Spine deformity最新文献

{"title":"Response to Letter to the Editor concerning \"Does pelvic fixation impact reoperation outcomes for neuromuscular scoliosis surgery? A 10-year matched cohort analysis\" by Etigunta SK, et al.","authors":"Suhas K Etigunta, Vivien Chan, Adeesya Gausper, Andy Liu, Christopher Mikhail, Alexander Tuchman, Kenneth D Illingworth, David L Skaggs","doi":"10.1007/s43390-026-01409-8","DOIUrl":"10.1007/s43390-026-01409-8","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1949-1950"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974955","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":"Adoption outpaces reimbursement in navigation-assisted pediatric posterior spinal fusion.","authors":"Soham Ghoshal, Margaret L Sullivan, Shanika D Silva, Craig M Birch, M Timothy Hresko, Grant D Hogue","doi":"10.1007/s43390-026-01362-6","DOIUrl":"10.1007/s43390-026-01362-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate reimbursement trends and surgical volumes associated with computer-assisted navigation (CAN) in pediatric posterior spinal fusion (PSF), with a focus on the impact of payer mix on institutional financial sustainability.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients aged 11-19 years undergoing CAN-assisted PSF at a single pediatric institution from 2021 to 2024. Billing records associated with CPT code 61,783 (computer-assisted spinal navigation add-on) were used to identify procedures. Annual procedure volumes were calculated and analyzed by payer type (private vs. public). Matched payments were adjusted to 2024 USD and analyzed using Wilcoxon rank-sum tests.</p><p><strong>Results: </strong>A total of 759 CAN-PSF procedures were analyzed, with 58% billed to private insurance, 37% to public insurance, and 5% to other payers. Procedure volume increased 70.5% from 2021 to 2024 (CAGR 19.5%). Across all payers, median reimbursement rates declined from 74% in 2021 to 67% in 2024 (p < 0.01). Private insurer reimbursement declined from 81 to 68%, representing a 13% decrease (p < 0.01), while public insurer reimbursement declined from 11 to 9%, representing a 2% decrease (p < 0.01). An inverse relationship was observed between rising procedure volume and declining reimbursement rates.</p><p><strong>Conclusion: </strong>Although CAN utilization in pediatric PSF significantly increased from 2021 to 2024, declining reimbursement rates pose financial challenges for institutions. These trends may limit equitable access to advanced surgical technologies, highlighting a need for policy reforms or adjustments in reimbursement practices to sustain CAN integration in pediatric spine surgery.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1841-1850"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663053","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":"Return to sports after surgery in adolescent idiopathic scoliosis.","authors":"Gabriela Cabrera, Boris Falconi, Lucas Piantoni, Rodrigo Remondino, Eduardo Galaretto, Carlos A Tello","doi":"10.1007/s43390-025-01257-y","DOIUrl":"10.1007/s43390-025-01257-y","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) affects approximately 1-3% of the population, of whom less than 10% will require surgical intervention. Sports activities are inherent to these ages as well as present in the school curriculum. Sports activities can be categorized into non-contact, contact, and collision sports. Currently, there is a lack of consensus in the literature regarding the decision-making process for the resumption of sports activities and the types of activities permitted after posterior spinal fusion in AIS patients. The aim of this study was to explore spine surgeon's recommendations for resuming sports after AIS surgery.</p><p><strong>Materials and methods: </strong>We developed an ad-hoc survey consisting of ten questions and sent it via e-mail to members of the spine society nationwide.</p><p><strong>Results: </strong>Sixty-one members responded to the questionnaire. Overall, 20.7% recommended a return to non-contact sports after 6 months, while 20.7% allowed a return to contact sports and 23.1% a return to collision sports after 12 months or more.</p><p><strong>Conclusion: </strong>Adolescents with idiopathic scoliosis can resume their daily activities and sports after undergoing posterior spinal surgery. However, establishing a clear classification for different types of sports activities remains challenging, leading to discrepancies regarding decision-making during the postoperative period. Internationally validated guidelines for determining the type and timing of return to sports activities are still pending.