Spine deformity最新文献

{"title":"Evaluating the prevalence of psychiatric comorbidities associated with pediatric scoliosis utilizing ResearchMatch.","authors":"Jeffrey W Chen, Stefan W Koester, Campbell Liles, Stephen Gannon, Christopher M Bonfield","doi":"10.1007/s43390-024-00926-8","DOIUrl":"10.1007/s43390-024-00926-8","url":null,"abstract":"<p><strong>Purpose: </strong>The goal of this study is to characterize the self-reported prevalence of psychiatric comorbidities among patients with adolescent scoliosis.</p><p><strong>Methods: </strong>Eligible patients across the US were surveyed using ResearchMatch, a validated online platform. The survey collected patient demographics, type of scoliosis, scoliosis treatment received, and the mental health diagnoses and interventions.</p><p><strong>Results: </strong>Nearly all (98%) of the 162 respondents were patients themselves, the remainder of which were parents. The majority of whom were female (93%), Caucasian (85%), and diagnosed with idiopathic scoliosis (63%). The median age of diagnosis was 13 (IQR 11-18). Most respondents had mild to moderate scoliosis (65%), and 17% received surgical treatment. 76 of 158 (48%) responded that scoliosis affected their overall mental health, and 92 (58%) had received a mental health diagnosis-76% were diagnosed after their scoliosis diagnosis. Of the 92 with mental health diagnoses, the most common diagnoses were clinical depression (83%), anxiety (71%), negative body image (62%). Over 80% of patients received medical treatment or therapy. Of those with depression, 38.4% received counseling and 45.2% received medication. 52% of the respondents also had immediate family members with mental health diagnoses, with siblings (48%) having the highest proportion.</p><p><strong>Conclusion: </strong>According to the CDC, the prevalence of US teenagers with diagnosed depression was found to be 3.9% and anxiety disorder to be 4.7%, notably higher among adolescent girls. In this national sample, over half of adolescent scoliosis patients report psychiatric comorbidity, often diagnosed years later. The most prevalent psychiatric condition is depression, anxiety, and body-image disturbances. These findings highlight the importance of awareness of the psychiatric impact of adolescent scoliosis, and importance of screening and treatment of comorbid mental health conditions.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1583-1593"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971809","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":"Autofusion is underrated, or is it?","authors":"Blake K Montgomery, Simon Tang","doi":"10.1007/s43390-024-00947-3","DOIUrl":"10.1007/s43390-024-00947-3","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1851-1852"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081466","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":"Applications of artificial intelligence for adolescent idiopathic scoliosis: mapping the evidence.","authors":"Samuel N Goldman, Aaron T Hui, Sharlene Choi, Emmanuel K Mbamalu, Parsa Tirabady, Ananth S Eleswarapu, Jaime A Gomez, Leila M Alvandi, Eric D Fornari","doi":"10.1007/s43390-024-00940-w","DOIUrl":"10.1007/s43390-024-00940-w","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent idiopathic scoliosis (AIS) is a common spinal deformity with varying progression, complicating treatment decisions. Artificial intelligence (AI) and machine learning (ML) are increasingly prominent in orthopedic care, aiding in diagnosis, risk-stratification, and treatment guidance. This scoping review outlines AI applications in AIS.</p><p><strong>Methods: </strong>This study followed PRISMA-ScR guidelines and included articles that reported the development, use, or validation of AI models for treating, diagnosing, or predicting clinical outcomes in AIS.</p><p><strong>Results: </strong>40 full-text articles were included, with most studies published in the last 5 years (77.5%). Common ML techniques were convolutional neural networks (55%), decision trees and random forests (15%), and artificial neural networks (15%). Most AI applications in AIS were for imaging analysis (25/40; 62.5%), focusing on automatic measurement of Cobb angle, and axial vertebral rotation (13/25; 52%) and curve classification/severity (13/25; 52%). Prediction was the second most common application (15/40; 37.5%), with studies predicting curve progression (9/15; 60%), and Cobb angles (9/15; 60%). Only 15 studies (37.5%) reported clinical implementation guidelines for AI in AIS management. 52.5% of studies reported model accuracy, with an average of 85.4%.