Spine deformity最新文献

{"title":"Bracing effectiveness in idiopathic early onset scoliosis followed to skeletal maturity: a systematic review and meta-analysis.","authors":"Matthew Bellamy, Wei Shao Tung, Raveen Jayasuriya, Daniel Hind, Lizzie Swaby, Nikki Totton, Ashley Cole","doi":"10.1007/s43390-025-01043-w","DOIUrl":"https://doi.org/10.1007/s43390-025-01043-w","url":null,"abstract":"<p><strong>Purpose: </strong>Treating idiopathic Early Onset Scoliosis (idiopathic EOS) is challenging due to ongoing growth and extensive follow-ups. While bracing is effective for Adolescent Idiopathic Scoliosis (AIS), its value for children under 10 remains debated. This systematic review and meta-analysis evaluates the effectiveness of spinal bracing in idiopathic EOS, followed to skeletal maturity.</p><p><strong>Methods: </strong>We searched Ovid Medline and Web of Science until November 1st, 2023. Studies included idiopathic EOS patients between the ages of 3 and 10 (corresponding to Juvenile Idiopathic Scoliosis), followed to skeletal maturity, with no more than 25% initiating bracing after age 11. The primary outcome was the percentage undergoing scoliosis surgery. Pooled outcomes were calculated using a random effects model and 95% confidence intervals.</p><p><strong>Results: </strong>Out of 417 studies, 15 met the inclusion criteria, encompassing 868 patients. All were observational with a high risk of bias. The pooled percentage of patients undergoing surgery was 40% (95% CI 27-55%). The percentage of patients with a 5-degree progression or more and those progressing beyond 45 degrees were 44% (95% CI 24-66%) and 33% (95% CI 17-54%), respectively. Factors including larger initial Cobb angles, younger age, smaller in-brace correction, and poor compliance were identified as progression risk factors.</p><p><strong>Conclusions: </strong>Bracing may prevent progression to surgery in idiopathic EOS when initiated early, but progression and surgery are still more common compared to adolescents. This is the first systematic review and meta-analysis looking at the success of bracing in idiopathic EOS, followed up to skeletal maturity. The high bias and variability of included studies limit the strength of these conclusions, highlighting the need for high-quality research with innovative trial designs.</p><p><strong>Level of evidence: </strong>IV (systematic review of level IV studies).</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010541","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 association of congenital diaphragmatic hernia with scoliosis.","authors":"Michal Koziara, Stuart Irvine, Nicholas Wei, Prasad Karpe, Paul Rushton, David Fender, Bruce Jaffray","doi":"10.1007/s43390-025-01041-y","DOIUrl":"https://doi.org/10.1007/s43390-025-01041-y","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the prevalence of scoliosis in patients who have undergone surgical repair of CDH and attempt to assess the aetiology of scoliosis in affected cases.</p><p><strong>Methods: </strong>A prospectively collected database of patients with CDH treated in a single centre between 1997 and 2023 was reviewed. Cases with adequate records who continued to reside locally having survived beyond age 2 and > 2 years following CDH repair were included. Congenital spinal abnormalities and scoliosis were diagnosed from imaging studies. In those who developed scoliosis, medical notes were reviewed to assess the aetiology of scoliosis and its treatment.</p><p><strong>Results: </strong>145 patients (92 male) who had undergone CDH repair were included. The median age at CDH repair was at 4 days. The mean time from CDH repair to this study was 14.1 years (2.0-26.2). 15 developed scoliosis (10.3%). In 8 cases, the scoliosis was considered a reflection of multisystem abnormalities including congenital vertebral anomalies in 3 cases (2%). In the 7 remaining cases the scoliosis had no obvious cause. Of those with scoliosis, to date, 3 have had surgical treatment with 1 awaiting surgery, 7 have not required scoliosis treatment and 4 have died.</p><p><strong>Conclusions: </strong>Scoliosis is relatively common in those who have undergone CDH repair, typically presenting before age 10 years. Scoliosis when present was commonly part of a multisystem issue, with congenital vertebral anomalies rare. There appears no strong association between use of synthetic patch and scoliosis. Few children undergoing CDH repair will require treatment of a scoliosis.