Spine deformity最新文献

{"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}

{"title":"Anterior release is not needed to restore kyphosis in moderate AIS with hypokyphosis.","authors":"Craig R Louer, Jacquelyn S Pennings, Maty Petcharaporn, Arun R Hariharan, John S Vorhies, Michael P Kelly, Suken A Shah, Peter O Newton, Burt Yaszay, Harms Study Group","doi":"10.1007/s43390-025-01119-7","DOIUrl":"10.1007/s43390-025-01119-7","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate if AR offers improved 3D kyphosis restoration during PSF for hypokyphosis in moderate AIS (< 70° coronal cobb), where the decision for AR is likely driven by sagittal concerns.</p><p><strong>Methods: </strong>A multicenter pediatric spine registry was queried for hypokyphotic (< 10°) Lenke 1-4 AIS patients aged < 20 years with > 2-year surgical follow-up. Coronal curves were limited to < 70°. A linear mixed model was created to predict 2-year 3D kyphosis by treatment and pre-op 3D kyphosis, while controlling for age, sex, thoracic coronal deformity and flexibility, osteotomy use, implant characteristics, surgery recency, and surgeon.</p><p><strong>Results: </strong>1384 patients were included with 53 (3.8%) undergoing PSF + AR. Mean preop 3D kyphosis was similar between PSF and PSF + AR groups (- 3.7° vs. - 0.5°; p = 0.08). PSF-AR had similar 2-year 3D kyphosis (23.0° [95% CI 20.5-25.4°] vs. 23.3° [22.9-23.6°]) and correction (26.7° [23.3-29.9°] vs. 23.7° [23.3-24.2°]) compared to PSF. When controlling for covariates, the models demonstrated no difference between approach (p = 0.058) or interaction of approach and preop 3D kyphosis (p = 0.31). Post-hoc power analysis showed an adequate sample size to detect a difference of 5° between approaches. PSF + AR had longer surgical times (324 vs. 266 min, p < 0.001) though no significant increase in overall complications (17% vs. 12.4%) compared to PSF alone.</p><p><strong>Conclusion: </strong>In AIS patients with coronal curve < 70° and 3D hypokyphosis of 10 to - 40°, treatment with PSF + AR did not improve 2-year sagittal correction more than PSF alone. Surgeon identity and surgery recency influenced post-operative kyphosis more than any other patient or surgical factor.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1465-1475"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209353","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":"Predictors of massive transfusion of allogenic blood products during posterior spinal fusion in patients with cerebral palsy.","authors":"Ali Asma, Nicholas Gajewski, Suken A Shah, Armagan Can Ulusaloglu, Denver B Kraft, Petya K Yorgova, Paul D Sponseller, Amit Jain, Burt Yaszay, Amer F Samdani, Firoz Miyanji","doi":"10.1007/s43390-025-01091-2","DOIUrl":"10.1007/s43390-025-01091-2","url":null,"abstract":"<p><strong>Purpose: </strong>This article aimed to determine modifiable risk factors to prevent massive blood transfusion of blood products (MTBP) during spinal fusion in patients with cerebral palsy.</p><p><strong>Methods: </strong>Patient data were queried from a prospectively collected multicenter database. Perioperative MTBP was defined as the administration of allogenic blood products equaling at least half (50%) of the patients' preoperative blood volume during the surgical procedure. Univariate and multivariate logistic regression was used for statistical analysis.</p><p><strong>Results: </strong>Three hundred thirty-three patients were included. Ninety-four percent of patients were Gross Motor Classification System IV and V. The incidence of MTBP was 29.7% (99/333). The lack of antifibrinolytic use was significant at univariate analysis. Preoperative low weight, blood volume loss, hybrid system, and unit rod use remained significant after the adjustment in multivariate analysis. Loss of more than 68% of patient blood volume was the threshold for MTBP. Patients receiving MTBP had increased hospital (P = 0.006) and intensive care unit (P < 0.001) stays. However, surgical site complications, deep wound infections, and reoperation rate were not different (P = 0.12, P = 0.46, P = 0.22, respectively). There was a significant decrease in MTBP incidence from 2008 (53%) to 2016 (11%) (P < 0.001) with routine administration of antifibrinolytics.</p><p><strong>Conclusion: </strong>The incidence of MTBP in patients with cerebral palsy undergoing PSF during the study period was 29.7% and this rate has decreased over time, making the surgery safer. Optimization of preoperative nutrition status, use of pedicle screw constructs when possible, and use of antifibrinolytics when not contraindicated is recommended to reduce the risk of perioperative MTBP.