Spine deformity最新文献

{"title":"Double claw construct with hooks for proximal fixation in adolescent idiopathic scoliosis: a randomized controlled trial.","authors":"J J M Renkens, A Willems, M Reijman, P de Baat, L W L de Klerk, J P H J Rutges","doi":"10.1007/s43390-025-01161-5","DOIUrl":"https://doi.org/10.1007/s43390-025-01161-5","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal fixation in adolescent idiopathic scoliosis (AIS) surgery is a matter of discussion. All screw (AS) constructs provide better coronal correction than hybrid constructs, but high thoracic pedicle screw placement can be challenging. This study investigated whether an AS-construct provides better correction than a proximal double hook-claw (PH) construct.</p><p><strong>Methods: </strong>AIS patients undergoing posterior spinal fusion (PSF) were randomized to AS-construct or PH-construct from 2016 to 2020 with a two-year follow-up. Primary outcome is the main thoracic (MT) Cobb angle correction after two years. Secondary outcomes are thoracic kyphosis (TK), proximal junctional angle (PJA), proximal thoracic (PT) Cobb angle, SRS-22r, and complications after two years.</p><p><strong>Results: </strong>60 patients (30 AS, 30 PH) were included. No baseline differences were found. Preoperative MT Cobb angle was 62° ± 11° (AS) vs. 65° ± 12° (PH). There was no statistical difference in MT Cobb angle after two years: 25° ± 9° (AS) vs. 27° ± 7° (PH) (p = 0.247). No difference in PT Cobb angle was found: 20° ± 9° (AS) vs. 21° ± 9° (PH) and TK: 23° ± 9° (AS) vs. 22° ± 7° (PH). SRS-22r improved in both groups with no statistical difference: 3.9 ± 0.5 to 4.3 ± 0.5 (AS) vs. 3.7 ± 0.5 to 4.3 ± 0.5 (PH). There were 13 complications (ten patients) in AS group and 17 (13 patients) in PH group, including 1 major complication in each group (deep wound infection).</p><p><strong>Conclusion: </strong>AS-construct does not provide better coronal Cobb correction after two years after surgery. A PH-construct is a reliable and safe option for proximal fixation AIS patients. TRN: NTR-NL5552 (2016).</p><p><strong>Trial registration: </strong>Overview of medical research in the Netherlands (OMON): NL-OMON43852.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967775","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":"Behavior of the un-instrumented lumbar curve following exclusive tethering of the thoracic region.","authors":"Ritt R Givens, Matan S Malka, Christina Carin Rymond, Kevin Lu, Firoz Miyanji, Juan Carlos Rodriguez, Kevin Smit, Ron El-Hawary, Stefan Parent, Walter Huu Truong, Michelle C Welborn, Michael G Vitale","doi":"10.1007/s43390-025-01152-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01152-6","url":null,"abstract":"<p><strong>Introduction: </strong>Anterior vertebral body tethering (AVBT) has recently been utilized as a surgical alternative to posterior spinal fusion for a subset of pediatric scoliosis patients. Indications for AVBT are evolving and, while early results have been promising, there is a paucity of literature examining the behavior of the lumbar curve after exclusive tether of the thoracic region. It was hypothesized that thoracic tether leads to a spontaneous decrease in the un-instrumented lumbar curve.</p><p><strong>Methods: </strong>The study population consisted of 166 patients with idiopathic scoliosis enrolled in the Pediatric Spine Study Group registry undergoing thoracic tether with a minimum of two-year follow-up. Exclusion criteria included: patients with non-idiopathic scoliosis, patients with prior spine surgery, and patients instrumented below L1.</p><p><strong>Results: </strong>Overall curve correction was notable, with mean pre-op, immediate post-op, and two-year follow-up angles of 51.3°, 29.7°, and 30.3° respectively for the thoracic curve and 32.7°, 22.9°, and 24.1° respectively for the un-instrumented lumbar curve. Overall, 124 subjects (74.7%) had a decrease in lumbar curve > 5° immediately post-op. Over a two-year follow-up period, 32 subjects (19%) had a continued decrease in lumbar curve > 5°, 91 subjects (54%) had minimal change, and 43 subjects (26%) had an increase in lumbar curve > 5°. In a subgroup analysis of 36 subjects with a decrease in thoracic curve > 5° from post-op to two-year follow-up, 11 subjects (31%) had a concomitant decrease in lumbar curve with only 5 (14%) showing an increase in lumbar curve > 5°. The changes in lumbar curve from pre-op to post-op and from post-op to two-year follow-up were found to be associated with changes in the thoracic curve for the same periods (rho = 0.603, p < 0.001; rho = 0.413, p < 0.001 respectively). When considering Lenke lumbar modifiers, the un-instrumented lumbar curve corrected an average of 35%, 27%, and 20% following surgery and 27%, 30%, and 17% at two-year follow-ups for A, B, and C curves respectively (p < .001 for all data points compared to pre-op).