Spine deformity最新文献

{"title":"What imaging does my AIS patient need? A multi-group survey of provider preferences.","authors":"Jenny L Zheng, Ying Li, Grant Hogue, Megan Johnson, Jason B Anari, Maia D Regan, Keith D Baldwin","doi":"10.1007/s43390-024-00995-9","DOIUrl":"10.1007/s43390-024-00995-9","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent idiopathic scoliosis (AIS) is a common diagnosis managed by pediatric orthopedic surgeons with nonoperative radiographic monitoring representing a cornerstone of treatment. Differences in practices and techniques for obtaining radiographic studies contribute to variation, cost of care, and hamper data aggregation. We surveyed several large organizations dedicated to children's orthopedics or scoliosis care to obtain a consensus for radiographic evaluation of AIS.</p><p><strong>Methods: </strong>A REDCap-based survey was developed across four institutions and beta-tested by staff and fellows from a single institution. The finalized survey was distributed to members of POSNA, PSSG, and SOSORT, and shared on social media. Participants were asked to rank the importance of various datapoints in radiographic assessment of the spinal deformity, skeletal maturity, and study indications during initial, subsequent, preoperative, and final office visits for AIS. Response rate for the overall group was 26%.</p><p><strong>Results: </strong>Cobb angle was considered the most important (> 94%) radiographic index across all time points. For positioning, 46% of respondents favored arms bent touching clavicles as the ideal positioning for X-rays, and another 24% favored arms down with palms forward (Table 2). The majority of respondents obtain lateral X-rays at the first visit (99%) and at the preoperative visit (70%). At the preoperative visit, sagittal contour (86%), apex location (85%), and Lenke classification (73%) were considered important factors to record. Flexibility studies are primarily obtained at the preoperative visit (89%) and 81% of respondents prefer bending films as the flexibility technique of choice. Regarding measures of skeletal maturity, Sanders bone age was considered to be the most important by over 70% of respondents across initial, subsequent, preoperative and brace wean visits (Fig. 2). MRIs were obtained routinely by 34% of respondents and only when the patient had a concerning symptom or finding for 67% of respondents.</p><p><strong>Conclusions: </strong>Despite large variations in radiographic examination of AIS, large areas of agreement were found. It is important to establish standards for positioning patients, evaluating skeletal maturity, and obtaining assessments including lateral views, flexibility studies, and advanced imaging. Establishing common practices for radiographic evaluation of AIS will allow for less variation in care and for critical questions to be answered through registry formation and large multicenter data collection.</p><p><strong>Significance: </strong>This study establishes current practitioner opinion on the radiographic evaluation of the AIS patient. Minimum data sets are useful for data aggregation and answering research questions in the face of data variability.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"351-359"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569284","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":"Is the information provided by large language models valid in educating patients about adolescent idiopathic scoliosis? An evaluation of content, clarity, and empathy : The perspective of the European Spine Study Group.","authors":"Siegmund Lang, Jacopo Vitale, Fabio Galbusera, Tamás Fekete, Louis Boissiere, Yann Philippe Charles, Altug Yucekul, Caglar Yilgor, Susana Núñez-Pereira, Sleiman Haddad, Alejandro Gomez-Rice, Jwalant Mehta, Javier Pizones, Ferran Pellisé, Ibrahim Obeid, Ahmet Alanay, Frank Kleinstück, Markus Loibl","doi":"10.1007/s43390-024-00955-3","DOIUrl":"10.1007/s43390-024-00955-3","url":null,"abstract":"<p><strong>Purpose: </strong>Large language models (LLM) have the potential to bridge knowledge gaps in patient education and enrich patient-surgeon interactions. This study evaluated three chatbots for delivering empathetic and precise adolescent idiopathic scoliosis (AIS) related information and management advice. Specifically, we assessed the accuracy, clarity, and relevance of the information provided, aiming to determine the effectiveness of LLMs in addressing common patient queries and enhancing their understanding of AIS.