Spine deformity最新文献

{"title":"Pelvic asymmetry in children with neuromuscular scoliosis: a computed tomography-based 3D analysis.","authors":"Arispe Juan Pablo, Carlos Tello, Piantoni Lucas, Galaretto Eduardo, Remondino Rodrigo, Calcagni Julián, Noel Mariano","doi":"10.1007/s43390-024-01025-4","DOIUrl":"https://doi.org/10.1007/s43390-024-01025-4","url":null,"abstract":"<p><strong>Purpose: </strong>Pelvic fixation in pediatric neuromuscular patients with scoliosis is performed when significant pelvic obliquity is present. Instrumentation to the pelvis can be technically demanding and challenging, often associated with a high complication rate, prolonged operative time, increased radiation exposure, and increased intraoperative bleeding. The high complexity of the pelvic instrumentation technique, particularly in severe cases, led us to develop computed tomography (CT)-based 3D in a series of 53 consecutive neuromuscular patients. This analysis aimed to improve the understanding of pelvic asymmetry and preoperatively simulate pelvic instrumentation.</p><p><strong>Methods: </strong>A CT-based 3D analysis of all pelvises was performed using Mimics software (version 21), segmenting them for analysis in all three planes. We proceeded with the simulation of pelvic instrumentation with iliac screws, obtaining the angle values and corresponding orientations in the three planes for each screw. A total of 53 CT scans were analyzed, corresponding to 36 patients with myelodysplasia and 17 with neuromuscular disorders.</p><p><strong>Results: </strong>Pelvic asymmetry was observed in 88.6% (47 CT scans) of the patients. This asymmetry indicated that the weight-bearing hemipelvis underwent anatomical changes compared to the contralateral hemipelvis, including opening or closing of the pelvis relative to the sacroiliac joint, pivoting of the hemipelvis in a cephalocaudal or caudocephalic direction, and shortening of the innominate line.</p><p><strong>Conclusion: </strong>The shape of the weight-bearing hemipelvis is closely related to pelvic asymmetry. A distinct pattern was identified, characterized by cephalic or caudal pivoting, greater prominence of the iliac crest, increased distance from the sciatic spine to the coccyx, and shortening of the innominate line. This finding is relevant for surgical planning and pelvic fixation.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459487","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":"Assessing blood volume returned with use of intraoperative cell salvage in adult spinal deformity correction.","authors":"Katherine D Drexelius, Lindsey E Miller, Rebecca J DeCarlo, Trent A VanHorn, Michael A Bohl","doi":"10.1007/s43390-025-01055-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01055-6","url":null,"abstract":"<p><strong>Purpose: </strong>While multiple studies have evaluated the role of intraoperative red blood cell salvage (IOCS) in instrumented posterior spinal fusion as a method to reduce allogenic blood transfusion and its associated risks and cost, few studies have quantified the blood available for return to the patient when using IOCS. Given this paucity of data, the purpose of this study was to evaluate the relationship between estimated blood loss and cell saver volume returned.</p><p><strong>Methods: </strong>Patients aged 18 years or older who underwent elective spinal fusion for correction of deformity requiring six or more levels of fusion were included. Demographic data, surgical details, EBL as measured by cell saver, and cell saver blood volume returned were recorded.</p><p><strong>Results: </strong>138 consecutive patients were included in the study. Average EBL as measured by cell saver across 138 cases was 734 cc. Based on patients' height, weight, and sex, the average percentage of estimated circulating blood volume lost during surgery was 15.9%. Average EBL per level was 84.2 cc.; mean percentage of total blood volume lost per level was 1.8%. Average blood volume returned was 256 cc., resulting in an average 34.9% of blood loss returned to the patient via IOCS.</p><p><strong>Conclusions: </strong>On average, 34.9% of blood lost was subsequently transfused. While literature on this topic is very limited, this finding was similar to smaller cohorts that have examined IOCS autologous transfusion volumes. A better understanding of the available fraction of blood for return may allow providers to predict the need for allogenic blood transfusion or more clearly evaluate cost effectiveness of IOCS.