gt;2&lt;/sup&gt;=0.15, p&lt;0.001). In the derivation cohort, the area under the curve (AUC) for operative time ≥8 hours and allogeneic transfusion were 0.74 and 0.71, respectively. In the validation cohort, the AUC for operative time ≥8 hours and allogeneic transfusion were 0.74 and 0.70, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A pediatric spinal deformity surgical invasiveness index w","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1367-1376"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031719","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}
引用次数: 0
Closing-opening vertebral column resection for thoracolumbar congenital kyphosis: technical note and case report. 闭式-开式脊柱切除术治疗胸腰椎先天性后凸:技术笔记及病例报告。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-05-25 DOI: 10.1007/s43390-025-01108-w
Anouar Bourghli, Louis Boissiere, Faisal Konbaz, Cecile Roscop, Khaled Almusrea, Ibrahim Obeid
{"title":"Closing-opening vertebral column resection for thoracolumbar congenital kyphosis: technical note and case report.","authors":"Anouar Bourghli, Louis Boissiere, Faisal Konbaz, Cecile Roscop, Khaled Almusrea, Ibrahim Obeid","doi":"10.1007/s43390-025-01108-w","DOIUrl":"10.1007/s43390-025-01108-w","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the technique of closing-opening vertebral column resection (COVCR) in an adult patient with severe thoracolumbar kyphosis secondary to two adjacent posterior hemivertebrae.</p><p><strong>Background: </strong>COVCR is a rare technique as it can only be applied in a very specific deformity configuration.</p><p><strong>Methods: </strong>We report the case of a 26-year-old male who has been complaining of middle and low back pain for over 10 years with difficulties when walking for long distances. Full spine anteroposterior and lateral X-rays revealed a severe thoracolumbar kyphosis with an angulation of 95° between T10 and L1. CT scan confirmed the presence of two adjacent posterior hemivertebrae at the level of T11 and T12. MRI did not show any spinal cord anomalies.</p><p><strong>Results: </strong>The patient underwent a posterior resection of T11 and T12 vertebrae with instrumentation from T7 to L4. Through the use of a side-to-side domino connector, closing of the middle column and opening of the anterior column were achieved demonstrating a COVCR. No cage was inserted. Thoracolumbar kyphosis was corrected to 25°. He could walk on day 2 with a satisfactory clinical and radiological result at 2 years.</p><p><strong>Conclusion: </strong>This is the first paper to describe the true COVCR as a surgical technique for the management of congenital thoracolumbar kyphosis. Such variation of VCR may be applied in the presence of a posterior hemivertebra where the configuration enables opening of the anterior column and closing of the middle column.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1489-1496"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143463","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}
引用次数: 0
Intraoperative cell salvage utilization for blood conservation during pediatric and adult spinal surgery: a state-of-the-art systematic review. 在儿童和成人脊柱手术中,术中细胞回收用于血液保护:一项最新的系统综述。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1007/s43390-025-01098-9
Grant Feuer, Prerana Katiyar, Justin L Reyes, Caroline Taber, Josephine R Coury, Fthimnir M Hassan, Joseph M Lombardi, Ahmed Shawky Abdelgawaad, Alan H Daniels, Lawrence G Lenke, Zeeshan M Sardar
{"title":"Intraoperative cell salvage utilization for blood conservation during pediatric and adult spinal surgery: a state-of-the-art systematic review.","authors":"Grant Feuer, Prerana Katiyar, Justin L Reyes, Caroline Taber, Josephine R Coury, Fthimnir M Hassan, Joseph M Lombardi, Ahmed Shawky Abdelgawaad, Alan H Daniels, Lawrence G Lenke, Zeeshan M Sardar","doi":"10.1007/s43390-025-01098-9","DOIUrl":"10.1007/s43390-025-01098-9","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this systematic review was to identify the efficacy of cell salvage in adult and pediatric spinal surgery.