</p><p><strong>Conclusion: </strong>Lumbar curves tended to mirror the behavior of the maximal thoracic curve in terms of correction or decompensation both during surgery and during the two-year follow-up. Furthermore, un-instrumented lumbar curves with a Lenke C modifier tended to achieve a lower percentage correction. These data provide clearer insights into the response of the lumbar curve following thoracic tethering and the effect of growth modulation.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967837","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":"Internal mechanism failure of magnetic controlled growing rods (MCGRs) for early-onset scoliosis: a systematic review of implant retrieval analysis studies.","authors":"Riaz Mohammed, Pranav Shah, Bnar Massraf, Sashin Ahuja","doi":"10.1007/s43390-025-01171-3","DOIUrl":"https://doi.org/10.1007/s43390-025-01171-3","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetic controlled growing rods (MCGRs) are used to treat early-onset scoliosis when nonsurgical options fail, controlling curve progression and allowing for continued spinal growth. Recent reports of unplanned reoperations and mechanical failure of MCGRs have led to further research. This is a systematic review on the retrieval analysis of explanted MCGR rods. Understanding the failure mechanisms will shed light on the survivorship and complications associated with the implant.</p><p><strong>Methods: </strong>A Medline and EMBASE database search was performed, looking at all variations in the terms \"magnetic controlled growing rods\" and the terms \"retrieval/explant/metallosis\" All published retrieval analysis studies of MCGR were included, and all clinical outcome studies, biomechanical testing studies, review articles, and case reports were excluded. Data were collected regarding the source, year, and aim of the study; number of patients and rods analysed; duration of implantation; and main findings and conclusions.</p><p><strong>Results: </strong>Nine studies (454 rods) reported metallosis due to O-ring damage (67%), internal mechanism failure of locking pins (45%) and rod fracture (7%) in all MCGR generations. Actuator locking pin fractures reported in 174 rods (38.3%) continue to persist despite newer implant iterations. The pin fracture rates decreased from 52% in MAGEC 1.3 to 15% in MAGEC X.</p><p><strong>Conclusions: </strong>MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC.</p><p><strong>Levels of evidence: </strong>MCGR failure is multifactorial, and metallosis is of significant concern because of the unknown long-term effects in patients. Early recognition and revision of existing rods in situ is essential, along with continued efforts to reduce mechanical failure in future iterations of MAGEC. This systematic review provides Level III evidence on failure mechanisms in MCGR, as the results were obtained from Level III studies. The levels of evidence for all relevant references can be found in the reference section.</p><p><strong>Level ii: </strong>[1-4].</p><p><strong>Level iii: </strong>[5-34].</p><p><strong>Level iv: </strong>[35-44].</p><p><strong>Level v: </strong>[45-50].</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967803","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":"Correction: What can we learn from scoliosis in children with the 22q11.2 deletion syndrome? Prognostic factors at pre-adolescent age for fast progressive, mild and self-resolving forms during adolescence.","authors":"Sabrina Donzelli, Peter Lafranca, Maarten van Smeden, René Castelein, Tom Schlösser","doi":"10.1007/s43390-025-01155-3","DOIUrl":"https://doi.org/10.1007/s43390-025-01155-3","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967842","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":"Older adult idiopathic scoliosis patients have greater improvement in self-image compared to younger adult and adolescent idiopathic scoliosis patients following posterior spinal fusion.","authors":"Taylor J Jackson, Fthimnir M Hassan, Matthew Weintraub, Omar Taha, Mehdi Elfilali, Edwin Kulubya, Erik Lewerenz, Justin L Reyes, Riley Sevensky, Josephine R Coury, Andrew Zhang, Michael J Strong, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke","doi":"10.1007/s43390-025-01165-1","DOIUrl":"https://doi.org/10.1007/s43390-025-01165-1","url":null,"abstract":"<p><strong>Purpose: </strong>The complex relationship between spine deformity and self-image is incompletely understood. This study aims to evaluate how age affects self-image in idiopathic scoliosis.