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441988","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":"Is there any difference in the perioperative outcome between male and female adolescent idiopathic scoliosis patients undergoing posterior spinal fusion? A propensity score matching analysis study of 570 patients.","authors":"Chee Kidd Chiu, Siti Mariam Abd Gani, Yuki Mihara, Mohd Shahnaz Hasan, Chris Yin Wei Chan, Mun Keong Kwan","doi":"10.1007/s43390-025-01057-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01057-4","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the perioperative outcome differences between male and female AIS patients who underwent posterior spinal fusion (PSF) surgeries.</p><p><strong>Methods: </strong>This was a retrospective study of 570 patients (84 male, 486 female). Patients were divided into male and female groups. A propensity score matching analysis was performed with match tolerance of 0.005. Preoperative data collected were age, height, weight, body mass index (BMI), Lenke curve classification, preoperative Cobb angle, and preoperative flexibility. Intraoperative data collected were operation duration, intraoperative blood loss, amount of salvaged blood, number of patients required transfusion, number of screws and fusion level. Postoperative data collected were postoperative hemoglobin, postoperative Cobb angle, correction rate, length of postoperative hospital stay and perioperative complications.</p><p><strong>Results: </strong>Before matching, age, height, weight, and fusion level showed significant difference between genders (p < 0.05). After matching, there was no difference in the perioperative outcome parameters. When matched patients excluding height and weight, males had significantly longer wound, higher intraoperative blood loss and more blood salvaged from cell saver. When matched patients excluding fusion levels, males had significantly higher intraoperative blood loss. When matched patients excluding age, we found no significant differences.</p><p><strong>Conclusion: </strong>Male AIS patients who underwent PSF surgeries were older, taller, heavier and had longer fusion levels but there was no difference in perioperative outcomes between matched male and female patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441989","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":"Spinal deformity transitional care from pediatric to adult population: a descriptive study.","authors":"Mélanie Ta, Marc Khalifé, Christophe Glorion, Pierre Guigui, Stéphanie Pannier, Emmanuelle Ferrero","doi":"10.1007/s43390-024-01024-5","DOIUrl":"https://doi.org/10.1007/s43390-024-01024-5","url":null,"abstract":"<p><strong>Background: </strong>Spinal deformity can develop in childhood and adulthood. There is often a loss of follow-up for these patients during the transition to adulthood. The aim of this study was to describe the management of those patients. Hypothesis transitional care enhances patient's adherence to long-term follow-up.</p><p><strong>Methods: </strong>A consultation was organized between two orthopedic surgery departments, one pediatric and the other adult, to ensure a transitional follow-up. All patients followed up in the pediatric department for spinal deformity between 2019 and 2021 were included (Ped group). Patients referred to the adult department were analyzed (Ped_Ad group). Data collected included type of deformity, age at first and last consultation, overall follow-up time, and number lost to follow-up (LTFU).</p><p><strong>Results: </strong>Overall, 383 patients were included: 11% were referred to an adult center (Ped_Ad), and 89% remained in pediatrics (Ped). Age at first and last consultation was significantly higher in the Ped_Ad group. Mean follow-up time was 4 years in both groups. In the Ped group, 18% of patients had undergone surgery, versus 61% in the Ped_Ad group. The rate of LTFU was twice higher in the Ped group (25%) than in the Ped_Ad group (12%), but the difference was not significant (p = 0.07). Among LTFU, patients aged between 14 and 16 years were the most represented (53%), and they were most often unoperated patients in the Ped group.</p><p><strong>Conclusion: </strong>When adult follow-up was organized, adherence to follow-up was better. This would enable patients to be managed earlier, in the event of worsening of an unoperated deformity.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433648","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":"Does transitioning to a dual surgeon approach improve outcomes for posterior spinal fusion of adolescent idiopathic scoliosis and neuromuscular scoliosis?","authors":"Nicholas B Taylor, Dana Perim, Marlon Murasko, Ashar Ata, Kelley Banagan","doi":"10.1007/s43390-025-01059-2","DOIUrl":"https://doi.org/10.1007/s43390-025-01059-2","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective, chart review.