Spine deformity最新文献

{"title":"Curve magnitude and vertebral rotation influence the MRI predictability of pedicle dimensions in adolescent idiopathic scoliosis: an analysis of 1,860 pedicles.","authors":"Karthik Ramachandran, Ashish Shankar Naik, Pushpa Bhari Thippeswamy, Ajoy Prasad Shetty, Rishi Mugesh Kanna, Shanmuganathan Rajasekaran","doi":"10.1007/s43390-025-01131-x","DOIUrl":"https://doi.org/10.1007/s43390-025-01131-x","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study is to assess the MRI predictability of pedicle dimensions in AIS patients with curve magnitude more than 50° and to determine the influence of curve magnitude and vertebral rotation on MRI predictability.</p><p><strong>Methods: </strong>The study included a comparative analysis of preoperative MRI (pMRI), and intraoperative CT (iCT) scan images of surgically corrected AIS patients with a curve magnitude of more than 50°. Bilateral T2-L4 pedicle levels were evaluated to measure the chord length and isthmic diameter in pMRI and iCT axial cuts. Vertebral rotation was assessed using the Nash and Moe method. Patients were categorised based on structural curve magnitude into group 1 (50°-70°), group 2 (71°-90°), and group 3 (> 90°).</p><p><strong>Results: </strong>A total of 1860 pedicles in 62 patients were analysed. Comparison between iCT and pMRI measurements showed excellent reliability (ICC > 0.90) for pedicle diameter at all levels except the apical levels. Comparison based on curve magnitude revealed at the apical levels showed good correlation (ICC = 0.87) in Group 1, moderate correlation (ICC = 0.75) in Group 2 and poor reliability (ICC = 0.37) in Group 3. However, the pedicle length showed excellent reliability (ICC = 0.92) across all three groups. Moreover, MRI reliability for predicting vertebral dimensions decreased as the degree of rotation increased.</p><p><strong>Conclusions: </strong>Both the curve magnitude and vertebral rotation significantly impact the MRI prediction of the pedicle dimensions, with predictability decreasing as the curve magnitude and vertebral rotation increase.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326865","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 hidden asymmetry: facet joint tropism as a clue to spinal malalignment and muscle degeneration in adult spinal deformity.","authors":"Ganesh Kumar, Alex T Johnson, Archit Goyal, Vikas Tandon, Rajat Mahajan, Bibhudendu Mohapatra, Kalidutta Das","doi":"10.1007/s43390-025-01133-9","DOIUrl":"10.1007/s43390-025-01133-9","url":null,"abstract":"<p><strong>Objectives: </strong>The role of facet joint tropism (FJT) in degenerative spinal disorders such as disc herniation, spondylolisthesis, and lumbar canal stenosis is well-established. However, its association with adult spinal deformity (ASD) remains underexplored. Hence, we aim to study the correlation of FJT with spinopelvic parameters and lumbar paraspinal muscle morphology in ASD patients.</p><p><strong>Materials and methods: </strong>We analysed 117 patients with ASD from 2021 to 2024. An absolute value difference (ΔFJA) of more than 10 degrees between the right- and left-facet joint angle (FJA) was defined as FJT. We considered patients with FJT at the apex vertebra as the FJT + group and with ASD but without FJT as the FJT- group.</p><p><strong>Results: </strong>The mean ΔFJAs between the FJT + (n = 45) and FJT- (n = 45) were 17.14 and 5.38, respectively. For Cobb angle (CA) > 40˚ (n = 13), 84.6% (n = 11) belonged to the FJT + group. For CA 10-19˚(n = 28), 78.6% (n = 22) belonged to the FJT- group. Of the radiological parameters, differences in CA (p = 0.012), pelvic incidence (PI) (p = 0.031), grades of vertebral body rotation (VBR) (p = 0.022), facet joint osteoarthritis grades (FJOA) (p = 0.040) and cross-sectional area (CSA) of concave multifidus muscle (MF) (p = 0.010) were statistically significant between both the groups. The CSA of MF was decreased on the concave side (2.45 cm²) compared to the convex side (3.70 cm²) and was negatively correlated with ΔFJA (R² = 0.642, p = 0.020). The ΔFJA had significant positive correlation with CA (R² = 0.550, p = 0.010), PI (R² = 0.624, p = 0.030), grades of VBR (R² = 0.610, p = 0.007), and grades of FJOA (R² = 0.780, p = 0.005).</p><p><strong>Conclusions: </strong>Patients with ASD and FJT exhibited greater Cobb angle, higher PI, higher grades of FJOA and VBR, and lower CSA of concave MF. However, the role of facet joint tropism in adult spinal deformity-whether causal or compensatory-warrants validation through longitudinal, long-term studies.