</p><p><strong>Methods: </strong>A comprehensive systematic review of four biomedical databases was conducted to identify study articles of interest. Articles from original studies were compiled for the composition of this manuscript. Spinal surgery is becoming increasingly common in both the United States and around the world. As such, spine surgeons typically make use of many methods to manage blood loss including intra-operative hypotension, use of crystalloid and colloid fluid resuscitation, anti-fibrinolytics, allogenic blood transfusions, and autologous transfusions. Allogenic blood is a common method to maintain blood volume throughout surgery but carries risks including transfusion reactions, immunosuppression, and transmission of viral blood-borne illnesses. Autologous blood products, like intra-operative cell saver or cell salvage (CS), offer a way to return the patient's own blood. However, CS remains controversial at this time. Some studies have found it to be efficacious in avoiding allogenic transfusion, while others have found that the results are no different in those who did not utilize CS. Some studies have even found that those who receive CS are more likely to require allogenic transfusions. This systematic review seeks to examine all the available literature on the use of CS in spinal surgery.</p><p><strong>Conclusion: </strong>Currently, the role of CS is controversial in spinal surgery with studies reporting variable benefit. Many articles suggest that CS is only financially viable at higher volumes of blood loss and in more complex surgeries. Moreover, research regarding cost-effectiveness is lacking and is complicated by geographic factors. A multi-center large-scale randomized clinical trial could lead to the development of a model wherein the utility of CS could be assessed across a range of spinal surgeries, and could lead to the development of guidelines driving an individualized approach to the use of CS in spine surgery.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1305-1326"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216786","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}
引用次数: 0
Growth modulation increases clinical success in vertebral body tethering. 生长调节增加椎体栓系的临床成功。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-05-15 DOI: 10.1007/s43390-025-01105-z
Daniel G Hoernschemeyer, Samuel D Hawkins, Nicole M Tweedy, Melanie E Boeyer
{"title":"Growth modulation increases clinical success in vertebral body tethering.","authors":"Daniel G Hoernschemeyer, Samuel D Hawkins, Nicole M Tweedy, Melanie E Boeyer","doi":"10.1007/s43390-025-01105-z","DOIUrl":"10.1007/s43390-025-01105-z","url":null,"abstract":"<p><strong>Purpose: </strong>The relationship between skeletal maturity and postoperative growth modulation (GM) in patients treated with Vertebral Body Tethering (VBT) is poorly understood. We aimed to: (1) identify preoperative skeletal maturity factors associated with GM, and (2) assess the relationship between GM and postoperative success in patients treated with VBT.</p><p><strong>Methods: </strong>We retrospectively reviewed radiographic data from 55 patients with a minimum follow-up of 2 years (2.6 ± 0.5). Changes in standing height and skeletal maturity (Sanders Stage [SS], Triradiate Cartilage [TRC], and Risser Stage [RS]) were assessed at all timepoints. Patients that exhibited GM were defined by ≥ 6° of deformity correction from first erect to any postoperative timepoint. Successful outcomes were defined by a Cobb Angle of ≤ 30° at latest follow-up.</p><p><strong>Results: </strong>We observed GM in 42% (23 of 55) of patients. GM was influenced by SS (p = 0.017) and TRC (p = 0.013), but not RS (p = 0.104). We observed a successful outcome in 91% of patients that exhibited GM compared to 44% of those that did not (p < 0.001; OR 12.9). No difference was identified in preoperative deformity magnitude or amount of initial correction achieved between patients that did and did not exhibit GM. Patients who exhibited GM had a higher revision rate (30.4%) than when compared to those who did not (3.0%, p = 0.005, OR 9.7).</p><p><strong>Conclusion: </strong>Postoperative success after VBT is directly related to GM. Patients who modulate their deformity are 12.9 times more likely to exhibit a successful outcome and can be identified preoperatively based on SS or TRC.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1421-1429"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080145","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}