</p><p><strong>Purpose: </strong>Improvements in operative time, blood loss, and length of stay (LOS) when using a dual surgeon approach for the treatment of scoliosis have been suggested in the literature; however, the external validity of these findings has been debated. In this study, we examined the impact of transitioning from a single surgeon to a dual surgeon approach in the treatment of adolescent idiopathic scoliosis (AIS) and neuromuscular scoliosis (NMS) across non-contemporary periods at a single institution.</p><p><strong>Methods: </strong>Through a retrospective chart review we identified 208 adolescent patients who underwent spinal fusion for the treatment of AIS or NMS between November 2015 and January 2022. The 73 cases meeting inclusion criteria were analyzed for operative time, blood loss, pre-and post-operative Cobb angles, and hospital length of stay.</p><p><strong>Results: </strong>The dual surgeon AIS group was found to have a shorter hospital (3.6 vs. 5.2 days, p < 0.001) and ICU length of stay (0.3 vs. 3.7 days, p < 0.001), greater Cobb angle correction (35.6 vs. 23.3 degrees, p < 0.001), and lower transfusion requirement compared to the single surgeon AIS group (0.1 vs. 0.7 units, p = 0.003). Total operative time and estimated blood loss (EBL) were not significantly different. The dual surgeon NMS group only showed shorter ICU length of stay (2.9 vs. 9.1 days, p = 0.043).</p><p><strong>Conclusions: </strong>Utilizing a dual surgeon approach for AIS patients could improve hospital and ICU length of stay, blood transfusion requirements, and Cobb angle correction without an increase in operative time.</p><p><strong>Level of evidence: </strong>Level III, retrospective, comparative study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425937","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":"Pain catastrophizers undergoing posterior spinal fusion (PSF) for idiopathic scoliosis have lower preoperative SRS-30 scores but do not require increased postoperative narcotics.","authors":"Elaine Tran, David Thornberg, Anne-Marie Datcu, Chan-Hee Jo, Brandon Ramo","doi":"10.1007/s43390-025-01058-3","DOIUrl":"https://doi.org/10.1007/s43390-025-01058-3","url":null,"abstract":"<p><strong>Background: </strong>Pain catastrophizing has been linked to poorer patient-reported pain outcomes for orthopedic surgery, but its effect on perioperative pain and narcotic use is poorly understood. Our purpose was to determine if pain catastrophizing has a negative effect on perceptions of perioperative pain and narcotic use in patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis (IS).</p><p><strong>Methods: </strong>A retrospective, IRB-approved review of prospectively collected data of IS patients undergoing PSF. Patients were considered PCs when they scored above the 75th percentile in the PCS (total score ≥ 30). Inpatient narcotic consumption was calculated as morphine equivalent per Kg (mEq/Kg).</p><p><strong>Results: </strong>Five hundred seventeen patients (411F, 106M) underwent PSF for IS. Forty-five (8.7%) patients were pain catastrophizers (PCs). PC patients had significantly lower pain, appearance, and mental scores. PCs scored slightly higher on VAS pain scores (2.20 vs 1.92, p = 0.015) in the first 24 h only. There were no differences in opioid use between PC vs. non-PC cohorts for inpatient (2.01 vs 2.14 mEq/Kg, p = 0.4), discharge (5.6 vs 5.87 mEq/Kg, p = 0.3), or total narcotics (7.61 v 8.01 mEq/Kg, p = 0.2). Fifty-five patients out of five hundred seventeen requested narcotic refills with no difference in refill rates between cohorts (p = 0.7076).</p><p><strong>Conclusion: </strong>We found that pain catastrophizers had lower pre-operative SRS-30 scores across all domains except satisfaction. We found no association between pain catastrophizing and increased opioid use in either the inpatient stay or post-discharge. While pain catastrophizing has been associated with lower pre- and post-operative pain scores, it does not appear to predispose to higher narcotic utilization perioperatively.