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1565-1569"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252954","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":"Response to Letter to the Editor: \"Pain in individuals with adolescent idiopathic scoliosis: prevalence and association with physical function and psychosocial well-being using patient-reported outcome measures\".","authors":"Jarod T Griffin, Anita Bagley, Henry Iwinski, Vishwas Talwalkar, Rolando Roberto, David Dueber, Donna Oeffinger","doi":"10.1007/s43390-026-01485-w","DOIUrl":"10.1007/s43390-026-01485-w","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1955-1956"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228076","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":"Analysis of tether breakages during revision after failed thoracolumbar double-row vertebral body tethering.","authors":"Jil Frank, Alice Baroncini, Mahmoud Alkharsawi, Per Trobisch","doi":"10.1007/s43390-026-01345-7","DOIUrl":"10.1007/s43390-026-01345-7","url":null,"abstract":"<p><strong>Purpose: </strong>Vertebral Body Tethering (VBT) yields improving postoperative results. However, tether breakage remains a common complication, especially in thoracolumbar (TL) curves, and can negatively impact the outcome. The pathomechanism behind TL tether breakages is not well understood, yet this knowledge is essential for improving surgical planning. Therefore, the study aimed to investigate the timing and location of tether breakage in double-row (TL) revision cases.</p><p><strong>Material: </strong>This study performed a descriptive analysis of consecutively explanted double-row implants in TL VBT patients who underwent revision due to tether breakage and for whom photographic documentation was available. A > 5° increase in the interscrew angle on consecutive radiographs suggested tether breakage.</p><p><strong>Results: </strong>Data from 50 instrumented levels in ten patients were available. The UIV ranged from T9 to T11 and the LIV from L3 to L4. Revision surgery was performed, on average, 35 months after the index surgery. The study showed that the > 5° rule identified a higher percentage of segments with both tethers broken (68%) than segments with only one broken tether (54%). There was no difference in the occurrence of anterior (61%) and posterior (62%) tether breakage. The anterior tether broke in the distal segment in all ten cases, while the posterior tether broke in the distal segment in nine out of ten cases.</p><p><strong>Conclusion: </strong>This study showed that the distal segment of the lumbar spine is prone for tether breakage. Fewer breakages were observed in the thoracic segments. Additionally, no clear breakage pattern in relation to implant standing time was observed.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1807-1815"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616505","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":"Transverse-plane descriptors and modifiers of the SRS-Lenke-Aubin 3D classification provide complementary and clinically informative 3D features beyond 2D assessment in Lenke 1 AIS curves.","authors":"Carl-Eric Aubin, Brice Ilharreborde, Lawrence G Lenke, Delphine Aubin, Takashi Kaito, Christiane Caouette, Virginie Lafage, Justin S Smith, Jeffrey Mullin, A Noelle Larson, Peter O Newton, Michael G Vitale, Michelle C Welborn","doi":"10.1007/s43390-026-01470-3","DOIUrl":"10.1007/s43390-026-01470-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To investigate how the transverse-plane descriptors and modifiers of the SRS-Lenke-Aubin 3D classification-orientation of the regional plane of deformation (ORPD), apical vertebral rotation (AVR), and apical displacement (3D distance from the apex to the end-vertebrae line, DAEVL)-characterize Lenke 1 thoracic curves and complement conventional 2D Lenke modifiers and radiographic measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;One hundred sixty-two Lenke 1 adolescent idiopathic scoliosis patients underwent 3D reconstruction from preoperative biplanar radiographs. Associations between transverse-plane descriptors (ORPD, AVR, DAEVL) and standard coronal and sagittal radiographic measures (Cobb angles, thoracic kyphosis [TK], lumbar lordosis [LL]) were analyzed across proximal thoracic (PT), main thoracic (MT), and thoracolumbar/lumbar (TL/L) regions. Relationships between classical Lenke modifiers and transverse-plane modifiers derived from the SRS-Lenke-Aubin 3D classification were evaluated using contingency tables, chi-square tests or Fisher-Freeman-Halton exact tests as appropriate, and Cramér's V. Pearson correlations and multivariate linear regression were used to assess regional coupling and the independent contributions of coronal and sagittal parameters to ORPD. Subgroup analyses compared Lenke 1A, 1B, and 1C patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across analyses, substantial inter-patient variability was observed, with wide dispersion of transverse-plane descriptors for similar 2D measurements. Relationships between coronal severity and transverse-plane