</p><p><strong>Conclusion: </strong>This review highlights the applications of AI in AIS care, notably including automatic radiographic analysis, curve type classification, prediction of curve progression, and AIS diagnosis. However, the current lack of clear clinical implementation guidelines, model transparency, and external validation of studied models limits clinician trust and the generalizability and applicability of AI in AIS management.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1545-1570"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996403","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":"Increased lengthening frequency does not adversely affect the EOSQ scores in magnetically controlled growing rod surgeries in 133 subjects followed to final fusion.","authors":"Sheryl Zhi Wen Saw, Jack Zijian Wei, Jason Pui Yin Cheung, Kenny Yat Hong Kwan, Kenneth Man Chee Cheung","doi":"10.1007/s43390-024-00923-x","DOIUrl":"10.1007/s43390-024-00923-x","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetically Controlled Growing Rod (MCGR) allows frequent outpatient rod lengthening when treating Early Onset Scoliosis (EOS) patients. But there is lack of expert consensus on the optimal MCGR lengthening interval. EOS 24-Item Questionnaire (EOSQ) is validated for assessing health-related quality of life (HrQOL), family burden, and satisfaction. This is the first study assessing how MCGR lengthening intervals affects patient-perceived outcomes.</p><p><strong>Methods: </strong>This is a multicentred cohort study with subjects recruited from 2012 to 2018 and followed till fusion. EOS subjects who underwent MCGR surgeries were grouped into high, medium or low lengthening interval subgroups based on 16 and 20 week cut-offs. Repeated measure analysis was performed on EOSQ's specified 12 domains. EOSQ results were taken: before index surgery, after index surgery, and prior to definitive treatment. Demographic, clinical and radiographic data were included in model adjustment.</p><p><strong>Results: </strong>133 subjects with mean follow-up of 3.5 (± 1.3) years were included, with 60 males and 73 females; 45 idiopathic, 23 congenital, 38 neuromuscular, and 27 syndromic patients. Mean Cobb angle at surgery was 67° (± 22°) with mean age of 8.3 (± 2.5) years. Between groups, clinical and radiographic parameters were comparable. Higher EOSQ scores in medium lengthening interval subgroup was present in fatigue (p = 0.019), emotion (p = 0.001), and parental impact (p = 0.049) domains, and overall score (p = 0.046). Trendline contrast between subgroups were present in general health (p = 0.006) and physical function (p = 0.025) domains.</p><p><strong>Conclusion: </strong>Patient-perceived outcome improvements appear similar between lengthening interval subgroups. All MCGR lengthening intervals were tolerated by patients and family, with no negative impact observed.</p><p><strong>Level of evidence: </strong>Prognostic Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1841-1850"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545189","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":"Socioeconomic differences in access to scoliosis care in the pediatric population.","authors":"Steven M Garcia, Kian Niknam, Faith Sumandea, Ishaan Swarup","doi":"10.1007/s43390-024-00912-0","DOIUrl":"10.1007/s43390-024-00912-0","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent idiopathic scoliosis (AIS) is a common spinal deformity affecting pediatric patients, with up to 10% requiring surgical intervention. Studies have shown disparities in these patients associated with race, ethnicity, and insurance type, but there is limited information on disparities that exist based on geographical parameters. In this study, we aim to explore the disparities in the care for AIS by looking at differences in the rates of readmission, infection, and revision between patients residing in rural and urban environments.</p><p><strong>Methods: </strong>This is a retrospective cohort study utilizing the Pediatric Health Information System. Pediatric patients that underwent posterior spinal fusion (PSF) for AIS from October 2015 to July 2022 were included. Diagnoses and procedures were identified based on ICD-10 codes and internal tools built into the database. Descriptive statistics were used to summarize the data, including demographics, infection rates, readmission rates, and revision rates. T tests, Chi-squared tests, and logistic regression were used to assess differences between the rural and urban populations. We utilized STATA/SE 15.1 for all data analysis.