</p><p><strong>Level of evidence: </strong>II: retrospective comparative study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410632","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 single-centre early experience of the Pulse™ navigation system for posterior spinal fusion in adolescent idiopathic scoliosis (AIS).","authors":"Adam P Lloyd, Haiming Jin, George McKay, Mathew Sewell, Jwalant Mehta, David S Marks, Morgan E B Jones","doi":"10.1007/s43390-025-01054-7","DOIUrl":"https://doi.org/10.1007/s43390-025-01054-7","url":null,"abstract":"<p><strong>Purpose: </strong>Pedicle screw-based constructs are the standard of surgical management in AIS. Several manufacturers have developed navigation systems utilising intraoperative 3D imaging to improve screw placement accuracy. However, concerns remain regarding intraoperative radiation exposure utilising these systems compared to traditional techniques. The aim of this study was to evaluate our experience of 3D intraoperative imaging compared to techniques utilising 2D fluoroscopy for pedicle screw placement in cases of posterior spinal fusion (PSF) for AIS.</p><p><strong>Methods: </strong>This was a single-centre, retrospective analysis of cases undergoing PSF for AIS using 3D navigation or freehand screw insertion techniques. The two groups were matched for curve type, curve magnitude, implant density and fused levels. We compared the correction achieved, intraoperative radiation exposure, operating time and rates of intraoperative screw repositioning.</p><p><strong>Results: </strong>A total of 52 cases were identified (26 navigated and 26 freehand). No significant differences were observed in baseline characteristics between the two groups. There were no significant differences observed in correction achieved between groups; however, mean radiation exposure in the navigated cases was approximately 11 times higher. Operative time was significantly longer in the navigated group but there was a significant reduction in requirement for intraoperative screw repositioning using navigation at 0.2% versus the freehand group at 1.5%.</p><p><strong>Conclusions: </strong>Our early experience of intraoperative 3D imaging for navigated implant insertion for AIS has shown equivalence to freehand techniques in achieved correction, with fewer changes in intraoperative screw positioning at the expense of significantly increased overall radiation exposure and procedure duration.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390387","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 versus vertebral body tethering for paediatric scoliosis: a meta-analysis of comparative studies.","authors":"Abdulrahman O Al-Naseem, Abdulaziz Al-Naseem, Buthaina Al Balushi, Yousef Marwan, Julian Leong, Roozbeh Shafafy","doi":"10.1007/s43390-025-01050-x","DOIUrl":"https://doi.org/10.1007/s43390-025-01050-x","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior spinal fusion (PSF) is currently the gold standard technique for surgical correction of scoliosis however, there is a growing interest in non-fusion techniques like vertebral body tethering (VBT). The aim of this study is to compare surgical outcomes between PSF and VBT.</p><p><strong>Methods: </strong>This systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines with a search of the following databases to identify all comparative studies: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL).</p><p><strong>Results: </strong>A total of 11 comparative studies with 1112 patients were included. PSF offered significantly greater percentage coronal curve correction postoperatively (P = 0.0001) and at 2 years (P < 0.00001). Time to revision (P = 0.03), number of instrumented levels (P < 0.0001), estimated blood loss (EBL) (P = 0.001), operation duration (OD) (P < 0.00001) and postoperative shoulder height difference (P < 0.00001) were significantly greater in the PSF group. Odds of unplanned surgical revisions were lower in the PSF group (P < 0.0001). Secondary outcome data showed that VBT patients had significantly lower preoperative cobb angles (P < 0.00001), a younger age at surgery (P = 0.002), less postoperative pain (P = 0.002) and lower opioid consumption (P = 0.02). VBT tether breakage events were reported at rates of 13-23%. VBT also offered faster return to sports and greater lumbar flexibility. No significant difference was seen in length of hospital stay (P < 0.05).</p><p><strong>Conclusion: </strong>PSF and VBT are viable treatment options with different pros and cons. Choice of treatment should consider individual patient characteristics and daily requirements.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190604","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":"Etiology remains king: health-related quality of life outcome at 5 years following growth friendly instrumentation for EOS.","authors":"K Aaron Shaw, David Thornberg, Anna McClung, Chan-Hee Jo, Mark Erickson, Michael Vitale, Scott Luhmann, Lindsay Andras, Peter Sturm, Hiroko Matsumoto, Brandon Ramo","doi":"10.1007/s43390-024-01029-0","DOIUrl":"https://doi.org/10.1007/s43390-024-01029-0","url":null,"abstract":"<p><strong>Purpose: </strong>The etiology of early-onset scoliosis (EOS) has been shown to significantly influence baseline parent-reported health-related quality of life (HRQoL) measures as assessed by the Early Onset Scoliosis Questionnaire (EOSQ). However, it remains unclear how etiology influences mid-term outcomes following growth friendly instrumentation (GFI) for EOS.