</p><p><strong>Methods: </strong>We sourced 20 webpages for the top frequently asked questions (FAQs) about AIS and formulated 10 critical questions based on them. Three advanced LLMs-ChatGPT 3.5, ChatGPT 4.0, and Google Bard-were selected to answer these questions, with responses limited to 200 words. The LLMs' responses were evaluated by a blinded group of experienced deformity surgeons (members of the European Spine Study Group) from seven European spine centers. A pre-established 4-level rating system from excellent to unsatisfactory was used with a further rating for clarity, comprehensiveness, and empathy on the 5-point Likert scale. If not rated 'excellent', the raters were asked to report the reasons for their decision for each question. Lastly, raters were asked for their opinion towards AI in healthcare in general in six questions.</p><p><strong>Results: </strong>The responses among all LLMs were 'excellent' in 26% of responses, with ChatGPT-4.0 leading (39%), followed by Bard (17%). ChatGPT-4.0 was rated superior to Bard and ChatGPT 3.5 (p = 0.003). Discrepancies among raters were significant (p < 0.0001), questioning inter-rater reliability. No substantial differences were noted in answer distribution by question (p = 0.43). The answers on diagnosis (Q2) and causes (Q4) of AIS were top-rated. The most dissatisfaction was seen in the answers regarding definitions (Q1) and long-term results (Q7). Exhaustiveness, clarity, empathy, and length of the answers were positively rated (> 3.0 on 5.0) and did not demonstrate any differences among LLMs. However, GPT-3.5 struggled with language suitability and empathy, while Bard's responses were overly detailed and less empathetic. Overall, raters found that 9% of answers were off-topic and 22% contained clear mistakes.</p><p><strong>Conclusion: </strong>Our study offers crucial insights into the strengths and weaknesses of current LLMs in AIS patient and parent education, highlighting the promise of advancements like ChatGPT-4.o and Gemini alongside the need for continuous improvement in empathy, contextual understanding, and language appropriateness.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"361-372"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569256","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":"Spine deformity surgery in patients with Beals syndrome can be effectively performed but does risk revision surgery.","authors":"Anne-Marie Datcu, David Thornberg, Anna Booth, Daniel J Sucato","doi":"10.1007/s43390-024-00993-x","DOIUrl":"10.1007/s43390-024-00993-x","url":null,"abstract":"<p><strong>Purpose: </strong>Beals syndrome or congenital contractual arachnodactyly is a rare disorder characterized by multiple joint contractures, Marfanoid body habitus and crumpled ears and has been associated with scoliosis. This study reports a clinical series of patients with Beals syndrome who have had surgical treatment for their spinal deformity.</p><p><strong>Methods: </strong>A retrospective review of all patients at a single institution who had a genetically-confirmed diagnosis of Beals syndrome and had surgical treatment for their scoliosis were reviewed for surgical outcome and complications.</p><p><strong>Results: </strong>There were eight patients who had surgery at an average age of 11.5 years, four were female and four had cardiovascular abnormalities requiring treatment. The preoperative coronal Cobb was 82.3° which improved to 42.1°(46.8% correction), and 46.5° (43.5% correction) at final follow-up. Preoperative halo-gravity-traction was used in three patients. Three patients had a posterior instrumentation and fusion (PSFI), 2 a combined anterior/PSFI, 1 had tethering, 1 with PSFI with posteriorly-approached discectomy, and 1 with a PSFI and vertebral column resection. One of the eight patients had a critical intraoperative neuromonitoring event but was normal following appropriate responses and no patient awoke with neurologic deficits. Two had an unplanned return to the operating room for implant dislodgement and each had a successful revision.