Spine deformity最新文献

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Pain in individuals with adolescent idiopathic scoliosis: prevalence and association with physical function and psychosocial well-being using patient-reported outcome measures. 青少年特发性脊柱侧凸个体的疼痛:使用患者报告的结果测量的患病率及其与身体功能和社会心理健康的关系
IF 1.8
Spine deformity Pub Date : 2025-08-14 DOI: 10.1007/s43390-025-01121-z
Jarod T Griffin, Anita Bagley, Henry Iwinski, Vishwas Talwalkar, Rolando Roberto, David Dueber, Donna Oeffinger
{"title":"Pain in individuals with adolescent idiopathic scoliosis: prevalence and association with physical function and psychosocial well-being using patient-reported outcome measures.","authors":"Jarod T Griffin, Anita Bagley, Henry Iwinski, Vishwas Talwalkar, Rolando Roberto, David Dueber, Donna Oeffinger","doi":"10.1007/s43390-025-01121-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01121-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study addressed conflicting evidence regarding pain in adolescents with adolescent idiopathic scoliosis (AIS) by assessing its prevalence and consequences on physical function, and psychosocial well-being in our patients.</p><p><strong>Methods: </strong>95 patients with AIS participated in a cross-sectional, observational study. Patient information, clinical and radiographic measures were collected. Participants completed four pain-related patient-reported outcomes (PROs) along with physical function and psychosocial PROs. Means, standard deviations (SD), interquartile ranges (IQR), and ceiling/floor percentages were calculated for each pain-related PRO. Pain prevalence was defined as percentage of participants exceeding one SD and percentage of participants above two SD of published normative values. Correlations assessed associations between pain-PRO scores and scores on other study measures. Differences in PRO scores between High Pain (HP) and Remaining Cohort (RC) groups, established through interquartile thresholds, were assessed via ANOVA and Cohen's d.</p><p><strong>Results: </strong>Cohort mean age was 14.1 ± 1.7 years, and mean curve magnitude of primary curve was 33 ± 13°. Pain prevalence ranged from 1 to 37% depending on the pain-related PRO. HP groups scored worse on physical function and psychosocial PROs than RC, but no differences between the groups were found for clinical measures.</p><p><strong>Conclusion: </strong>Relationships among pain, physical function, psychosocial well-being PRO scores, and clinical measures were established but causality could not be demonstrated. Most patients did not report pain. HP patients scored lower on physical function and psychosocial well-being PROs. HP threshold values can be used to identify HP patients so that interventions to reduce pain can be incorporated into their treatment plan.</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":"144856249","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}
引用次数: 0
False negative intraoperative neuromonitoring alerts during pediatric spinal deformity surgery: the dreaded outcome. 小儿脊柱畸形手术中假阴性神经监测警报:可怕的结果。
IF 1.8
Spine deformity Pub Date : 2025-08-11 DOI: 10.1007/s43390-025-01154-4
Hilton C Braithwaite Iv, Chris Bozorgmehr, Leah Rakers, Scott J Luhmann
{"title":"False negative intraoperative neuromonitoring alerts during pediatric spinal deformity surgery: the dreaded outcome.","authors":"Hilton C Braithwaite Iv, Chris Bozorgmehr, Leah Rakers, Scott J Luhmann","doi":"10.1007/s43390-025-01154-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01154-4","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative neuromonitoring (IONM) reduces postoperative spinal cord dysfunction during pediatric spinal deformity surgery by allowing intraoperative corrective actions. Currently, data on false negative IONM events in this population are limited. The purpose of this study is to describe false negative IONM cases and explore immediate and final outcomes.