</p><p><strong>Methods: </strong>Single-center study of adult (AdIS) and adolescent (AIS) idiopathic scoliosis patients treated with posterior spinal fusion (PSF). Preoperative and two-year postoperative patient-reported, radiographic, and perioperative outcomes were compared. Patients were grouped according to age, AIS (< 1 8 years), young adults (yAdIS, 18-40 years) and older adults (oAdIS, > 40 years).</p><p><strong>Results: </strong>176 patients were included, 54 AIS (ave. 15.8 years), 47 yAdIS (mean 25.2 years), and 74 oAdIS (mean 56.5 years). Preoperative curve magnitude was similar between groups (p = 0.0863). Postoperative, AIS and yAdIS had similar curves, but smaller than oAdIS (p = 0.0104) with similar corrections (p = 0.6476). AIS had lower EBL (p < 0.0001), shorter OR times (p < 0.0001), fewer levels (p < 0.0001) and pelvic instrumentation (p < 0.0001). AIS had greater preoperative self-image scores (3.5 vs. 3.1 vs. 2.5, p < 0.0001) with no difference seen postoperative (4.4 vs. 4.3 vs. 4.2, p = 0.1230). However, the greatest improvement was observed in oAdIS patients (p < 0.0001). Independent predictors of self-image scores varied by age and included anxiety/depression (β = - 1.057), BMI (β = 0.033), and postoperative CVA (β = - 0.021) for AIS; anxiety/depression (β = - 0.513) and curve correction (β = 0.0143) in yAdIS; and postoperative pelvic tilt (β = - 0.028, p = 0.0037) for oAdIS.</p><p><strong>Conclusion: </strong>AIS patients had the highest preoperative self-image scores, followed by yAdIS and then oAdIS. However, the greatest improvement was observed in the older patients, despite more surgical morbidity. Mental health diagnoses were associated with worse self-image scores in AIS and yAdIS, though not oAdIS.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967792","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 growth modulating effects of tether tension on vertebral growth are biphasic: a study of posterior vertebral body tethering (pVBT) in a novel kyphotic porcine model.","authors":"Matthew A Halanski, Brittney Kokinos, Ellen Leiferman, Minhao Zhou, Yousuf Abubakr, Max Twedt, Cameron Jeffers, David Bennett, Susan Hamman, Jennifer Frank, Melanie E Boeyer, Grace D O'Connell, Thomas Crenshaw","doi":"10.1007/s43390-025-01168-y","DOIUrl":"https://doi.org/10.1007/s43390-025-01168-y","url":null,"abstract":"<p><strong>Purpose: </strong>To measure the effects of posterior vertebral tethering (pVBT) on disc pressure and the effect of tether tension on growth modulation in the hyperkyphotic swine model, and to use computational modeling to predict growth modulation in scenarios unable to be tested in the animal model.</p><p><strong>Methods: </strong>Swine were divided into non-operative control, single-level apical pVBT, or multi-level posterior pVBT groups. Pulsed fluorochrome labeling was used to measure regional vertebral growth rates, digital radiographs to assess changes in vertebral alignment, and pressure transducers to measure intervertebral disc pressures. Finite element analysis (FEA) was performed to simulate tether-mediated disc space correction.</p><p><strong>Results: </strong>Kyphotic swine had significantly greater angular kyphosis than control swine at 11- and 13-weeks, and deformities increased from 2 to 5 months of age. At 2-weeks post-operative, high-tension single level tethering resulted in significantly greater growth modulation than low-tension (53 ± 43% vs - 1 ± 15%, p = 0.03) or non-operative controls (p = 0.01), however, at 2-4 weeks, growth modulation was normalized between the low and high tensioned cohorts (14 ± 11% vs 10 ± 10%, p = 0.6). The FEA predicted that growth plate stress distributions worsen as the average disc height post-realignment is decreased.</p><p><strong>Conclusion: </strong>Increased tether tension results in more effective early growth modulation in the young flexible spine without increasing disc pressure, however, these tension-related benefits are transitory as growth modulation becomes load-independent with time. Computational modeling predicted that in the less flexible spine, vertebral growth may be arrested rather than modulated.