</p><p><strong>Conclusions: </strong>Scoliosis associated with Beals syndrome can have large curves at the time of surgery and require a variety of surgical approaches to achieve a good result. Revision surgery with return to the operating room is necessary in 25% of patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"611-616"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522891","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":"Should the C7-T1 Junction Be Feared? The Effect of a T1 Upper Instrumented Vertebra on Development of Proximal Junctional Kyphosis.","authors":"Carlos Monroig-Rivera, Ingrid Okonta, Jennifer M Bauer, Amit Jain, Firoz Miyanji, Stefan Parent, Peter Newton, V Salil Upasani, Patrick Cahill, Daniel Sucato, Paul D Sponseller, Amer Samdani, D'Marfeivel McLean, Jaysson T Brooks","doi":"10.1007/s43390-024-01002-x","DOIUrl":"10.1007/s43390-024-01002-x","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal junctional kyphosis is an infrequent complication in AIS; however, equipoise remains on the effects of ending a fusion proximally at the C7-T1 junction on the future development of PJK. The purpose of this study was to determine the rate of PJK in patients with AIS who had a UIV of T1 vs those with a UIV of T2 at 5 years of follow-up.</p><p><strong>Methods: </strong>A query was performed of a prospective, multi-center AIS database of patients who received a PSF with at least 5 years of follow-up. Patients with a T1 UIV (n = 29) were compared to those with a T2 UIV (n = 58). PJK was defined as a proximal junctional angle (PJA) > 10 degrees.</p><p><strong>Results: </strong>There was no difference between the T1 and T2 UIV cohorts in preoperative T2-T12 kyphosis or pelvic incidence; however preoperatively, T1 UIV patients had a significantly decreased PJA at - 3° ± 4.5° as compared to T2 UIV patients 1.6° ± 6.5° (p = 0.0014). No patients with a T1 UIV experienced PJK at 5-years of follow-up, while 16% of patients with a T2 UIV experienced PJK (p = 0.025). No patients in the T2 UIV cohort required revision surgeries for their PJK. There was no difference found in total SRS22 scores, however at 5 years of follow-up, T2 UIV patients had better Pain domain scores (4.4 ± 0.6) vs T1 UIV patients (4.0 ± 0.6; p = 0.004).</p><p><strong>Conclusion: </strong>While T1 is an uncommon UIV in AIS, at 5 years of follow-up, a T1 UIV did not result in PJK, nor did it result in a clinically significant change in patient-reported outcome scores.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"595-601"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627353","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":"Elevated hospital floor-based HDU (POPUP-HDU): a new safe alternative to PICU for high-risk neuromuscular and syndromic children undergoing scoliosis surgery.","authors":"E Bada, J Gouda, M D Sewell, M Jones, G McKay, N Canchi-Murali, J B Spilsbury, D S Marks, A Gardner, J S Mehta","doi":"10.1007/s43390-024-00992-y","DOIUrl":"10.1007/s43390-024-00992-y","url":null,"abstract":"<p><strong>Purpose: </strong>Children undergoing either posterior spinal fusion (PSF) or index insertion of growing rods for neuromuscular or genetic/syndromic scoliosis may require post-operative care on the paediatric intensive care unit (PICU). Demands on this limited resource result in frequent bed shortage related cancellations. In response, an ad-hoc or 'pop-up' ward-based high-dependency unit (POPUP-HDU) was developed. This converts a ward bed to POP-HDU bed for the required time. This study assesses the safety and efficacy of postoperative management that utilises POPUP-HDU as an alternative to a PICU bed.</p><p><strong>Methods: </strong>Retrospective review of 111 consecutive children undergoing posterior surgery for scoliosis between June 2016 and April 2023. The inclusion criteria included a diagnosis of genetic/syndromic or neuromuscular scoliosis; PSF or primary insertion of distraction-based growth rods and requirement for postoperative care in a PICU. We excluded those children that were mandated to go to PICU post-operatively for any reason by the anaesthetic team.</p><p><strong>Results: </strong>49 patients (mean age 13.0 years) were managed on PICU, and 62 (mean age 11.4 years) on POPUP-HDU. The groups were matched with respect to body weight, curve magnitude, operative duration, type of fusion procedure performed, the presence of cardiac malformations, the use of home breathing support, the number of operated levels, pelvic instrumentation and intraoperative blood loss. 8 patients in the PICU, and 16 in the POP-HDU groups were readmitted back to PICU following step-down to the hospital ward (p = 0.27). The median PICU length of stay was 1 day in the PICU group and less than a day in POPUP-HDU (for those that needed to be subsequently admitted to PICU). The median total length of hospital stay was 10 days in the PICU group, and 8 days in POPUP-HDU (p < 0.05). 14 patients developed medical complications in the PICU group, compared to 19 in POPUP-HDU. There were no bedshortage cancellations in POPUP-HDU, compared to 23 in PICU.