</p><p><strong>Methods: </strong>An institutional neuromonitoring database (November 1992-April 2024) was reviewed to identify patients (0-18 years) who underwent spinal deformity surgery and experienced false negative IONM. The modalities included somatosensory evoked potentials (SSEP), descending neurogenic evoked potentials (DNEP), and transcranial motor-evoked potentials (TcMEP).</p><p><strong>Results: </strong>Out of the 5317 consecutive cases, 16 patients (0.32%) experienced false negative outcomes. Mean age was 14 years (11-16). Five cases (31.3%) had abnormal neurologic status preoperatively, and all 16 patients experienced neurologic decline, postoperatively. Outcomes were stratified by injury level: among spinal cord-level cases with known outcomes (n = 7), 29% achieved complete recovery; 90% of spinal cord-level injuries used SSEP/DNEP and 10% used SSEP/TcMEP. In nerve root-level cases (n = 6), 17% achieved full recovery. Reoperations included three decompressions, two instrumentation removals, and two revisions. At final follow-up, three patients (19%) had complete recovery, five (31%) partial recovery, five (31%) no recovery, and outcomes were unknown in three (19%).</p><p><strong>Conclusion: </strong>This is the largest series of false negative IONM cases in pediatric spinal deformity surgery to date, with 16 false negative outcomes (0.32%) from 5317 consecutive pediatric spinal deformity cases. In worst case scenario only 19% made a complete recovery. Currently, TcMEP and SSEP monitoring is standard of care and when both are used there was only one false negative case, supporting their use over SSEP/DNEP to mitigate the risk of false negative IONM in spinal cord level surgeries.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817435","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}
引用次数: 0
Association between preoperative activity levels and postoperative complications in adult spinal deformity surgery. 成人脊柱畸形手术中术前活动水平与术后并发症的关系
IF 1.8
Spine deformity Pub Date : 2025-08-11 DOI: 10.1007/s43390-025-01158-0
Rohit Bhan, Salim Yakdan, Christopher Diaz, Jingwen Zhang, Ziqi Xu, Karan Joseph, Benjamin Plog, Alexander T Yahanda, Justin K Zhang, Saad Javeed, Wilson Z Ray, Munish Gupta, Chenyang Lu, Michael P Kelly, Jacob K Greenberg, Brian Neuman
{"title":"Association between preoperative activity levels and postoperative complications in adult spinal deformity surgery.","authors":"Rohit Bhan, Salim Yakdan, Christopher Diaz, Jingwen Zhang, Ziqi Xu, Karan Joseph, Benjamin Plog, Alexander T Yahanda, Justin K Zhang, Saad Javeed, Wilson Z Ray, Munish Gupta, Chenyang Lu, Michael P Kelly, Jacob K Greenberg, Brian Neuman","doi":"10.1007/s43390-025-01158-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01158-0","url":null,"abstract":"<p><strong>Purpose: </strong>Adult spinal deformity (ASD) is a condition associated with significant pain, disability, and high complication rates after surgery, reaching 38-71%. These complications significantly impact recovery, which often takes over a year. Efforts to mitigate complications have focused on preoperative risk stratification using factors such as frailty and patient demographics. Emerging evidence suggests that preoperative mobility and targeted interventions, such as prehabilitation programs, may improve surgical outcomes. This study evaluates the relationship between preoperative activity levels, measured through wearable device, and postoperative complications in ASD surgery.</p><p><strong>Methods: </strong>This was a prospective cohort study including patients aged 21-85 years undergoing surgery for ASD. Participants were passively monitored before surgery using Fitbit trackers. Raw Fitbit data were extracted at the minute level and underwent feature engineering to derive meaningful clinical metrics. Activity features included activity amount (i.e. step count) and activity intensity (i.e. peak 30-min cadence) measures. Patients' characteristics and postoperative complications were extracted from Electronic Health Records. A Mann-Whitney U test was used to assess differences in activity metrics between patients with and without complications.