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967830","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":"Connective tissue disease patients do not have higher rates of PJK compared with idiopathic EOS following growth friendly instrumentation.","authors":"K Aaron Shaw, William Woodhams, John Smith, Paul Sponseller, Josh Pahys, Michael Vitale, Brandon Ramo","doi":"10.1007/s43390-025-01164-2","DOIUrl":"10.1007/s43390-025-01164-2","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal junctional kyphosis (PJK) is a condition frequently encountered in children with early onset scoliosis (EOS) undergoing growth-friendly instrumentation (GFI). Previous studies have identified risk factors but have not compared the rate of PJK between children with connective tissue disease (CTD) and idiopathic EOS (iEOS).</p><p><strong>Methods: </strong>Retrospective review of a multicenter spine database was performed. Patients with EOS undergoing GFI with a minimum of 5 years follow-up were identified and isolated to those with CTD (Marfan, Loeys-Dietz, Ehlers-Danlos, Soto, and Larsen) and idiopathic etiologies. PJK was defined as requiring revision surgery or as having > 10 degree change in proximal junctional angle (PJA). Surgical factors and implant variables were recorded. Radiographic parameters and complication development were compared between groups.</p><p><strong>Results: </strong>A total of 253 children (mean 5.7 years, 57% female) were identified (CTD:49, iEOS:204). A total of 58 patients developed radiographic PJK (23%) with only 11 (18.9%, 4% of total cohort) undergoing revision surgery at 5 years following implantation. There were no identified surgical factors or radiographic variables associated with the development of PJK. In comparing the CTD and iEOS cohorts, there was no difference in PJK (CTD:26.5%, iEOS:22.1%; P = 0.5). Additionally, there were no significant differences between groups for preoperative or 5-year follow-up radiographic parameters, although there was a trend toward greater increase in PJA from post-implant to 5 years in CTD patients (CTD: 2.5 ± 13.8° vs - 0.01 ± 9.9; P = 0.08). CTD and iEOS patients gained similar thoracic heights, 26.6 ± 20.7 mm vs 26.9 ± 21.7 mm (P = 0.8). There was no difference in overall complication rate but CTD patients experienced a greater number of complications/patient (3.1 vs 2.0; P = 0.004).</p><p><strong>Conclusion: </strong>PJK is a pervasive complication in EOS, occurring in 23% of patients undergoing GFI. Having an underlying CTD did not increase the risk of PJK development within 5 years of treatment.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875078","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":"Evaluation of Google and ChatGPT responses to common patient questions about scoliosis.","authors":"Sezgin Bahadır Tekin, Kamil Ince, Bedriye Gizem Tekin, Erkan Servet, Bahri Bozgeyik","doi":"10.1007/s43390-025-01169-x","DOIUrl":"https://doi.org/10.1007/s43390-025-01169-x","url":null,"abstract":"<p><strong>Objective: </strong>Scoliosis is primarily seen during adolescence and often causes significant concern among patients and their families when the deformity becomes noticeable. With technological advancements, patients frequently search the Internet for information regarding their disease's diagnosis, treatment, prognosis, and potential complications. This study aims to assess the quality of Google and ChatGPT responses to questions about scoliosis.</p><p><strong>Methods: </strong>A search was conducted using Google with the keyword \"scoliosis.\" The first ten questions listed under the \"People Also Ask\" (FAQs) section were recorded. Responses to these questions from ChatGPT and Google were evaluated using a four-level rating system: \"Excellent response not requiring clarification,\" \"satisfactory requiring minimal clarification,\" \"satisfactory requiring moderate clarification,\" and \"unsatisfactory requiring substantial clarification.\" Additionally, the sources of the responses were categorized as academic, commercial, medical practice, governmental, or social media.</p><p><strong>Results: </strong>ChatGPT provided \"excellent responses requiring no explanation\" for 9 out of 10 questions (90%). In contrast, none of Google's responses were categorized as excellent; 50% were unsatisfactory, requiring substantial clarification; 40% were satisfactory, requiring moderate clarification, and 10% were satisfactory, requiring minimal clarification. ChatGPT sourced 60% of its responses from academic resources and 40% from medical practice websites. Conversely, Google did not use scholarly sources, with 50% of reactions derived from commercial websites, 30% from medical practice sources, and 20% from social media. When the agreement between the 4 raters, regardless of AI, was examined using Fleiss Multirater Kappa in the reliability analysis, a statistically significant (p < 0.001) moderate agreement (κ = 0.48) was found.