</p><p><strong>Conclusions: </strong>For children with neuromuscular, genetic or syndromic scoliosis undergoing PSF or growth rods that are not deemed suitable for immediate ward-level post-operative care, POPUP-HDU provided a safe alternative to PICU for appropriate patients and was associated with shorter hospital stay and fewer cancellations for lack of PICU beds.</p><p><strong>Level of evidence: </strong>Therapeutic Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"603-610"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507400","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":"Characteristics of sagittal spinopelvic alignment in Thai population: a cross-sectional study.","authors":"Tinnakorn Pluemvitayaporn, Wachirawit Penrat, Sombat Kunakornsawat, Suttinont Surapuchong, Warot Ratanakoosakul, Kitjapat Tiracharnvut, Chaiwat Piyasakulkaew, Piyabuth Kittithamvongs","doi":"10.1007/s43390-024-00997-7","DOIUrl":"10.1007/s43390-024-00997-7","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of spinal deformity is a significant health concern often associated with the aging process. It is primarily attributed to the thickening of spinal joints, ligament pathologies, or the narrowing of the spinal canal, leading to compression of the spinal cord and nerve roots, and subsequently causing musculoskeletal problems. When considering corrective surgery for adult spinal deformities, it is crucial for spine surgeons to take into account the standard values of sagittal spinopelvic alignment. Notably, there is currently a lack of specific data on this aspect within the Thai population. Therefore, our study was focused on evaluating the alignment in the Thai population.</p><p><strong>Objectives: </strong>To analyze sagittal spinopelvic alignment parameters in the asymptomatic Thai population and compare them with other populations.</p><p><strong>Materials and methods: </strong>This study was designed as a cross-sectional analysis involving 194 participants, wherein the sagittal spinopelvic parameters were evaluated utilizing radiographic images. The measurements of the sagittal vertical axis (SVA), pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS), and pelvic tilt (PT) were determined by averaging the assessments conducted by two orthopedic residents and a spine surgeon. In addition, participants' demographic information was obtained through questionnaires, and further analysis was performed on age, gender, and body mass index data. The study also encompassed the determination of correlations between various parameters and the comparison of these parameters with other populations.</p><p><strong>Results: </strong>The body mass index (BMI) of the study participants demonstrated significant associations with several spinal parameters. Specifically, BMI showed significant correlations with sagittal vertical axis (SVA) (r = 0.2, p = 0.09), pelvic incidence (PI) (r = 0.4, p < 0.01), lumbar lordosis (LL) (r = 0.2, p = 0.02), sacral slope (SS) (r = -0.2, p = 0.02), and pelvic tilt (PT) (r = 0.2, p = 0.02). The SS exhibited a statistically significant decline with increasing age (p = 0.04). Furthermore, the mean SVA, PI, LL, SS, and PT differed significantly between the study participants and the Indian population. In addition, the SS was notably lower when compared to the European population.</p><p><strong>Conclusion: </strong>The study revealed the spinopelvic parameters in a cohort of healthy Thai population and observed a correlation between their body mass index (BMI) and pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS), and pelvic tilt (PT). Notably, the average SS among Thai adults was found to be statistically lower than that of individuals from Indian, European Caucasian, Asian, and Mexican populations. These insights hold potential value as a reference when strategizing surgical interventions for Thai patients with spinal deformities.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"617-623"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558725","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":"AIS patients have improved total SRS-22r self-image and satisfaction scores relative to pre-op at 10-year follow-up regardless of Lenke type.","authors":"John P Avendano, William ElNemer, Susana Núñez-Pereira, Paul D Sponseller","doi":"10.1007/s43390-024-01006-7","DOIUrl":"10.1007/s43390-024-01006-7","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies have investigated quality-of-life (QoL)-related outcome measures in adolescent idiopathic scoliosis (AIS) patients over long-term follow-up. We investigated whether patients with any given Lenke type improved relative to other types and whether selective fusions resulted in better QoL-related outcome measures.