</p><p><strong>Results: </strong>A total of 23 ASD patients were enrolled, with an average age of 66.6 years and an average of 10.4 fusion levels. All patients were fused to the pelvis, with 35% (8 patients) experiencing perioperative complications and 13% readmitted within 30 days. Complications included DVT, AKI, SSI, wound dehiscence, and reoperation. Patients with higher preoperative activity levels, demonstrated fewer complications. Significant differences were observed between patients with complications and those without in several activity metrics, including steps per activity bout (44.5 vs. 81.0; p = 0.017), active time per bout (1.78 vs. 2.59; p = 0.028), steps per minute of activity (23.5 vs. 29.1; p = 0.02), and maximum 30-min cadence (40.1 vs. 58.6; p = 0.04).</p><p><strong>Conclusion: </strong>Increased preoperative activity levels is associated with reduced complications after ASD surgery. Larger studies are needed to validate these findings, identify critical activity metrics, and establish thresholds for optimizing outcomes. These results highlight the potential benefits of prehabilitation in improving surgical outcomes for ASD patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822406","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}
引用次数: 0
Which slot scanning device is best for low-dose radiographs in pediatric scoliosis? A pilot study. 小儿脊柱侧凸低剂量x线片最佳的槽位扫描设备是哪一种?一项初步研究。
IF 1.8
Spine deformity Pub Date : 2025-08-09 DOI: 10.1007/s43390-025-01159-z
Hans K Nugraha, Ria V Paradkar, Beth A Schueler, Zaiyang Long, Nathan C Hull, Stephen M Broski, Todd A Milbrandt, A Noelle Larson
{"title":"Which slot scanning device is best for low-dose radiographs in pediatric scoliosis? A pilot study.","authors":"Hans K Nugraha, Ria V Paradkar, Beth A Schueler, Zaiyang Long, Nathan C Hull, Stephen M Broski, Todd A Milbrandt, A Noelle Larson","doi":"10.1007/s43390-025-01159-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01159-z","url":null,"abstract":"<p><strong>Purpose: </strong>Studies have demonstrated a higher lifetime risk of cancer in AIS patients compared to age-matched controls. An asynchronous slot scan feature with ultra-small angle tomosynthesis reconstruction recently became available at our institution. Thus, we aimed to compare the performance of this new technology to the existing biplanar slot scanner for scoliosis imaging using standard dose settings.</p><p><strong>Methods: </strong>All scoliosis patients under 18 years old from a single institution who underwent diagnostic imaging with both the asynchronous (True2Scale) and biplanar imaging system (EOS®) were included. Overall image quality was independently reviewed using a previously published method. Anthropomorphic phantom evaluations and dose measurements were conducted, with effective doses compared between systems. A computerized model based on phantom data estimated standardized patient effective doses.</p><p><strong>Results: </strong>40 imaging studies from 20 patients met the inclusion criteria. ICC for overall image quality was 0.88, with weighted-Cohen's Kappa analysis showing very high agreement (κ = 0.873). On average, patients imaged with the asynchronous system received 0.23 ± 0.15 (median: 0.10) mSv in each study, while patients imaged with the biplanar system received 0.12 ± 0.05 (median: 0.13) mSv. A bootstrap Welch's t-test showed a significant difference in mean radiation doses (p = 0.038, mean difference = 0.11 mSv, T2S higher than EOS). AP dose analysis showed no significant difference (p = 0.196), with the asynchronous system at 0.07 ± 0.03 (median: 0.07) mSv and biplanar at 0.06 ± 0.02 (median: 0.05) mSv.</p><p><strong>Conclusions: </strong>Both technologies with standard dose parameters provided comparable image quality. While the asynchronous system delivers slightly higher radiation doses, both systems expose patients to less than annual background radiation (3 mSv) and standard 2-view scoliosis imaging doses. Larger studies are warranted to confirm these pilot findings.</p><p><strong>Level of evidence: </strong>III-retrospective cohort study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804749","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}