</p><p><strong>Level of evidence: </strong>Level III-Retrospective cohort study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1517-1527"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029053","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":"Higher intraoperative blood loss is associated with increased risk of intraoperative neuromonitoring data loss for the type 3 spinal cord shape during spinal deformity surgery.","authors":"Chun Wai Hung, Fthimnir M Hassan, Nathan J Lee, Steven G Roth, Justin K Scheer, Erik Lewerenz, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke","doi":"10.1007/s43390-025-01090-3","DOIUrl":"10.1007/s43390-025-01090-3","url":null,"abstract":"<p><strong>Purpose: </strong>To assess risk factors associated with an increased risk of intraoperative neuromonitoring (IONM) loss among spinal deformity patients with type 3 spinal cord (T3SC) shapes.</p><p><strong>Methods: </strong>This is a retrospective cohort study of adult and pediatric patients with T3SC undergoing spinal deformity surgery from a single center between 2016 and 2023. The primary outcome examined was whether there was IONM data loss. Demographic, clinical, operative, and radiographic variables were compared between patients with and without IONM data loss.</p><p><strong>Results: </strong>A total of 79 patients with T3SC were identified: 31 (39.2%) had IONM data loss, while 48 (60.8%) did not. There were no differences between the groups in terms of age, sex, or BMI (p > 0.05). There were no significant differences in the preoperative and postoperative coronal (C-DAR), sagittal (S-DAR), or total deformity angle ratio (T-DAR) (p > 0.05). There was no difference in the proportion of patients with a VCR, or in the mean instrumented number of levels. There was no difference in measured cord deformation using the area of the spinal cord shape as well as the long- and short-axis dimensions on an axial MRI cut. However, there was a statistically significantly higher EBL (1320.7 ± 614.0 vs. 1049.0 ± 468.4, p = 0.0316), TXA use (2619.8 ± 1333.1 cc vs. 1925.9 ± 1304.2, p = 0.0372), and cell saver salvage (468.5 ± 266.2 vs. 311.5 ± 266.2, p = 0.0264) in the IONM-Loss group.</p><p><strong>Conclusion: </strong>In this largest reported cohort patients with T3SC undergoing spinal deformity surgery, the only factors found to be significantly associated with an increased risk of IONM loss was higher EBL, higher autologous salvage transfused blood volume, and higher TXA given. It is critical for deformity surgeons to be aware of the importance of blood and hemodynamics management when treating this unique and high-risk population.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1573-1583"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011225","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":"A retrospective analysis of patients deemed ineligible for surgery in a multidisciplinary complex spine conference.","authors":"Patricia Lipson, Rafael Garcia de Oliveira, Takeshi Fujii, Jean-Christophe Leveque, Venu M Nemani, Philip K Louie, Rajiv K Sethi","doi":"10.1007/s43390-025-01099-8","DOIUrl":"10.1007/s43390-025-01099-8","url":null,"abstract":"<p><strong>Purpose: </strong>Assess patient experiences and outcomes following a multidisciplinary conference recommendation against surgery, including the proportion who later pursued surgery elsewhere and their outcomes.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients advised against surgery during our internal multidisciplinary ASD conference. A phone-based survey gathered on patient satisfaction, effectiveness of alternative treatments, rates of operations at outside hospitals, and subsequent rates of complications, reoperations, and readmissions among those who underwent surgery.</p><p><strong>Results: </strong>One hundred one patients had an evaluation by a multidisciplinary conference from 2015 to 2024 with an initial recommendation against surgery; 9 later met surgical criteria and underwent surgery with our group, while 17 died before this study. Of the remaining 75, 2 were unable to participate due to medical reasons, and 33 were unreachable, leaving 40 survey participants. Nine declined to answer, and thirty-one completed the survey. Among respondents, 71% were satisfied with the recommendation against surgery, and 38.7% sought a second opinion. Of those, 41.7% (5/12) were recommended surgery, and 33% (4/12) underwent surgery elsewhere with minimal complications. Most respondents rated their quality of life as 'acceptable' and used physical therapy and pain management for symptom control.