</p><p><strong>Results: </strong>15,318 patients were included in the final cohort. Demographics and baseline characteristics were similar between the rural and urban patients, although more rural patients used Medicaid over commercial insurance (41.5% vs. 32.7%, p < 0.01), median household income was lower in rural patients (p < 0.01), and there was a higher proportion of Hispanic patients in the urban patient cohort (13.9% vs. 6.4%, p < 0.01). Complication rates were not significantly different between the urban and rural patient cohorts, although rural patients did have a significantly higher 90-day readmission rate (7.3% vs. 6.1%, p = 0.03) and higher rates of instrumentation removal (7.7% vs. 4.9%, p = 0.01).</p><p><strong>Conclusions: </strong>The surgical outcomes between rural and urban pediatric AIS patients undergoing PSF are comparable, although 90-day readmission rates and rates of instrumentation removal were higher in rural patients. Insurance status is likely a significant driver for the differences observed in this study. Future research is needed to better understand the reasons for these differences and to develop strategies to improve outcomes.</p><p><strong>Level of evidence: </strong>Retrospective cohort study, Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1667-1673"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427603","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":"Usefulness of modified S-line for upper instrumented vertebra selection in adolescent idiopathic scoliosis Lenke type 1C curve.","authors":"Hiroki Oba, Shota Ikegami, Masashi Uehara, Terue Hatakenaka, Yoshinari Miyaoka, Daisuke Kurogochi, Takuma Fukuzawa, Tetsuhiko Mimura, Shinji Sasao, Makiyama Fumiaki, Michihiko Koseki, Jun Takahashi","doi":"10.1007/s43390-024-00920-0","DOIUrl":"10.1007/s43390-024-00920-0","url":null,"abstract":"<p><strong>Purpose: </strong>Determine the effect of using the modified S-line vertebra (MSLV) as the upper instrumented vertebra (UIV) on postoperative trunk balance, L4 tilt, and clinical outcomes in selective thoracic fusion (STF) for adolescent idiopathic scoliosis (AIS) Lenke type 1C curve.</p><p><strong>Methods: </strong>Twenty-eight consecutive patients (all female; mean age: 15.4±2.0 years) with AIS Lenke type 1C curve were retrospectively enrolled. Primary outcome measures were coronal balance (absolute distance between C7 and the center of the sacral vertical line), L4 tilt, and Scoliosis Research Society (SRS)-22r scores at 2 years postoperatively. The group with the MSLV at the UIV was designated as the MSLV group (18 patients), and the group with the MSLV proximal (12 patients) or distal (4 patients) to the UIV was defined as the non-MSLV group.</p><p><strong>Results: </strong>We observed no significant differences between the groups regarding age, LIV and stable vertebra positioning, or preoperative X-ray parameters. Postoperative coronal balance was significantly better in the MSLV group (0.39±0.08 vs. 1.34±0.22 cm; P.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1709-1717"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591277","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":"Effects of pelvic fixation strategies and multi-rod constructs on biomechanics of the proximal junction in long thoracolumbar posterior instrumented fusions: a finite-element analysis.","authors":"Muzammil Mumtaz, Andrew P Collins, Niloufar Shekouhi, Karthika Varier, Sudharshan Tripathi, Christopher P Ames, Vedat Deviren, Aaron J Clark, Vijay K Goel, Alekos A Theologis","doi":"10.1007/s43390-024-00932-w","DOIUrl":"10.1007/s43390-024-00932-w","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effect of various pelvic fixation techniques and number of rods on biomechanics of the proximal junction of long thoracolumbar posterior instrumented fusions.</p><p><strong>Methods: </strong>A validated spinopelvic finite-element (FE) model was instrumented with L5-S1 ALIF and one of the following 9 posterior instrumentation configurations: (A) one traditional iliac screw bilaterally (\"2 Iliac/2 Rods\"); (B) T10 to S1 (\"Sacral Only\"); (C) unilateral traditional iliac screw (\"1 Iliac/2 Rods\"); (D) one traditional iliac screw bilaterally with one midline accessory rod (\"2 Iliac/3 rods\"); (E) S2AI screws connected directly to the midline rods (\"2 S2AI/2 Rods\"); and two traditional iliac screws bilaterally with two lateral accessory rods connected to the main rods at varying locations (F1: T10-11, F2: T11-12, F3: T12-L1, F4: L1-2) (\"4 Iliac/4 Rods\"). Range of motions (ROM) at T10-S1 and T9-T10 were recorded and compared between models. The T9-T10 intradiscal pressures and stresses of the T9-10 disc's annulus in addition to the von Mises stresses of the T9 and T10 vertebral bodies were recorded and compared.