引用次数: 0
Three-dimensional Rigo Cheneau-style brace for adolescent idiopathic scoliosis: higher in-brace correction and lower rates of curve progression. 三维Rigo cheneau式支架治疗青少年特发性脊柱侧凸:更高的支架内矫正率和更低的弯曲进展率。
IF 1.8
Spine deformity Pub Date : 2025-08-08 DOI: 10.1007/s43390-025-01153-5
Lisa Bonsignore-Opp, Ritt R Givens, Matan S Malka, Kevin Lu, Rajiv R Iyer, Nicole Bainton, Benjamin D Roye, Michael G Vitale
{"title":"Three-dimensional Rigo Cheneau-style brace for adolescent idiopathic scoliosis: higher in-brace correction and lower rates of curve progression.","authors":"Lisa Bonsignore-Opp, Ritt R Givens, Matan S Malka, Kevin Lu, Rajiv R Iyer, Nicole Bainton, Benjamin D Roye, Michael G Vitale","doi":"10.1007/s43390-025-01153-5","DOIUrl":"https://doi.org/10.1007/s43390-025-01153-5","url":null,"abstract":"<p><strong>Purpose: </strong>Bracing has long been the mainstay of conservative management for adolescent idiopathic scoliosis (AIS) yet there is little data comparing treatment outcomes among different brace types. The purpose of this study is to compare curve progression and need for surgery between patients treated with Rigo Cheneau-style orthoses (RCSO) that focus on three-dimensional correction and traditional thoracolumbar-sacral orthoses (TLSO).</p><p><strong>Methods: </strong>Patients who began treatment at a single institution with an initial major coronal curve between 20° and 45° and no previous scoliosis treatment were included. Study endpoints were skeletal maturity or definitive fusion surgery. The outcome measures were percent curve correction in-brace, coronal curve progression at study endpoint, major coronal curve progression > 5°, major coronal curve progression > 10°, and progression to surgery.</p><p><strong>Results: </strong>89 patients (47 RCSO and 42 TLSO) were included. Traditional TLSO patients had lower mean initial major curve compared to the RCSO cohort (30° vs. 33°, p = 0.021). TLSO patients had lower in-brace curve correction percent (22% vs. 48%, p < 0.001). Fifty-five percent of TLSO patients experienced curve progression of more than 5° compared to 30% of RCSO patients (p = 0.017). Forty-three percent of patients treated with TLSO experienced curve progression of more than 10° compared to only 13% of patients treated with RCSO (p = 0.001). By univariable analysis, there were no differences between TLSO and RCSO in risk of surgery recommended or performed (31% vs 30%, p = 0.905). However, the baseline predicted risk of progression ≥ 45° at initiation of bracing was lower in the TLSO cohort (49.1% vs. 61.5%, p = 0.079).</p><p><strong>Conclusions: </strong>Patients treated with RCSO have a higher in-brace curve correction and lower odds of curve progression compared to patients treated with TLSO.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800179","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}
引用次数: 0
Curved narratives: cultural representation of spinal deformity in children's animated films and its psychosocial implications. 弯曲叙事:儿童动画电影中脊柱畸形的文化表征及其社会心理含义。
IF 1.8
Spine deformity Pub Date : 2025-08-06 DOI: 10.1007/s43390-025-01156-2
Rodrigo Muscogliati, Aya Hassanieh, Reine El Ballani, Zeina Najem, Leen Najem, Joe Frem, Khaled Younes, Dima Ezzeddine, Caren Safi, Alexa Chedid, Reem Al Najjar, Elie Najjar
{"title":"Curved narratives: cultural representation of spinal deformity in children's animated films and its psychosocial implications.","authors":"Rodrigo Muscogliati, Aya Hassanieh, Reine El Ballani, Zeina Najem, Leen Najem, Joe Frem, Khaled Younes, Dima Ezzeddine, Caren Safi, Alexa Chedid, Reem Al Najjar, Elie Najjar","doi":"10.1007/s43390-025-01156-2","DOIUrl":"https://doi.org/10.1007/s43390-025-01156-2","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal deformities, particularly adolescent idiopathic scoliosis (AIS), are associated with impaired self-image. This study aimed to systematically evaluate how spinal deformities are portrayed in Disney and Pixar animated films and to assess whether recurring visual and narrative stereotypes reflect psychosocial challenges reported by adolescents with AIS.