</p><p><strong>Conclusion: </strong>While most patients were satisfied with our recommendation against surgery, a notable subset sought second opinions, and some ultimately underwent successful surgery. These findings highlight the need for periodic reassessment of multidisciplinary conference criteria to ensure optimal patient outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1585-1594"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034619","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":"The classics in quality and safety: a review of the top cited pediatric spine quality articles in the last 20 years.","authors":"Dominick A Tuason, Sahir S Jabbouri, Daniel J Bouton, Megan Johnson, Lorena Floccari, Brian E Kaufman, Michael P Glotzbecker","doi":"10.1007/s43390-025-01115-x","DOIUrl":"10.1007/s43390-025-01115-x","url":null,"abstract":"<p><p>In recent years, a concerted effort has been directed toward optimizing the quality, safety, and value of pediatric spine surgery. This review identifies the most cited articles from the Scoliosis Research Society's Quality and Safety Library and provides a comprehensive review that discusses perioperative management considerations for children with spinal deformities. It addresses pre-, intra-, and postoperative factors crucial for averting complications and optimizing patient outcomes. The review covers articles that advise the pediatric spine surgeon on classification and appropriate selection of fusion levels to accomplish the goals of a balanced, fused spine with retention of functional mobility. It also discusses strategies for infection prevention, neurologic monitoring response, use of enabling technologies, and mitigation of blood loss during scoliosis surgery. Finally, it examines the more recent use of dedicated pediatric spine teams, rapid recovery protocols, and opioid stewardship to enhance efficiency and accelerate recovery following surgery. This comprehensive review serves as a resource for pediatric spine surgeons, encompassing a spectrum of considerations to optimize safety and value in their practice. The collection of highly cited articles collectively contributes to refining surgical strategies, benefitting practitioners at all experience levels in delivering optimal care to pediatric spinal deformity patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1345-1357"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209354","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":"What happens to the hip after scoliosis surgery in neuromuscular patients? Analyzing factors linked to pain, displacement, and need for surgery.","authors":"Carmen Martínez-González, María Galán-Olleros, Laura Olías-Ortiz, Ana Ramírez-Barragán, Rosa M Egea-Gámez, Rafael González-Díaz, Ignacio Martínez-Caballero","doi":"10.1007/s43390-025-01097-w","DOIUrl":"10.1007/s43390-025-01097-w","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with neuromuscular diseases frequently develop hip displacement (HD) and scoliosis, creating complex challenges in determining the optimal treatment strategy and sequence. This study aims to assess the frequency of new hip problems, including pain and HD progression, as well as the need for additional hip surgery following scoliosis correction in neuromuscular patients, and to identify predictive factors for these issues.</p><p><strong>Methods: </strong>This retrospective study included 71 neuromuscular patients (142 hips) who underwent posterior spinal fusion (PSF) at a specialized center between 2015 and 2022. Clinical data such as age, sex, underlying pathology, ambulatory status, and prior hip surgeries were collected. Radiological parameters, including curve characteristics, coronal imbalance, Cobb angle, pelvic obliquity (PO), and migration percentage (MP), were measured pre- and post-operatively. Descriptive, comparative, and multivariate analyses, including logistic regression, were performed to identify significant predictors and determine optimal cutoff points.