引用次数: 0
Enabling technology in adult spinal deformity. 成人脊柱畸形的使能技术。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-04-16 DOI: 10.1007/s43390-025-01086-z
Jordan Lebovic, Matthew S Galetta, Zeeshan M Sardar, Michael Goytan, Alan H Daniels, Firoz Miyanji, Justin S Smith, Douglas C Burton, Themistocles S Protopsaltis
{"title":"Enabling technology in adult spinal deformity.","authors":"Jordan Lebovic, Matthew S Galetta, Zeeshan M Sardar, Michael Goytan, Alan H Daniels, Firoz Miyanji, Justin S Smith, Douglas C Burton, Themistocles S Protopsaltis","doi":"10.1007/s43390-025-01086-z","DOIUrl":"10.1007/s43390-025-01086-z","url":null,"abstract":"<p><p>This review analyzes enabling technology in Adult Spinal Deformity (ASD), with a focus on optimizing safety and teaching. The prevalence of ASD is rising, and recent technological advancements can empower surgeons to improve outcomes for ASD patients but also each comes with specific challenges. The paper highlights opportunities and potential obstacles in effective technology integration and assesses key enabling technologies, including surgical planning software, machine leaning, three-dimensional printing, augmented and virtual reality, patient-specific instrumentation as well as navigation and robotics.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1547-1561"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046036","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}
引用次数: 0
"Cured" patients with early-onset idiopathic scoliosis after serial casting are at risk of recurrence at intermediate follow-up. 早发性特发性脊柱侧凸在连续铸造后“治愈”的患者在中期随访时有复发的危险。
IF 1.8
Spine deformity Pub Date : 2025-09-01 Epub Date: 2025-05-03 DOI: 10.1007/s43390-025-01092-1
Rayyan Abid, Abigail E Manning, Peter F Sturm, Ying Li, Craig M Birch, Michal Szczodry, Michael P Glotzbecker
{"title":"\"Cured\" patients with early-onset idiopathic scoliosis after serial casting are at risk of recurrence at intermediate follow-up.","authors":"Rayyan Abid, Abigail E Manning, Peter F Sturm, Ying Li, Craig M Birch, Michal Szczodry, Michael P Glotzbecker","doi":"10.1007/s43390-025-01092-1","DOIUrl":"10.1007/s43390-025-01092-1","url":null,"abstract":"<p><strong>Purpose: </strong>Serial casting limits curve progression while preserving spinal growth, delaying or even eliminating the need for surgery. Some patients with EOIS can be \"cured\" with curve reduction under 15°. However, no long-term studies have defined whether \"cured\" patients maintain small curves or if they are at risk of progression. We examined if casting patients remained \"cured\" following treatment.</p><p><strong>Methods: </strong>We identified 40 EOIS patients who were treated with serial casting, achieved curves under 15° and had minimum 2 years of follow-up after completing the treatment. Failure was defined as an increase > 6° resulting in a curve magnitude > 15° at any point during follow-up, requiring cast/brace treatment after cessation of initial cast/brace, or undergoing surgery. Average curve magnitude at the time of cure was 11.1°. Kaplan-Meier survival analysis was used to identify failure rates over time.</p><p><strong>Results: </strong>10 patients (25.0%) met criteria for failure. Mean time from cure to last follow-up was 4.3 years. 3 patients (7.5%) completed bracing and were later re-braced while 2 (5.0%) required surgery. Mean curve magnitude of \"failed\" patients was 27.4° with an average increase of 15.6°. At 5.1 years, probability of successful treatment is 64.2%. For \"failed\" patients, median time to failure was 2.4 years. Successful patients were braced for median 1.4 years, while \"failed\" patients had a median of 1 year.</p><p><strong>Conclusion: </strong>While EOIS patients may be \"cured\" with serial casting, this may not be sustained. The percentage of \"failures\" likely will increase with longer follow-up through skeletal maturity, and patients must be closely monitored after concluding casting/bracing.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1605-1610"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035342","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}
引用次数: 0
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