</p><p><strong>Methods: </strong>A systematic content analysis was conducted of all full-length Disney and Pixar films released from 1989 to 2025. Characters were included if they exhibited consistent anatomical features suggestive of kyphosis, scoliosis, or lordosis. Each character was assessed for physical, social, and moral traits using a standardized checklist. Clinical plausibility was confirmed by an FRCS-trained spine surgeon. Descriptive statistics were used to analyze prevalence and trait distribution.</p><p><strong>Results: </strong>Forty-eight characters met inclusion criteria, most showing kyphosis (79%). The majority were secondary (42%) or peripheral (35%) figures. Common portrayals included clumsiness (60%), frailty (42%), and frightening demeanor (33%). Only 27% were heroes and 19% were leaders. Female characters were underrepresented (27%).</p><p><strong>Conclusions: </strong>Spinal deformity is frequently depicted in children's animation through lenses of physical and social inferiority. These portrayals may contribute to internalized stigma and identity challenges in adolescents with AIS. Clinicians should consider these cultural narratives when discussing appearance-related treatment options.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795340","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}
引用次数: 0
Increased differential rod contouring reduces the effectiveness of surgical correction in patients with adolescent idiopathic scoliosis. 在青少年特发性脊柱侧凸患者中,增加的差异棒轮廓降低了手术矫正的有效性。
IF 1.8
Spine deformity Pub Date : 2025-07-30 DOI: 10.1007/s43390-025-01151-7
Alexandria Mallinos, Camille Pillot, Xiaoyu Wang, Todd Ritzman, Lorena V Floccari, Richard M Schwend, Carl-Eric Aubin
{"title":"Increased differential rod contouring reduces the effectiveness of surgical correction in patients with adolescent idiopathic scoliosis.","authors":"Alexandria Mallinos, Camille Pillot, Xiaoyu Wang, Todd Ritzman, Lorena V Floccari, Richard M Schwend, Carl-Eric Aubin","doi":"10.1007/s43390-025-01151-7","DOIUrl":"https://doi.org/10.1007/s43390-025-01151-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of increasing the differential precontouring angle of concave and convex rods on three-dimensional correction during posterior spinal fusion in patients with adolescent idiopathic scoliosis (AIS) and determine the threshold beyond which additional contouring yields no further correctional benefit in a computational model.</p><p><strong>Methods: </strong>Patient-specific computational biomechanical models were developed using radiographs from 10 thoracic Lenke 1 AIS patients. Posterior instrumentation included bilateral uniaxial pedicle screws from T4 to L1 and rods of various diameters and materials. First-order simulations of the primary correction maneuver using the rod translation technique were performed using MSC Adams. The effects of varying concave rod precontouring angles on the forces at play and resulting correction in the coronal, sagittal, and axial planes were analyzed.</p><p><strong>Results: </strong>Coronal plane correction decreased progressively with increasing rod contouring angles (p < 0.05) due to posterior displacement of the rod relative to the spine, reducing coronally-directed torque at the curve apex. Aggressive rod contouring (> 55°) improved sagittal plane correction (thoracic kyphosis), with the benefit depending on presenting kyphosis (p < 0.05). Normo-kyphotic curves showed better outcomes with moderate rod contouring (< 55°), whereas hypo-kyphotic curves required more aggressive bending (55-85°) to restore kyphosis, despite reduced coronal correction. Transverse plane effects from these simulations appeared less influential (p > 0.05). Screw axial forces increased linearly with concave rod bending angle.</p><p><strong>Conclusion: </strong>Increasing concave rod precontouring beyond 35° to 55° yields diminishing coronal plane correction, while offering selective benefit in restoring thoracic kyphosis in hypo-kyphotic AIS patients.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744897","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}