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333849","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":"Severe scoliotic deformities: results of surgical treatment and complications in a multicentric series of children and young adults.","authors":"Alice Baroncini, Aude Kerdoncuff, Daniel Larrieu, Cedric Barrey, Federico Solla, Christian Morin, Corinne Bronfen, Adele Hapiette, Gauthier Eloy, Richard La Croix, Thierry Odent, Ibrahim Obeid","doi":"10.1007/s43390-025-01122-y","DOIUrl":"https://doi.org/10.1007/s43390-025-01122-y","url":null,"abstract":"<p><strong>Purpose: </strong>The surgical management of severe spinal deformities (> 80°) in children and young adults remains challenging despite technical advances. Large, stiff curves with a short radius present a high complication rate, also in terms of acute or chronic spinal cord injury. There is a lack of consensus regarding the perioperative management of these curves, also due to the limited evidence available. This study aimed to review the strategies used in different hospitals for the surgical management of severe spinal deformities in young subjects and, in particular, to analyze the complication rate in a large series of patients.</p><p><strong>Methods: </strong>Multicentric, retrospective study on surgically treated patients younger than 25 with a coronal or sagittal deformity measuring at least 80°. Perioperative and radiographic data were collected. The rate of mechanical, neurologic, infectious, and other complications was analyzed, along with possible risk factors.</p><p><strong>Results: </strong>Data from 161 patients were analyzed. After surgery, there was a significant improvement of the deformity both on the coronal and sagittal plane. The overall complication rate was 25%. An increased angular ratio in the first postoperative X-ray was the main risk factor for the development of complications, along with a higher correction of the spinosacral angle. Performing a 3CO was associated with a higher risk of infections but not with a higher risk of mechanical complications. The use of an anterior approach did not increase the complication rate. A higher rate of non-mechanical and non-infectious complications was observed in patients who did not wear a brace or did not undergo halo traction before surgery.</p><p><strong>Conclusion: </strong>While spinal fusion is an effective treatment for the management of severe deformities, the rate of complications is still high.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326867","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":"Incidence of neurological deficits following proximal junctional kyphosis or failure in adult spinal deformity surgery: a systematic review and meta-analysis.","authors":"Abdullah M Alharran, Muteb N Alotaibi, Nizar Algarni, Mohammad A M A Mohammad, Mohammed T M H Alajmi, Ahmad A Alahmad, Yousef Marwan","doi":"10.1007/s43390-025-01117-9","DOIUrl":"https://doi.org/10.1007/s43390-025-01117-9","url":null,"abstract":"<p><strong>Introduction: </strong>Adult spinal deformity surgery is frequently performed to address degenerative conditions and scoliosis, but postoperative complications such as proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are common. These conditions can lead to neurological deficits and compromised surgical outcomes. This systematic review and meta-analysis aimed to evaluate the prevalence of neurological deficits associated with PJK and PJF.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted following PRISMA guidelines. A comprehensive search was performed across multiple databases, including PubMed, Web of Science, Cochrane, Embase, and Scopus, with no language restrictions. Studies that reported neurological deficits following PJK or PJF after adult spinal deformity surgery were included. Data extraction and quality assessment were performed by two independent authors using NIH quality assessment tools. Meta-analysis was conducted using random-effect models, and heterogeneity was evaluated using I².</p><p><strong>Results: </strong>Thirteen eligible studies were identified involving 2846 patients. Of these, 777 patients developed PJK or PJF, with 61 patients experiencing neurological deficits. The pooled prevalence of neurological deficits was 6.2% for PJF (95% CI: 0.062-0.192; p < 0.001) and 7.1% for PJK (95% CI: 0.027-0.115; p < 0.001). Heterogeneity amongst the studies was high for PJF (I² = 70.25%) and low for PJK (I² = 14.47%).</p><p><strong>Conclusion: </strong>This study highlights the incidence of neurological deficits following PJK and PJF in adult spinal deformity surgeries. Future research should focus on identifying the risk factors and utilising evidence-based strategies that can improve postoperative care and reduce complication rates.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326866","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":"Outcomes after vertebral body tethering for Lenke type 5 scoliosis continue to improve: analysis of different surgical techniques.","authors":"Per D Trobisch, Hong Jin Kim, Jil Frank, Pierre Noelen, Dong-Gune Chang","doi":"10.1007/s43390-025-01130-y","DOIUrl":"https://doi.org/10.1007/s43390-025-01130-y","url":null,"abstract":"<p><strong>Purpose: </strong>Vertebral Body Tethering (VBT) is a motion-preserving surgical technique for treating adolescent idiopathic scoliosis (AIS), particularly for thoracolumbar (TL) curves. While the technique has demonstrated potential benefits, its outcomes remain less predictable compared to posterior spinal fusion (PSF), with complications, such as tether breakages and revision surgeries. This study evaluates the impact of surgical experience and implant modifications on the outcomes of TL VBT for Lenke type 5 curves.