</p><p><strong>Methods: </strong>We utilized the Harms Study Group database to select patients with AIS who underwent posterior spinal fusion (PSF) with Scoliosis Research Society questionnaire-22 revised (SRS-22r) scores at minimum 10-year follow-up. Characteristics and SRS-22r were quantified by Lenke type and compared using ANOVA and Tukey post hoc tests. Multivariate analyses were conducted to identify the predictive value of Lenke types on QoL-related outcomes. Sub-group analysis split cohorts into those who underwent selective vs. non-selective fusion(s).</p><p><strong>Results: </strong>110 patients were available at minimum 10-year follow-up. Types 3, 4, and 6 curves generally demonstrated lower SRS-22r scores both preoperatively and at long-term follow-up. Independent of Lenke type, total SRS-22r, along with self-image and satisfaction, showed consistent improvement relative to pre-op at 10-year follow-up, whereas pain, mental health, and general function showed a slight worsening. Sub-group analyses revealed no significant differences in SRS-22r scores between selective and non-selective fusion groups.</p><p><strong>Conclusions: </strong>At 10-year follow-up, total SRS-22r, self-image, and satisfaction scores stayed consistently improved relative to preoperative status over time, while pain, general function, and mental health declined from 2 years onward. Increased age may play a role in enhancing self-image and satisfaction while worsening general function, pain, and mental health. Selectively vs. non-selectively fusing a patient should not hinge on fear of impacting patients' QoL-related measures, as our data suggest improvement in total SRS-22r, self-image, and satisfaction regardless.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"561-568"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954696","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":"Development of the scoliosis research society spinal deformity surgery safety checklist.","authors":"Rafael De la Garza Ramos, Justin K Scheer, Nabil Matmati, Lloyd A Hey, Douglas C Burton, Marinus de Kleuver, Christopher P Ames, Vijay Yanamadala","doi":"10.1007/s43390-024-00973-1","DOIUrl":"10.1007/s43390-024-00973-1","url":null,"abstract":"<p><strong>Purpose: </strong>Spine deformity surgery is a complex multi-step procedure that has a relatively high complication rate. The use of surgical safety checklists has been shown to reduce perioperative adverse events, but existing lists are varied and non-specific for spinal deformity surgery. Thus, the purpose of this study was to develop a comprehensive surgical checklist for complex spinal corrective surgery.</p><p><strong>Methods: </strong>An electronic survey consisting of 187 surgical checklist items that had been developed and used by a group of SRS members over a 5-year period was distributed to the Scoliosis Research Society Safety and Value Committee membership. The survey sections included: (1) pre-operative area, (2) initial operating room visit, (3) before turning, (4) positioning, (5) prepare and drape, (6) pre-incision timeout, (7) intraoperative, (8) finishing implant placement and confirming imaging, (9) final rods and locking, (10) prior to closure, (11) closure, (12) turn to supine, and (13) checkout/debriefing. Respondents graded each item on a five-point Likert scale based on their perceived importance and feasibility for inclusion in the checklist. Features graded as \"moderately important\" or \"very important\" to include by at least 70% of respondents were considered to meet the cutoff for inclusion-based standard Delphi practices. Study data were collated using REDCap.</p><p><strong>Results: </strong>A total of 25 surgeons completed the survey in its entirety. The overall checklist \"package\" was shortened to 9 individual checklist modules, with 2 to 16 items per checklist. In terms of individual checklist items, 40% of items (74 of 187) met the cutoff for inclusion; 17 of these items were graded as \"very important,\" which included verifying the presence of implantable devices, reviewing the surgical plan and positioning with the surgical staff, securing the endotracheal tube, bite block confirmation, prone and lateral positioning, neuromonitoring baseline readings, double-checking that the implant screw caps were locked prior to closure, and confirming that the patient was moving bilateral lower extremities before leaving the operating room when possible.