</p><p><strong>Methods: </strong>A retrospective review of a multi-center prospective spinal database was performed. Children undergoing primary distraction-based, GFI for EOS with complete baseline, 2-year, and 5-year post-surgical EOSQ were included. The identified children were subdivided by etiology as classified by the C-EOS system. EOSQ scores were compared over time according to etiology cohorts and between instrumentation types. Minimal clinically important difference (MCID) was defined as ≥ 20% change in domain score and compared across etiologies. Dominance analysis was used to assess for drivers of treatment satisfaction.</p><p><strong>Results: </strong>A total of 178 children (mean 7.3 ± 2.1 years, 51.1% female) were included. The most common etiology was neuromuscular (NM: 36.5%), with the majority of children treated with MCGR (N = 125). Significant differences between etiology groups were present with congenital and idiopathic cohorts demonstrating similar EOSQ domain scores that were significantly higher than neuromuscular and syndromic cohorts. In assessing clinically important changes in EOSQ scores over the 5-year follow-up period, neuromuscular and syndromic patients demonstrated the greatest capacity for improved outcomes. Instrumentation type had no influence on HRQoL scores at 5-year follow-up. Etiology was a driver of satisfaction with syndromic etiology and transfer domain score at 2 years follow-up associated with dissatisfaction.</p><p><strong>Conclusion: </strong>Curve etiology remains a significant driver of HRQoL domains following growth-friendly instrumentation for EOS. Neuromuscular and syndromic patient have significantly lower domain scores. Despite this, or perhaps because of it, they also demonstrate the greatest capacity for clinically important improvement in HRQoL measures 5 years following intervention.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074868","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":"Instrumentation using robotics coupled with navigation in pediatric spine deformity surgery: a technical report of sacropelvic instrumentation.","authors":"Craig Birch, Nicole Welch, Danielle Cook, Daniel Hedequist","doi":"10.1007/s43390-025-01047-6","DOIUrl":"https://doi.org/10.1007/s43390-025-01047-6","url":null,"abstract":"<p><strong>Purpose: </strong>This technical report presents the intraoperative experience of using robotic-assisted navigation (RAN) for sacropelvic instrumentation in pediatric spine deformity surgery.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent surgery using RAN for sacropelvic instrumentation at a single institution from 2019 to 2022 was conducted. In cases with screw confirmation imaging, screws were evaluated using the Gertzbein and Robbins classification scale.</p><p><strong>Results: </strong>52 cases were included. Average age at surgery was 14.1 years and 67.3% of patients were female. The most common diagnosis was spondylolisthesis (48.1%). The average major curve in scoliosis cases was 77°. A Schanz pin in the posterior superior iliac spine was placed in 98.1% of surgeries compared to 1 case with a spinous process clamp. Intraoperative 3D imaging scans (Scan & Plan) were used for 69.2% of the robotic registrations to the patient and intraoperative fluoroscopy-CT scans were used for 30.8%. 644 total screws were placed, with 427 placed robotically. Specifically, in the sacral-pelvic region, 98 S1, 18 S2, 58 S2AI, and 5 iliac screws were placed using RAN (179 screws). In 17 cases with 139 total robotic screws, post-instrumentation intraoperative 3D imaging or postoperative CT scans were obtained. Of these screws, 99.3% (138/139; 95% CI = 95.5-99.96) were placed accurately (Grade A or Grade B). One S2AI screw had an anterior breach on intraoperative 3D imaging scan and was changed prior to closure. Loss of RAN registration was observed in 2 cases (3.8%). No cases required return to the operating room for screw malposition.</p><p><strong>Conclusion: </strong>This study highlights high screw accuracy with no neurologic compromise associated with the use of RAN technology.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074998","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}