</p><p><strong>Results: </strong>For T10-S1 ROM, 4 iliac/4 rods had lowest ROM in flexion and extension, while 2 S2AI/2 rods showed lowest ROM in rotation. Constructs with 3 or 4 rods had lower stresses on the primary rods compared to 2-rod constructs. At the proximal adjacent disc (T9-10), 4 iliac/4 rods showed lowest ROM, lowest intradiscal pressures, and lowest annular stress in all directions (most pronounced in flexion-extension). Under flexion and extension, 4 iliac/4 rods also showed the lowest von Mises stresses on the T10 vertebral body but the highest stresses on the T9 vertebral body.</p><p><strong>Conclusions: </strong>Dual iliac screws with 4 rods across the lumbosacral junction and extending to the thoracolumbar junction demonstrated the lowest T10-S1 ROM, the lowest adjacent segment disc (T9-T10) ROM, intradiscal pressures, and annular stresses, and the lowest UIV stresses, albeit with the highest UIV + 1 stresses. Additional studies are needed to confirm whether these biomechanical findings dictate clinical outcomes and effect rates of proximal junctional kyphosis and failure.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1571-1582"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005177","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":"Innovative technologies in thoracolumbar and lumbar spine surgery failing to reach standard of care: state-of-art review.","authors":"Prerana Katiyar, Matan Malka, Justin L Reyes, Joseph M Lombardi, Lawrence G Lenke, Zeeshan M Sardar","doi":"10.1007/s43390-024-00898-9","DOIUrl":"10.1007/s43390-024-00898-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate previously popular technologies in the field of spine surgery, and to better understand their advantages and limitations to the current standards of care. Spine surgery is an ever-evolving field that serves to resolve various spinal pathologies in patients of all ages. While there are established treatments for various conditions, such as lumbar spinal stenosis, idiopathic scoliosis, and degenerative lumbar disease, there is always further research and development in these areas to produce innovative technologies that can lead to better outcomes. As this process progresses, we must remind ourselves of previously tried and tested inventions and their outcomes that have fallen short of becoming a standard to ensure we are able to learn lessons from the past.</p><p><strong>Methods: </strong>A thorough literature review was conducted with the aim of compiling literature of previously utilized technologies in spine surgery. Biomedical databases were utilized to gather relevant articles including PubMed, MEDLINE, and EMBASE. Emphasis was placed on gathering articles with technologies or therapeutics aimed at treating common spinal pathologies including lumbar spinal stenosis (LSS), adolescent idiopathic scoliosis (AIS), and other degenerative lumbar spine diseases. The keywords used were: \"failed technologies\", \"historical technologies\", \"spine surgery\", \"spinal stenosis\", \"adolescent idiopathic scoliosis\", and \"degenerative lumbar spine disease\". A total of 47 articles were gathered after initial review.</p><p><strong>Results: </strong>Different technologies pertaining to spine surgery were identified and critically evaluated. Some of these technologies included X-STOP, Vertiflex, Vertebral Body Stapling, and Dynesys. These technologies were evaluated for their strengths and limitations across their spinal pathology applications. While each type of technology had their benefits, the data tended to be mixed with various limitations across studies.</p><p><strong>Conclusion: </strong>These technologies have been trialed in the field of spine surgery across various spinal pathologies, but still prove of limited efficacy and shortcomings to the current standards of care.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1521-1527"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097010","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":"Placement of ilio-sacral screws in fusionless technique for pediatric neuromuscular scoliosis utilizing planning software, in conjunction with intraoperative navigation, results in a safer optimal screw: a CT-based study.","authors":"Jasper De Geyter, Thijs Ackermans, Pierre Moens, Charlotte-Elise Broeckx, Tine De Mulder, Lieven Moke, Sebastiaan Schelfaut","doi":"10.1007/s43390-024-00915-x","DOIUrl":"10.1007/s43390-024-00915-x","url":null,"abstract":"<p><strong>Purpose: </strong>The insertion of ilio-sacral (IS) screws for distal anchoring in the instrumentation of pediatric neuromuscular scoliosis (NS) presents a significant challenge, often leading to elevated rates of complications. Utilizing computed tomography (CT) navigation and preoperative planning technology is proposed as a potential solution to mitigate these challenges. This study aims to assess the precision of IS screw placement through CT-graphic measurements, both with and without preoperative planning, followed by navigated IS screw insertion, in pediatric neuromuscular scoliosis.