geometry were region-dependent. ORPD showed no statistically significant association with Cobb magnitude in the PT and MT regions (p &gt; 0.05), whereas a moderate and statistically significant association was observed in the TL/L region (r = 0.4792, p &lt; 0.001). Associations between AVR and Cobb magnitude were weak in PT (r = 0.1688, p = 0.0317) and moderate in both MT (r = 0.4424, p &lt; 0.001) and TL/L (r = 0.4085, p &lt; 0.001). ORPD and AVR were not significantly associated in PT, showed a weak inverse association in MT (r = -0.2177, p = 0.0054), and were moderately associated in compensatory TL/L (r = 0.5342, p &lt; 0.001). TK demonstrated a moderate-to-strong inverse association with MT ORPD (r = -0.6344, p &lt; 0.001), while LL showed no significant association with TL/L ORPD (r = 0.1177, p = 0.1357). DAEVL showed moderate associations with Cobb magnitude across regions and selective coupling with ORPD and AVR. Strong associations were observed between the Lenke lumbar modifier and TL/L ORPD, and between the thoracic sagittal profile modifier and MT ORPD (both p &lt; 0.001), indicating partial overlap but suggesting complementarity between 2D and 3D descriptors. Multivariate regression confirmed region-specific behavior, with MT ORPD primarily influenced by sagittal profile and TL/L ORPD predominantly driven by coronal magnitude. Subgroup analyses revealed distinct 3D signat","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1529-1543"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253022","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":"Incidence and outcomes of spinopelvic fixation loosening following adult spinal deformity surgery.","authors":"John D Arena, Yohannes Ghenbot, Mert Marcel Dagli, Joshua L Golubovsky, Ben Gu, Addison Quinones, Dominick Macaluso, Neil R Malhotra, Zarina S Ali, Brendan F Judy, Jang W Yoon, William C Welch, Vincent Arlet, John H Shin, Ali K Ozturk","doi":"10.1007/s43390-026-01281-6","DOIUrl":"10.1007/s43390-026-01281-6","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the incidence and clinical outcomes of spinopelvic fixation loosening following surgical correction of adult spinal deformity (ASD).</p><p><strong>Methods: </strong>A single-institution retrospective cohort of 152 consecutive patients meeting inclusion criteria who underwent long-segment fusion with pelvic fixation for correction of ASD was reviewed. Pelvic screws were assessed on follow-up post-operative standing radiographs for evidence of loosening. Surgical revision of spinal instrumentation served as the primary outcome. PROMIS Pain Interference and Physical Function T-Scores were assessed as secondary outcomes among the subset of cases (n = 92) with available scores.</p><p><strong>Results: </strong>Pelvic screw loosening was appreciated in 25 cases (16.4%) with initial evidence of loosening identified a median 1.1 years (Q1: 0.8, Q3: 2.5) following surgery. Loosening of pelvic screws (OR 3.0, 95% CI 1.2-7.3, p = .017) was associated with significantly increased odds of eventual instrumentation revision surgery, including specifically surgical revision of spinopelvic fixation (OR 5.5, 95% CI 1.6-18.5, p = .006). 4 of 26 cases (15%) with S2-Alar-Iliac (S2AI) screws required revision surgery compared to 37 of 126 cases (29%) without S2AI screws. PROMIS T-Scores were significantly worse for patients requiring instrumentation revision surgery but did not differ between cases with and without loosening.</p><p><strong>Conclusion: </strong>Loosening of spinopelvic fixation occurs frequently following correction of ASD and can develop years following surgery. While distal construct screw loosening may be appreciated incidentally at follow-up, loosening of pelvic screws was associated with significantly increased odds of eventual instrumentation revision surgery.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1661-1669"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259485","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":"Distal hyperlordotic distribution does not increase the risk of mechanical complications in adult spinal deformity patients undergoing long-construct fusion to the pelvis with optimal global sagittal alignment.","authors":"Lluís Vila, Sleiman Haddad, Eva Jacobs, Susana Núñez-Pereira, Javier Pizones, Anika Pupak, Gina Faragó, Alejandro Gómez-Rice, Ibrahim Obeid, Louis Boissière, Cécile Roscop, Yann Philippe Charles, Ahmet Alanay, Markus Loibl, Frank Kleinstück, Ferran Pellisé","doi":"10.1007/s43390-026-01360-8","DOIUrl":"10.1007/s43390-026-01360-8","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether distal hyperlordotic distribution (DHD), defined by the Lordosis Distribution Index (LDI) from the Global Alignment and Proportion (GAP) score, increases the risk of mechanical complications (MC) in adult spinal deformity (ASD) patients with optimal postoperative global sagittal alignment and total lordosis after long-construct fusion to the pelvis.