</p><p><strong>Results: </strong>The mean age of patients was 15 ± 2 years, with 59% female and 84.5% nonambulatory. After scoliosis surgery, 15.5% of hips developed new hip problems: 20 hips experienced pain and 9 had HD progression, with 7 requiring additional surgery (3 reconstructive and 4 palliative). Factors including a preoperative up-hip and increased MP, with a cutoff > 25%, were strong predictors of hip pain. HD progression was linked to a postoperative up-hip and increased MP, with MP > 60% emerging as a critical predictor. The need for additional hip surgery was associated with cerebral palsy (CP) and with increased MP.</p><p><strong>Conclusions: </strong>Approximately 1 in 7 hips developed new-onset problems following PSF in neuromuscular patients. Factors including a preoperative up-hip and increased MP were significant predictors of adverse outcomes, underscoring the importance of thorough preoperative assessment, personalized surgical planning, and proactive counseling regarding potential postoperative complications.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1497-1506"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045349","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":"Utility of flexibility assessment by preoperative fulcrum-side bending for distal adding-on after posterior corrective fixation in adolescent idiopathic scoliosis Lenke types 1 and 2.","authors":"Tetsutaro Abe, Masashi Miyazaki, Noriaki Sako, Nobuhiro Kaku","doi":"10.1007/s43390-025-01104-0","DOIUrl":"10.1007/s43390-025-01104-0","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the factors associated with distal adding-on (DAO) in Lenke type 1, 2 adolescent idiopathic scoliosis (AIS), particularly concerning flexibility assessment using preoperative fulcrum side bending (FSB). In addition, a secondary aim of this study was to compare the effectiveness of Fulcrum Side Bending (FSB) and Active Side Bending (ASB) radiographs, obtained in standing and supine positions, in assessing the flexibility of the main curve.</p><p><strong>Methods: </strong>We analysed 32 patients who underwent posterior corrective fixation for Lenke type 1, 2 AIS. Correction was performed using the all-pedicle screw method and the fixed caudal end was the last touching vertebra (LTV). Radiographic parameters, such as the standing Cobb angle (proximal thoracic, PT; main thoracic, MT; thoracolumbar, TL), were measured before surgery, after surgery and 2 years postoperatively. The Cobb angle was also evaluated under stress conditions of ASB and FSB, and the difference from the standing Cobb angle was calculated as ΔASB and ΔFSB. Patients were grouped based on the occurrence of DAO.</p><p><strong>Results: </strong>DAO occurred in 12 patients (37.5%); comparing the DAO and non-DAO groups, ΔFSB(PT) (11.2 ± 6.0 vs. 6.9 ± 5.8, p = 0.04) and ΔFSB(MT) (43.9 ± 13.1 vs. 35.9 ± 6.7, p = 0.02) and correction rate (MT) (81.2 ± 8.4 vs. 73.6 ± 9.8, p = 0.02) were significantly greater. Logistic regression analysis showed that the risk factors for DAO were ΔFSB (MT) (odds ratio 1.23 ± 0.098, p = 0.03) and correction rate (MT) (odds ratio 1.17 ± 0.083, p = 0.04).</p><p><strong>Conclusions: </strong>ΔFSB and correction rate in MT were a risk factor for DAO. In cases with large MT corrections, the coronal plane was overbalanced in the TL, which could cause DAO during the postoperative course. Care should be taken in the setting of the lowest instrumented vertebra (LIV) to prevent DAO in patients with significant MT correction on preoperative FSB.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1447-1454"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046041","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":"Posterior spinal fusion outcomes for moderate adolescent idiopathic scoliosis in boys and girls: should we counsel them the same?","authors":"Julia Todderud, Michelle C Marks, Daniel Sucato, Nicholas Fletcher, Peter Newton, Michael Kelly, Keith Bachmann, Stefan Parent, Firoz Miyanji, Burt Yaszay, Patrick Cahill, A Noelle Larson","doi":"10.1007/s43390-025-01096-x","DOIUrl":"10.1007/s43390-025-01096-x","url":null,"abstract":"<p><strong>Purpose: </strong>With this study, we aim to evaluate and compare the perioperative outcomes of PSF for girls and boys. We hypothesize that female patients will have better curve correction and lower rates of complications when compared to male patients.