</p><p><strong>Conclusion: </strong>This study has led to the development of a specific spinal deformity surgical checklist of 74 (many specific to spine surgery) items that were considered important for inclusion; 17 were considered \"very important\".</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"327-338"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507399","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":"Body mass index adjustments in children with early onset scoliosis: arm span BMI.","authors":"Michael Trask, Scott Yang, Apeksha Gupta, Burt Yaszay, Jennifer M Bauer, Gregory Redding","doi":"10.1007/s43390-025-01056-5","DOIUrl":"https://doi.org/10.1007/s43390-025-01056-5","url":null,"abstract":"<p><strong>Purpose: </strong>Body mass index (BMI), is a nutritional index based on standing height and weight. Children with early onset scoliosis (EOS) have shorter height due to their spine curvature. In these patients' pulmonary function tests, which are also based off height, arm span is standardly used as a surrogate for height to allow for normative comparisons. Arm span has not been used for nutritional assessments in children with EOS.</p><p><strong>Methods: </strong>We used both arm span and measured height to calculate BMI, and BMI as a percent of predicted published norms (BMI%ile) to assess the error produced using height in this population of children. We used a Wilcoxon signed-rank test to compare standard height BMI (BMI) vs arm span BMI (asBMI) and BMI%iles, Spearman correlation to assess the influence of age or coronal curve angle on any differences, and an adjusted linear model for the coronal curve's impact on BMI.</p><p><strong>Results: </strong>BMI and BMI%ile consistently over-estimated nutritional status compared to asBMI with substitution of arm span for height. 15.6% of patients had a BMI%ile of < 1% using height compared to 44.4% using arm span. The difference between BMI and asBMI correlated with the coronal curve magnitude but not with age. The adjusted linear model showed that for each degree of Cobb angle, the difference between BMI and asBMI increased by 0.0294 kg/m² (p = 0.0062).</p><p><strong>Conclusion: </strong>Arm span BMI reveals lower, more accurate nutritional status in children with EOS than standard height BMI.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484011","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":"Surgical site infection risk in neuromuscular scoliosis patients undergoing posterior spinal fusion.","authors":"Ryan Sefcik, Michael Kreft, Kenzie Lundqvist, Richard Steiner, Todd Ritzman, Lorena Floccari","doi":"10.1007/s43390-024-01015-6","DOIUrl":"https://doi.org/10.1007/s43390-024-01015-6","url":null,"abstract":"<p><strong>Purpose: </strong>Scoliosis in neuromuscular scoliosis (NMS) is a spinal deformity often treated with posterior spinal fusions (PSF). There is a relatively high risk to develop surgical site infection (SSI) after PSF in NMS compared to adolescent idiopathic scoliosis (AIS) patients. The purpose of this retrospective cohort study was to determine perioperative risk factors for NMS patients undergoing PSF.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Pediatric database was queried for patients who underwent PSF for NMS and/or cerebral palsy from 2015 to 2020. Statistical analysis of patient characteristics was completed utilizing likelihood ratio chi-squared test for categorical factors and median test or Wilcoxon rank sum test for quantitative factors. Logistic regression was used for odds ratios for quantitative factors.</p><p><strong>Results: </strong>4145 patients underwent PSF for NMS, and 102 developed an SSI (2.5%). Identified risk factors include American Society of Anesthesiologists (ASA) ≥ 3 (p = 0.030, odds ratio 2.4), preoperative corticosteroids (p = 0.049, odds ratio 2.4), preoperative ostomy (p = 0.026, odds ratio 1.6), prolonged anesthetic time (p = 0.045, odds ratio 1.09 per 60 min), prolonged operative time (p = 0.043, odds ratio 1.1 per 60 min), and postoperative development of urinary tract infection (UTI) (p < 0.001, odds ratio 4.5). Patients with SSI had higher body mass index (p = 0.047, odds ratio 1.3 per 5 kg/m²).</p><p><strong>Conclusion: </strong>The prevalence of deep SSI was 2.5% in this cohort, and risk factors include ASA ≥ 3, preoperative ostomy, prolonged anesthetic or operative time, and postoperative UTI. Large multicenter database studies can help identify and stratify risk factors for SSI in this high-risk patient population.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468954","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}