</p><p><strong>Methods: </strong>A retrospective analysis was performed on all consecutive AIS patients who underwent TL VBT from 2017 to 2022. The cohort was divided into three groups based on surgical technique and implant evolution: Group 1 (single-tether), Group 2 (double-tether), and Group 3 (advanced experience with 2nd generation implants). Radiographic outcomes, success rates (defined as a postoperative Cobb angle ≤ 30°), and complications were analysed at 1- and 2-year follow-ups.</p><p><strong>Results: </strong>30 patients were included. Average correction rates were 53.7%, 62.6%, 71.2% for groups 1, 2, and 3. Group 3 had a 100% success rate at 2 years, compared to 42.9% in Group 1 and 40% in Group 2 (P = 0.010). Early tether breakage rate (at 1 year) significantly correlated with experience (85.7% vs. 40% vs. 12.5%). Revision rate was 28.6% for Group 1 and 0 for groups 2 and 3.</p><p><strong>Conclusions: </strong>These findings suggest that advanced surgical techniques and improved implants are key to achieving superior radiological outcomes and reducing revision rates.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302769","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":"Examining the impact of adolescent idiopathic scoliosis on psychosocial well-being and physical function: revealing insights from patient-reported outcomes.","authors":"Donna J Oeffinger, Henry Iwinski, Vishwas Talwalkar, Rolando Roberto, David Dueber, Anita Bagley","doi":"10.1007/s43390-025-01120-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01120-0","url":null,"abstract":"<p><strong>Purpose: </strong>Using patient-reported questionnaires (PROs), the impact of adolescent idiopathic scoliosis (AIS) on psychosocial well-being domains of Self-Image, Self-Esteem, Mental Health and Peer Relationships, and the interplay between these domains, physical function and clinical measures was investigated.</p><p><strong>Methods: </strong>95 patients from a convenience cohort with AIS completed questionnaires (SRS-22r, SAQ, PODCI, PROMIS, and Harter's Self-Perception Profile), and clinical data were collected. PRO scores analyses included descriptive statistics, unpaired t-test comparing typical peers and correlations. Scores on PRO domains for the lowest interquartile groups (LowIQR) were compared with the Remaining Cohorts (RC) using t tests, and differences were evaluated using Cohen's d statistic.</p><p><strong>Results: </strong>The entire study cohort reported psychosocial well-being similar to their AIS and typical peers. Scores on PsychoSocial Self-Image measures and PODCI Happiness, a mental health domain, and physical function measures of PODCI Transfer&Mobility and Sports&Physical Function were worse than typical population. Curve severity and clinical measures were not linked to PRO scores. For LowIQR patients, scores were statistically worse than the RCs in many domains with effect sizes indicating clinically noticeable differences. Patients in LowIQRgroups reported scores below typical peers on Mental Health, Self-Esteem and global self-image measures, while RC did not.</p><p><strong>Conclusions: </strong>This research enhances the clinical utility of PROs for assessing psychosocial well-being in patients with AIS by establishing thresholds for identification of patients reporting scores worse than their AIS peers. Interventions targeting psychosocial well-being may help mitigate the potential negative impact of scoliosis on adolescents.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294926","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":"Comparing surface topographic range of motion in pediatric patients with Scheuermann kyphosis to healthy controls.","authors":"Jenna L Wisch, Akshitha Adhiyaman, Ankush Thakur, Colson P Zucker, Benjamin N Groisser, Patrick Nian, Amith Umesh, Ram Haddas, M Timothy Hresko, Matthew E Cunningham, John S Blanco, Howard J Hillstrom, Roger F Widmann, Jessica H Heyer","doi":"10.1007/s43390-025-01126-8","DOIUrl":"https://doi.org/10.1007/s43390-025-01126-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares the range of motion (ROM) in all three planes in patients with Scheuermann kyphosis (SK) to healthy controls using surface topographic (ST) scanning.</p><p><strong>Methods: </strong>SK patients and healthy controls between 11-21 years old were recruited prospectively. Patients underwent ST scanning in maximal forward bend, twist to the right and left, and side-bend to the right and left. Sagittal, axial, and coronal ROM were computed using an automated pathway. An analysis of variance was used to determine significant differences in the ROM (coronal, axial, and sagittal) and asymmetry (coronal and axial) of SK patients versus controls. Scoliosis Research Society (SRS) 22r total, self-image, pain and function, as well as Patient-Reported Outcome Measurement Information System (PROMIS) mobility, physical activity and pain interference scores, and HSS Pedi-FABS were collected for all patients.