</p><p><strong>Conclusion: </strong>ChatGPT outperformed Google by providing more accurate, well-referenced responses and utilizing more credible academic sources. This suggests its potential as a more reliable tool for obtaining health-related information.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862402","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":"Brace yourself (Part-time): part-time bracing leads to curve improvement in juvenile idiopathic scoliosis.","authors":"Christina C Rymond, Rishi Sinha, Omar Taha, Matthew Weintraub, Ritt Givens, Mehdi M Elfilali, Jacob R Ball, Afrain Z Boby, Alondra Concepcion-Gonzalez, Kevin Lu, Ameeka George, Michael G Vitale, Benjamin D Roye","doi":"10.1007/s43390-025-01162-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01162-4","url":null,"abstract":"<p><strong>Purpose: </strong>The efficacy of bracing for juvenile idiopathic scoliosis (JIS) remains controversial. Although full-time bracing is standard for curves > 25°, part-time bracing for smaller curves (< 25°) may prevent progression. This study evaluates the effectiveness of part-time bracing compared to observation in JIS patients with 15-24° curves, hypothesizing that part-time bracing reduces curve progression and the need for full-time bracing.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed skeletally immature JIS patients (4-10 years old) with 15-24° curves. Patients underwent either observation or part-time bracing (8-12 h/day). Minimum two-year outcomes included: (1) curve change (> 5°), (2) progression to > 25° requiring full-time bracing, and (3) prescription for full-time bracing.</p><p><strong>Results: </strong>Eighty-three patients (59% observed, 41% braced) were analyzed. The braced cohort demonstrated slightly higher baseline curves (+ 1.6°, p = 0.01). By final follow-up, braced patients improved by 3.2° (p = 0.05), while the observed cohort worsened by 3.4° (p = 0.05). More braced patients improved > 5° (69% vs. 21%, p < 0.001), whereas more observed patients progressed > 5° (54% vs. 11%, p < 0.001) and to > 25° (54% vs. 20%, p = 0.002). Full-time bracing was prescribed for 63% of observed patients but only 17% of braced patients (p < 0.001).</p><p><strong>Conclusion: </strong>Part-time bracing not only prevents curve progression, but also frequently leads to improved curve magnitude in JIS patients with smaller curves, minimizing the need for full-time bracing.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856227","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":"Improving shoulder balance in lenke type 2 and 4 adolescent idiopathic scoliosis: clinical advantages of a proximal thoracic concave rod technique.","authors":"Ibrahim Obeid, Lluís Vila, Louis Boissière, Cécile Roscop, Alice Baroncini, Yann Philippe Charles, Ferran Pellisé, Javier Pizones, Ahmet Alanay, Frank Kleinstück, Daniel Larrieu, Anouar Bourghli","doi":"10.1007/s43390-025-01157-1","DOIUrl":"https://doi.org/10.1007/s43390-025-01157-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate a novel proximal thoracic concave rod (PTCR) technique for improving postoperative shoulder imbalance (SI) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 2 and 4 curves, compared to conventional methods.</p><p><strong>Methods: </strong>A retrospective study of 30 AIS patients (10 with PTCR, 20 without) from a multicentric European database was conducted. Patients aged ≤ 18 years undergoing surgery for Lenke types 2 or 4 curves with ≥ 2 years of follow-up were included. Radiographic parameters, including Clavicle Angle (CA) and T1 Coronal Tilt (T1CT), were assessed preoperatively, immediately postoperatively, and at 2 years. Demographic, surgical, radiological parameters, and patient-reported outcomes measures (PROMs) were compared between groups.</p><p><strong>Results: </strong>PTCR significantly improved SI, achieving optimal CA in 80% of cases versus 35% in the non-PTCR group (p = 0.02). CA correction was superior in the PTCR group (-1.66° ± 1.34° vs. 1.06 ± 2.59°, p < 0.001). While T1CT correction showed greater improvement in the PTCR group (-3.62° ± 5.56° vs. -0.31° ± 8.13°) it was not statistically significant (p = 0.258). PTCR did not increase surgical time, blood loss, or complications.</p><p><strong>Conclusions: </strong>PTCR is a promising approach for managing shoulder imbalance in AIS patients with Lenke types 2 or 4 curves. Larger prospective studies are necessary to validate these findings.</p><p><strong>Level of evidence: </strong>Level of Evidence: III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856228","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}