</p><p><strong>Methods: </strong>Thirty-two treated patients were grouped based on surgical procedure: planned (P): 19 patients (n = 38 screws) and non-planned (NP): 13 patients (n = 26 screws). All screw placements (P and NP) took place under CT navigation. IS screw trajectories of P-group were drawn preoperatively on CT images with the cranial trajectory planning program and fused with the intraoperative CT images. There are several important anatomical structures that should be avoided when placing the IS screw (L5 root, spinal canal, L5S1 facet, SI joint, neurovascular structures anteriorly to the sacrum, S1 root in the S1 foramen and the intestines). Each trajectory was evaluated based on seven radiographical parameters whom we have enlisted partially based on the essentials of a good trajectory described by Miladi et al. (1: Ilium; 2: SI joint; 3: Promontorium; 4: Sacral plate; 5: Anterior sacral cortex; 6: S1 foramen; 7: Spinal canal). An independent sample T test was executed to compare both groups.</p><p><strong>Results: </strong>The trajectories in the P group showed a significantly (P < 0.05) higher overall similarity and optimality (12.1 ± 2.1 vs 9.1 ± 2.2 points) compared to the non-planned trajectory.</p><p><strong>Conclusions: </strong>Preoperative planning and navigated placement of IS screws on fusion images with intraoperative CT, results in a better trajectory of the ilio-sacral screws.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1735-1743"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420793","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":"Reliability and validity of the pediatric adaptation of the mJOA scale for evaluating cervical spine disorders.","authors":"Olga M Sergeenko, Dmitry M Savin, Alexey V Evsyukov, Alexander V Burtsev","doi":"10.1007/s43390-024-00931-x","DOIUrl":"10.1007/s43390-024-00931-x","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate the validity and reliability of the pediatric adaptation of the Japanese Orthopedic Association (mJOA) scale in pediatric patients with various cervical spine pathologies.</p><p><strong>Methods: </strong>Initial assessments were performed by a neurosurgeon, followed by an independent evaluation by a neurologist within 1-2 days to test inter-rater reliability. The same clinician assessed the same group of children using the adapted mJOA scale at different point in time (between 1 month and 1 year after the initial assessment) to test intra-rater reliability. For known-groups validity, the pediatric mJOA scale assessments were compared between two groups of pathologies with different prognosis. Concurrent validity was assessed against the McCormick scale, and convergent validity was tested by reassessing patients using the adult mJOA scale two or more years after the initial assessment by pediatric one.</p><p><strong>Results: </strong>A cohort of 169 pediatric patients aged 6 months to 18 years (mean age: 10 ± 4.6 years) with various cervical spine pathologies was recruited. Pathologies included atlanto-axial rotatory fixation (AARF), Chiari type I anomaly, congenital cervical spine scoliosis, atlanto-axial dislocation (AAD) and instability (AAI), cervical spine stenosis and trauma, and congenital cervicothoracic dislocations. The majority of patients underwent cervical spine surgery and were followed up for an average of 6.9 ± 2.97 years. The pediatric mJOA scale demonstrated high inter-rater reliability (r = 0.99, p < 0.0001) and strong intra-rater reliability (r = 0.82, p < 0.0001). Significant differences in pediatric mJOA scores were observed between patients with expected-intact neurological status and those with expected-pathological neurological status (p < 0.0001). The pediatric mJOA scale showed a strong correlation with the McCormick grading system (r = 0.97, p < 0.001) and good correlation with the adult mJOA scale during long-term follow-up (r = 0.82, p < 0.0001).</p><p><strong>Conclusions: </strong>The pediatric version of the mJOA scale is a reliable and valid tool for assessing pediatric patients with cervical spine disorders. Its high reliability and validity support its use in both clinical practice and research.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1595-1606"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724422","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}