引用次数: 0
Does postoperative shoulder imbalance affect patient reported functional outcomes after posterior surgical correction of adolescent idiopathic scoliosis? A systematic review and meta-analysis. 青少年特发性脊柱侧凸后路矫正术后肩部不平衡是否影响患者报告的功能结果?系统回顾和荟萃分析。
IF 1.6
Spine deformity Pub Date : 2025-07-23 DOI: 10.1007/s43390-025-01148-2
Alan Maximiliano Gessara, Siddharth Shah, Mostafa ELMeshneb, Akshay Gadiya, Masood Shafafy, Michael Grevitt, Shakil Mohammed Patel
{"title":"Does postoperative shoulder imbalance affect patient reported functional outcomes after posterior surgical correction of adolescent idiopathic scoliosis? A systematic review and meta-analysis.","authors":"Alan Maximiliano Gessara, Siddharth Shah, Mostafa ELMeshneb, Akshay Gadiya, Masood Shafafy, Michael Grevitt, Shakil Mohammed Patel","doi":"10.1007/s43390-025-01148-2","DOIUrl":"https://doi.org/10.1007/s43390-025-01148-2","url":null,"abstract":"<p><strong>Purpose: </strong>Failure to balance the shoulders whilst surgically correcting AIS has been reported in many publications as being associated with negative PROMS. However, the evidence to support this, in our opinion, is limited. The purpose of this study was to systematically review the literature and perform a meta-analysis to identify whether postoperative shoulder imbalance affects patient reported outcome measures.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted on the available literature comparing clinical and/or radiographic features of postoperative shoulder imbalance following surgery for AIS with patient reported outcome measures.</p><p><strong>Results: </strong>Thirteen studies with 924 patients were included. The mean follow-up was 3.7 years (2-16). The incidence of radiographic PSI was 30.1% and clinical PSI was 22.7%. A mix of validated (most commonly used SRS-22) and nonvalidated PROMs were used. Studies using radiographic PSI assessment showed no difference in PROMs for most validated scores. Clinical assessment studies showed that patients with even shoulders were also unsatisfied with their appearance. Meta-analysis of the extractable and analysable data showed no significant difference in PSI vs No-PSI in SRS-22.</p><p><strong>Conclusion: </strong>Contrary to popular belief, the findings of this systematic review and meta-analysis demonstrate that PSI is not associated with negative PROM using validated outcome measures.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691450","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}
引用次数: 0
Robotic-assisted pedicle screw placement improves accuracy, precision, and breach rates compared with freehand and image-guided navigation techniques: a cadaveric study. 与徒手和图像引导导航技术相比,机器人辅助椎弓根螺钉置入提高了准确性、精确度和骨折率:一项尸体研究。
IF 1.6
Spine deformity Pub Date : 2025-07-21 DOI: 10.1007/s43390-025-01150-8
Gregory S Kazarian, Benjamin N Groisser, Ankush Thakur, Mihir S Dekhne, Howard J Hillstrom, Austin C Kaidi, Jung Kee Mok, Akshitha Adhiyaman, Olivia C Tracey, Colson Zucker, Jenna L Wisch, Matthew Cunningham, M Timothy Hresko, Ram Haddas, John Blanco, Douglas N Mintz, Ryan E Breighner, Roger F Widmann, Jessica H Heyer
{"title":"Robotic-assisted pedicle screw placement improves accuracy, precision, and breach rates compared with freehand and image-guided navigation techniques: a cadaveric study.","authors":"Gregory S Kazarian, Benjamin N Groisser, Ankush Thakur, Mihir S Dekhne, Howard J Hillstrom, Austin C Kaidi, Jung Kee Mok, Akshitha Adhiyaman, Olivia C Tracey, Colson Zucker, Jenna L Wisch, Matthew Cunningham, M Timothy Hresko, Ram Haddas, John Blanco, Douglas N Mintz, Ryan E Breighner, Roger F Widmann, Jessica H Heyer","doi":"10.1007/s43390-025-01150-8","DOIUrl":"https://doi.org/10.1007/s43390-025-01150-8","url":null,"abstract":"<p><strong>Study design: </strong>Cadaveric study.</p><p><strong>Purpose: </strong>Compare the accuracy and precision of robotic navigation (RAN), freehand (FH) and freehand navigation (NAV) techniques for pedicle screw placement.