</p><p><strong>Methods: </strong>Retrospective analysis of a prospective, multicenter database. ASD patients undergoing fusion from L2 or higher to the pelvis with ≥ 2 years follow-up and optimal postoperative global alignment (RSA = 0) and total lordosis (RLL = 0), according to the GAP score, were included. Patients were classified into Ideal (LDI = 0) and DHD (LDI = 3) groups. Rates of MCs (stratified in PJK or PJF), reoperations, and functional outcomes were compared. A post-hoc non-inferiority analysis utilizing a 10% clinical margin was performed.</p><p><strong>Results: </strong>A total of 125 patients met criteria (91 Ideal; 34 DHD). The DHD group, compared to the Ideal group, had a significantly lower preoperative pelvic incidence (50.9° vs. 57.2°, p = 0.014) and more frequently underwent three-column osteotomies (35.3% vs. 18.7%, p = 0.050). At 2-year follow-up, DHD was statistically non-inferior to the Ideal distribution regarding PJFs (absolute risk difference was -7.3%, 90% CI: -16.1% to 1.5%) and for PJKs (absolute risk difference was 1.5%, 90% CI: -6.0% to 9.0%). Reoperation rates (38.2% vs. 28.6%, p = 0.299) and patient-reported functional outcomes were comparable.</p><p><strong>Conclusion: </strong>In ASD patients with pelvic fixation and optimal global alignment, DHD is statistically non-inferior to ideal distributions regarding the risk of MCs, including PJK and PJF, and reoperations. In addition to this, DHD represents a physiological scenario in patients with lower pelvic incidence. Future predictive models should focus on penalizing distal hypolordosis rather than universally penalizing DHD.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1639-1650"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628455","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":"Identifying risk factors for early 30-day postoperative complications following pediatric scoliosis surgery: a systematic review and meta-analysis.","authors":"Sai Sanikommu, Victor M Lu, Sima M Vazquez, Amer Samdani, Steven W Hwang","doi":"10.1007/s43390-026-01351-9","DOIUrl":"10.1007/s43390-026-01351-9","url":null,"abstract":"<p><strong>Background: </strong>Early (within 30 days) postoperative complications following pediatric scoliosis surgery continue to be of clinical importance; however, reported risk factors demonstrate inconsistency across various studies. We conducted a systematic review and meta-analysis to quantify patient- and procedure-related predictors of 30-day postoperative outcomes complications.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Scopus, and Web of Science identified observational studies reporting risk factors for 30-day postoperative complications following scoliosis surgery. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random-effects models. Heterogeneity was assessed with the I² statistic.</p><p><strong>Results: </strong>Ten observational studies comprising 113,082 patients met the inclusion criteria; nine reported adjusted estimates. Osteotomy was significantly associated with increased risk (OR = 1.40; 95% CI 1.25-1.55; I² = 0%), as was pelvic fixation (OR = 1.65; 95% CI 1.07-2.55; I² = 0%), with no observed heterogeneity across studies. In contrast, multiple medical and patient-related risk factors including cardiopulmonary, hematologic and metabolic comorbidities were not significantly associated with postoperative morbidity, although point estimates suggested a directionally elevated risk and were characterized by wide confidence intervals. Male sex and neuromuscular disorders were also not associated with a significant increase in risk.</p><p><strong>Conclusions: </strong>Among the evaluated factors, complex surgical techniques involving osteotomy and pelvic fixation were the most consistent predictors of early postoperative complications within the contemporary literature. Preoperative patient comorbidities showed variable, generally non-significant associations, underscoring the need for standardized risk definitions and prospective multicenter studies to better predict outcomes in the early postoperative period.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1827-1839"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594481","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":"In reply to the letter to the editor regarding \"Does an increased preoperative body mass index (BMI) affect adolescent idiopathic scoliosis surgery outcomes and complications? A meta-analysis\".","authors":"Ralph Maroun, Mohammad Daher, Amer Sebaaly, Alan H Daniels","doi":"10.1007/s43390-026-01424-9","DOIUrl":"10.1007/s43390-026-01424-9","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1943-1944"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006550","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}