</p><p><strong>Results: </strong>23 patients with SK and 98 controls were analyzed. SK group was 78.3% male with BMI of 24.1 kg/m², average thoracic kyphosis angle of 75.0°. Control group was 55.1% male with a BMI 20.9 kg/m². Compared to controls, patients with SK had 18.0° less sagittal, 12.0° less coronal ROM, and 15.5° less axial ROM. Controlling for age, sex, BMI, HSS Pedi-FABS did not change significance except for axial asymmetry index when controlling for sex. Patients with SK had lower SRS22r pain scores (4.1 vs. 4.4, p = 0.023), SRS22r self-image scores (3.5 vs. 4.5, p < 0.001) and SRS22r total scores (3.9 vs. 4.4, p < 0.001) compared to controls.</p><p><strong>Conclusions: </strong>Patients with SK have reduced ROM in all three planes measured by ST, compared to controls. The restriction in motion is accompanied by lower SRS22r pain and total scores, indicating that motion may play an important role in a patient's quality of life. This study is limited by the lack of evaluation of extension when assessing sagittal range of motion, which has previously been documented to be compromised by SK.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275897","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":"Comparative meta-analysis of vertebral body tethering and posterior spinal fusion in patients with idiopathic scoliosis. Evaluation of radiographic, perioperative, clinical, patient-reported outcomes, and complication rates.","authors":"Stavros Stamiris, Cornelius Sofos, Athanasios Sarridimitriou, Panagiotis Kakoulidis, Panagiotis Christidis, Dimitrios Stamiris, Elissavet Anestiadou, Angeliki Cheva, Christiana Chatzianestiadou, Pavlos Christodoulou, Christos Karampalis","doi":"10.1007/s43390-025-01113-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01113-z","url":null,"abstract":"<p><strong>Background: </strong>Although posterior spinal fusion (PSF) is considered the gold standard for the treatment of idiopathic scoliosis, it has been associated with several limitations. Vertebral body tethering (VBT) offers a motion-preserving alternative, with growing evidence supporting its clinical efficacy.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Cochrane, Web of Science and Scopus databases was performed to identify comparative studies between VBT and PSF in patients with idiopathic scoliosis. Primary outcomes included major curve correction and postoperative major and minor curve angles. Secondary outcomes included radiographic parameters (shoulder height difference, spinal height gain, coronal balance, thoracic kyphosis, lumbar lordosis), perioperative metrics [length of stay (LOS), estimated blood loss (EBL), operative time, instrumented levels], patient-reported outcomes [Scoliosis Research Society-22 Questionnaire (SRS-22)], complication and revision rates.</p><p><strong>Results: </strong>Seventeen studies met the inclusion criteria. VBT patients required shorter instrumentations (p < 0.00001). PSF achieved lower postoperative major (p < 0.00001) and minor curve angles (p = 0.00001), better coronal balance (p = 0.005) and superior major curve correction from baseline (p < 0.00001), but with questionable clinical significance. VBT demonstrated greater lumbar flexion capacity (p < 0.00001), superior shoulder balance (p < 0.00001) and better outcomes in SRS-22 pain (p = 0.02), satisfaction (p = 0.03) and function (p = 0.02) at two-year follow-up. VBT also had shorter operation times (p = 0.0007), less blood loss (p < 0.00001), but higher complication (p = 0.0002) and revision rates (p < 0.00001). No difference detected in lumbar lordosis (p = 0.08), thoracic kyphosis (p = 0.15), SRS-22 self-image (p = 0.20) and total (p = 0.12), lumbar side bending (p = 0.81), axial rotation (p = 0.43) and hospital stay (p = 0.7).</p><p><strong>Conclusions: </strong>PSF demonstrates superior coronal spinal alignment, along with lower complication and revision rates. In contrast, VBT offers better preservation of spinal motion, improved shoulder balance, enhanced early quality of life, and reduced blood loss and operative time, while requiring shorter instrumentations. Treatment decisions should be individualized, taking into account patient-specific factors. Long-term outcome data are needed to guide clinical practice.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249406","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":"Multicenter validation of a surgical planning tool for lumbar vertebral body tethering simulating growth modulation over 2 years.","authors":"Nikita Cobetto, Marie-Ève Fecteau, Christiane Caouette, Marine Gay, A Noelle Larson, Dan Hoernschemeyer, Melanie Boeyer, Ron El-Hawary, Ahmet Alanay, Carl-Eric Aubin","doi":"10.1007/s43390-025-01123-x","DOIUrl":"https://doi.org/10.1007/s43390-025-01123-x","url":null,"abstract":"<p><strong>Purpose: </strong>Vertebral body tethering (VBT) for lumbar curves may have wider application than for thoracic curves due to greater growth potential than thoracic spine and benefits of preserved flexibility. Predicting long-term correction remains challenging, with high revision rates and complications (14-32%) including under-/over-correction, tether breakage, adding-on. This study aimed to validate a planning tool for lumbar VBT using a patient-specific finite element model (FEM) integrating mechanobiological growth modulation as a function of preoperative skeletal maturity.