</p><p><strong>Methods: </strong>Three cadavers were assigned to the FH, NAV, and RAN methods. Cadavers were CT scanned preoperatively, then underwent bilateral T1-L5 screw planning. RAN and NAV screws were placed by one surgeon, while the FH screws were placed by a second surgeon. Automated computer vision techniques were used to assess the tip, tail, and mid-pedicle screw positions compared to the preoperative plan along three axes on postoperative CT scans. Systematic error, precision, and accuracy were defined by signed mean error, two standard deviations (SDs), and mean absolute error (MAE), respectively. A factorial ANOVA with pairwise comparisons was used with post-hoc t-tests using Bonferroni corrections.</p><p><strong>Results: </strong>Eighty-seven screws were placed in three cadavers (24 RAN, 29 NAV, 34 FH). Fifteen screws were skipped due to registration difficulties (10 RAN, 5 NAV). RAN outperformed NAV and FH in regard to MAE angular deviation from planned screw trajectory (p < 0.001), the mid-pedicle in the superior-inferior direction (p = 0.002), and at the screw tip in all planes (p < 0.05), with a maximum error of 1.29 mm and 1.98° (vs. 2.29 mm and 5.23° for NAV and 5.67 mm and 11.18° for FH). No RAN screws had medial breach (1 (3.4%) for NAV; 4 (11.8%) for FH).</p><p><strong>Conclusions: </strong>In our study, RAN demonstrated the best accuracy and precision in the majority of measured parameters, when compared to FH and NAV techniques.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683035","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}
引用次数: 0
Utility of routine postoperative imaging following posterior spinal fusion for AIS. 后路脊柱融合术对AIS术后常规影像学的应用。
IF 1.6
Spine deformity Pub Date : 2025-07-18 DOI: 10.1007/s43390-025-01149-1
Soham Ghoshal, Shanika D Silva, David S Liu, K Mikayla Flowers, Margaret L Sullivan, Craig M Birch, Daniel J Hedequist, M Timothy Hresko, Grant D Hogue
{"title":"Utility of routine postoperative imaging following posterior spinal fusion for AIS.","authors":"Soham Ghoshal, Shanika D Silva, David S Liu, K Mikayla Flowers, Margaret L Sullivan, Craig M Birch, Daniel J Hedequist, M Timothy Hresko, Grant D Hogue","doi":"10.1007/s43390-025-01149-1","DOIUrl":"https://doi.org/10.1007/s43390-025-01149-1","url":null,"abstract":"<p><strong>Purpose: </strong>The necessity of routine radiographic imaging after spinal fusion surgery is debated due to variations in surgeons' practices. The aim of this study is to determine the role of immediate postoperative radiographic imaging following posterior spinal fusion for AIS. Our hypothesis is that routine immediate postoperative radiographic imaging in patients with AIS undergoing posterior spinal fusion does not impact the decision to return to the operating room.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of AIS patients (ages 11-19) who underwent PSF at a single institution. The proportion of unplanned returns to the operating room (UPROR) cases was estimated with a Clopper-Pearson 95% confidence interval. Risk factors for UPROR were compared using Wilcoxon rank-sum and Fisher's exact tests.</p><p><strong>Results: </strong>Among 527 patients, only 3 (0.5%) had UPROR, and just 1 (0.2%) returned due to routine postoperative imaging findings. Patients with and without UPROR had similar surgical times (321 vs. 277 min, p = 0.24), blood loss (18% of EBV vs. 14% of EBV, p = 0.29), and intraoperative tranexamic acid use (p = 0.52). No demographic or surgical factors differed between the groups. The estimated excess radiation burden was 36.36 mSv.</p><p><strong>Conclusion: </strong>The decision to undergo reoperation based on routine immediate postoperative imaging findings is exceedingly rare. In addition, blood loss, surgical time, and use of TXA did not differ between those who did return to the operating room and those who did not. These findings demonstrate that most patients do not benefit from routine immediate postoperative imaging.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660113","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}
引用次数: 0
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