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010849","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":"Which Lenke type curve is most appropriate for vertebral body tethering in adolescent idiopathic scoliosis?","authors":"Abel De Varona-Cocero, Djani Robertson, Camryn Myers, Fares Ani, Constance Maglaras, Tina Raman, Themistocles Protopsaltis, Juan C Rodriguez-Olaverri","doi":"10.1007/s43390-025-01049-4","DOIUrl":"https://doi.org/10.1007/s43390-025-01049-4","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical trials have studied the effects of curve magnitude and flexibility, age, and skeletal immaturity on the outcomes of VBT. No studies have assessed the effect of Lenke curve type on the outcomes of VBT. This study compares outcomes in patients who underwent VBT with Lenke type 1, 3, 5, and 6 curves.</p><p><strong>Methods: </strong>Single center retrospective review of patients undergoing mini-open thoracoscopic-assisted two row vertebral body tethering (2RVBT) for the correction of AIS with a minimum 2-year follow-up were included. Patients were grouped by Lenke type, which yielded 4 groups; types 1, 3, 5, or 6. Analysis included preoperative demographic parameters, as well as radiographic and clinical outcome measures.</p><p><strong>Results: </strong>156 2RVBT (Lenke 1, N = 61; Lenke 3, N = 35; Lenke 5, N = 37; Lenke 6, N = 23) patients met inclusion criteria. The mean preoperative apex Cobb angle in the Lenke type 1, 3, 5, and 6 groups were 50.2 ± 9.1, 50.5 ± 10.1, 45.0 ± 8.6, and 49.0 ± 10.8, respectively. This corrected to 21.2 ± 10.2, 19.2 ± 8.5, 13.6 ± 7.2, 18.5 ± 8.3 in Lenke type 1, 3, 5, and 6 groups, respectively, demonstrating that Lenke type 5 saw greatest correction following 2RVBT. With regards to revision recommendation following tether breakage, Lenke type 3 curves were most frequently indicated for fusion, whereas Lenke type 1 curves were most frequently not indicated for revision surgery.</p><p><strong>Conclusion: </strong>Lenke type 5 curves are the most amenable to correction via 2RVBT, as evident by their lower post-operative apex Cobb angles and lowest rate of recommendation for revision to posterior spinal fusion.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010976","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":"Enhanced recovery after surgery for adolescent idiopathic scoliosis: a revised systematic review and meta‑analysis.","authors":"Paolo Brigato, Sergio De Salvatore, Leonardo Oggiano, Davide Palombi, Gian Mario Sangiovanni, Gianmichele Di Cosimo, Daniela Perrotta, Laura Ruzzini, Pier Francesco Costici","doi":"10.1007/s43390-025-01040-z","DOIUrl":"https://doi.org/10.1007/s43390-025-01040-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent idiopathic scoliosis surgery (AIS) is often associated with high costs and significant recovery challenges. Enhanced recovery after surgery (ERAS) protocols aim to improve outcomes, reducing hospital stays and complications compared to traditional (TD) pathways. This study evaluates the impact of ERAS protocols on AIS treatment.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic review identified 30 studies (n = 15,954 patients). Search terms included \"ERAS,\" \"adolescent idiopathic scoliosis,\" and \"posterior spinal fusion.\" Outcomes assessed included surgical metrics, recovery milestones, complications, and pain. A meta-analysis was performed, and the risk of bias was evaluated using the MINORS score.</p><p><strong>Results: </strong>ERAS patients (n = 5582) had shorter surgical durations (- 23 min, p = 0.08) and reduced blood loss (- 126 mL, p = 0.033) compared to TD patients (n = 7916). Recovery milestones improved, including earlier ambulation (- 37.4 h, p < 0.0001), patient-controlled analgesia discontinuation (- 1.1 days, p < 0.0001), catheter removal (- 0.75 days, p < 0.001), and shorter hospital stays (- 1.7 days, p < 0.0001). Complications were lower in the ERAS group (4% vs. 8%, p = 0.0074), while wound-related complications and 30-day readmission rates were comparable. Pain scores were significantly reduced from surgery day to postoperative day 2 (p < 0.0181).</p><p><strong>Conclusion: </strong>ERAS protocols improve recovery and reduce complications in AIS surgery, with shorter hospital stays and enhanced patient outcomes. These findings support broader implementation and further randomized trials to evaluate long-term benefits and patient satisfaction.