</p><p><strong>Methods: </strong>Thirty-five retrospective idiopathic scoliosis patients who underwent lumbar VBT, with or without concomitant thoracic VBT, were included. A personalized FEM calibrated to preoperative spine deformity, flexibility and weight was created using 3D radiographic reconstructions. The FEM was linked to an algorithm integrating spine growth and mechanobiological growth modulation, calibrated using preoperative Sanders score. VBT surgery was simulated to replicate immediate postoperative correction and predict two-year correction. Simulated Cobb angles, sagittal curves, and apical axial rotation were compared to actual two-year radiographic measurements.</p><p><strong>Results: </strong>Preoperative Cobb angles averaged 37 ± 12° (thoracic) and 48 ± 9° (thoraco-lumbar/lumbar). Immediate postoperative correction was 38 ± 15% and 59 ± 16%, with two-year corrections of 44 ± 24% and 73 ± 21%, respectively. Simulated postoperative correction was accurate within 3° (Cobb angles), while simulated 2-year outcomes were accurate within 3° (Cobb), 2° (kyphosis), 4° (lordosis), and 3° (axial rotation), showing no significant differences from reference results (p < 0.05; statistical power 90%).</p><p><strong>Conclusion: </strong>The patient-specific FEM and growth modulation algorithm accurately predicted two-year correction. This tool can support preoperative planning, reduce surgeon variability, and potentially improve VBT outcomes by providing a predictive tool to help surgical planning.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249407","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":"Racial disparities in pediatric spinal fusion surgery affect perioperative outcomes: a national multicenter study.","authors":"Alden H Newcomb, Haseeb E Goheer, Christopher G Hendrix, Amanda W Hayes, W Garret Burks, Jonathan J Carmouche","doi":"10.1007/s43390-025-01094-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01094-z","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the effect of race and ethnic differences in perioperative outcomes and short-term complications in patients undergoing pediatric spinal fusion surgery.</p><p><strong>Methods: </strong>A retrospective cohort study was performed using prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP-Pediatric) Pediatric database merged with the Pediatric Spinal Fusion Procedure Targeted database from 2016 to 2022 to identify pediatric patients under 18 years who had undergone any spinal fusion procedure for scoliosis using Common Procedural Terminology codes. The study population was divided into four cohorts (1) White (2) Black (3) Asian and (4) Other or Unknown. One-way ANOVA for continuous variables and chi-square tests for categorical variables were used to identify differences in perioperative variables between the four groups. Multivariable logistic regression analysis assessed the effect of race on perioperative surgical and medical complications, extended hospital length of stay, and intensive care unit stay (ICU). Significance was defined as p < 0.05.</p><p><strong>Results: </strong>A total of 39,666 pediatric spinal fusion patients were identified between 2016 and 2022, of which 25, 521 were White, 6007 were Black, 1342 were Asian, and 6796 were unknown or other. Black and Asian patients experienced significantly higher rates of postoperative medical complications at 75.70 and 74.52%, compared with 69.03% for White patients (p < 0.001). Both Black [OR: 1.383, 95% CI (1.292-1.481)] and Asian [OR: 1.320, 95% CI (1.157-1.509)] patients had an independently increased risk for medical complications, whereas only Black patients had an increased risk for ICU stay [OR: 1.222, 95% CI (1.143-1.306)] complications following a multivariate logistic regression analysis (p < 0.001).</p><p><strong>Conclusions: </strong>This study provides evidence of racial disparities in outcomes after pediatric spine surgery, even after controlling for demographic and health factors. Pediatric Black and Asian patients undergoing pediatric spinal fusion have a significantly higher risk of postoperative medical complications compared with White patients. These findings emphasize the need to focus on identifying the root cause and ways to reduce racial disparities in pediatric spine surgery. The present study brings awareness to the disparity in the pediatric spine population and is useful as we work towards the reduction in such disparities and their root causes.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235098","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}