</p><p><strong>Methods: </strong>This study employed a retrospective review of AIS patients who underwent PSF at 23 sites between 2011 and 2021, limited to preoperative curves between 40 and 60° and stratified based on sex assigned at birth. All patients had preoperative and 2-year follow-up and were evaluated for correction, complications, surgery metrics, and patient reported outcomes.</p><p><strong>Results: </strong>1714 patients were included in this study: 1381 girls, 333 boys. At time of surgery, the mean age was 15.4 ± 2 years for girls and 16.4 ± 2 years for boys. Boys were significantly taller and heavier than the girls. The preoperative curve magnitude was equivalent (major Cobb 50° in girls and boys, p = 0.799). Boys and girls had median 10 levels instrumented [IQR 2] (p = 0.012). At 2-year follow-up, girls with primary thoracic curves had better coronal curve measurements (22° ± 7 vs 23° ± 8, p = 0.002) and percent correction (56% ± 14 vs 53% ± 16, p = 0.004). For primary lumbar curves, curve measurements and percent correction were not different. SRS scores for 2-year post-operative patient reported outcomes were not different in boys and girls. 191 girls experienced complications compared to 48 boys (14% of their cohorts, p = 0.31). 67 girls and 14 boys underwent reoperation (5% vs 4%, p = 0.61).</p><p><strong>Conclusions: </strong>At 2 years following spinal fusion for AIS, boys and girls with moderate curves exhibit similar postoperative curve correction and SRS scores. Complication rates had no difference by patient sex.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"1477-1487"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015723","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":"Patient-specific biomechanical modeling of intraoperative scoliosis correction on the 2-year outcomes for thoracolumbar/lumbar vertebral body tethering.","authors":"Marine Gay, Nikita Cobetto, Christiane Caouette, A Noelle Larson, Isabelle Villemure, Daniel Hoernschemeyer, Melanie Boeyer, Ron El-Hawary, Ahmet Alanay, Carl-Eric Aubin","doi":"10.1007/s43390-025-01166-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01166-0","url":null,"abstract":"<p><strong>Purpose: </strong>To biomechanically assess the influence of intraoperative correction and presenting Sanders maturity scores (SS) on growth modulation correction after 2 years in pediatric idiopathic scoliosis treated with Vertebral Body Tethering (VBT).</p><p><strong>Methods: </strong>Lumbar VBT was simulated using patient-specific finite element models (FEMs) from 20 cases of pediatric idiopathic scoliosis (average thoracolumbar/lumbar Cobb 47°; min: 34°, max: 63°), calibrated for preoperative SS, weight, and spine flexibility. The validated FEM included lateral decubitus positioning and VBT instrumentation at the actual upper instrumented vertebra (UIV: T9-T12) and lower instrumented vertebra (LIV: L2-L4). Simulations tested three intraoperative nominal correction levels (35, 50, and 70%) across SS stages (3A, 3B, 4, 5), with immediate and 2-year postoperative corrections computed and analyzed.</p><p><strong>Results: </strong>A 35% intraoperative correction resulted in an immediate post-operative Cobb angle of 37° (23°-54°) but led to under-correction, with a final deformity of 38° (22°-63°) at 2 years. Curve progression occurred in 40% of SS3A cases, particularly in heavier patients (54 kg vs. 38 kg, p < 0.05). A 50% intraoperative correction yielded an immediate post-operative Cobb angle of 27° (16°-40°), with significant improvement at 2 years only in SS3A (p < 0.05). Clinically successful growth modulation (>5° improvement) correlated with lower weight (40 ± 6 kg vs. 54 ± 6 kg, p < 0.05). A 70% intraoperative correction produced an immediate post-operative Cobb angle of 17° (11°-22°) and significant improvement across all SS levels (p < 0.05), with final 2-year angles of 1° (-27° to 10°) for SS3A, 10° (-5° to 10°) for SS3B, 12° (0°-18°) for SS4, and 13° (4°-19°) for SS5. Overcorrection occurred in SS3A (4 cases) and SS3B (1 case).</p><p><strong>Conclusion: </strong>Successful outcomes at 2 years depend on the interaction of key factors, such as intraoperative correction, residual growth potential as defined by preoperative SS, patient weight, spinal flexibility, and mechanobiological growth modulation. The advanced and validated planning tool used for the simulations incorporates these elements, integrating both biomechanical and biological growth dynamics to support a more precise and personalized surgical approach.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967823","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}