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010743","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":"Thirty years later: the lingering effects of adolescent idiopathic scoliosis surgery with third-generation implants on quality of life.","authors":"Antonia Matamalas, Juan Bagó, Franciso Javier Sánchez Pérez-Grueso, Lucía Moreno-Manzano, Javier Pizones, Carlos Villanueva, Susana Núñez-Pereira, Sleiman Haddad, Ferrán Pellisé","doi":"10.1007/s43390-024-01034-3","DOIUrl":"https://doi.org/10.1007/s43390-024-01034-3","url":null,"abstract":"<p><strong>Purpose: </strong>To determine patient-reported clinical status in a cohort of patients operated on during adolescence for adolescent idiopathic scoliosis (AIS) using Cotrel-Dubousset instrumentation after a minimum follow-up (FU) of 25 years.</p><p><strong>Methods: </strong>Multicentric cross-sectional observational study. We assessed the clinical status of patients using the lumbar-pain numeric rating scale (NRS), ODI, SRS-22r, SF-36, and EQ-5D-5L. For NRS and SRS-22r, the reported \"Patient Acceptable Symptom State\" (PASS +) was used as a reference for normality. Further, normative data were used for SF-36 and EQ-5D-5L.</p><p><strong>Results: </strong>Out of 226 eligible patients, 152 (67% of the total; 87% female) were included (mean FU = 29.6 years). The mean age at FU was 45.1 years (SD3.4; range 36-55). The PASS + status was achieved by 56.7% of patients on the SRS-22 subtotal score, 56% of patients in the NRS and 56.8% in the ODI questionnaire achieving PASS + state. Significant differences were found between the normative values for the SF-36 and EQ-5D-5L scores, but the magnitude of the differences was not clinically relevant. Clinically significant differences were found for SF-36 bodily pain (43.0 vs. 50.0; p < 0.001), SF-36 PCS (42.8 vs. 50.0; p = 0.0001) and EQ-5D-5L pain score, with the scoliotic population having 4.1 times more risk of severe/extreme pain than their peers.</p><p><strong>Conclusions: </strong>Thirty years after surgery, AIS patients have more pain and worse physical functioning than their peers. However, the differences are not clinically relevant except for pain and physical activity. Further, on average, the former are in good clinical condition, although surgery has not normalized their lives.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010898","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 and complications of vertebral body tethering by patient gender.","authors":"Julia Todderud, Todd Milbrandt, Alice Baroncini, Maty Petcharaporn, Michelle Marks, Daniel Hoernschemeyer, Peter Newton, Stefan Parent, Ahmet Alanay, Firoz Miyanji, Baron Lonner, Kevin Neal, Burt Yaszay, Laurel Blakemore, Suken Shah, Lawrence Haber, Amer Samdani, A Noelle Larson","doi":"10.1007/s43390-024-01035-2","DOIUrl":"https://doi.org/10.1007/s43390-024-01035-2","url":null,"abstract":"<p><strong>Purpose: </strong>Non-fusion surgical options for pediatric scoliosis management such as vertebral body tethering (VBT) offer an alternative to spinal fusion. With this study, we aim to evaluate the postoperative outcomes in boys versus girls who have undergone VBT. Our hypothesis is that girls and boys will have similar outcomes by 2-year follow-up.</p><p><strong>Methods: </strong>This study employed a review of retrospective data for patients who underwent VBT at 10 sites between 2011 and 2020. Patients were stratified based on gender. All patients had preoperative and 2-year follow-up and were evaluated for curve correction, complications, surgery metrics, and patient reported outcomes.</p><p><strong>Results: </strong>328 patients were included in this study: 277 girls and 51 boys. Mean age at surgery was 12.2 years for girls and 13.4 years for boys. Mean preoperative curve magnitude and curve flexibility was similar between both groups. Compared to girls, boys were older, heavier and taller at the time of surgery; BMI was not different between the groups. Skeletal maturity was not different preoperatively or at 2 years. There were no significant differences for mean operative time, mean estimated blood loss, or levels instrumented. Postoperative stay was longer in the girls averaging 4.5 days compared to 3.9 days for the boys (p = 0.026). There were no statistically significant differences between boys and girls for the curve magnitude at final follow-up (28° vs 25° thoracic, 21° both groups lumbar) or percent correction (45% vs 38% thoracic, 38% vs 31% lumbar) at 2-year follow-up. Overall, 98 girls (35%) experienced medical or surgical complications compared to 18 boys (39%) (p = 0.599). Boys experienced higher rates of tether breakage at latest follow-up (33% vs. 17%, p = 0.008) and more loss of correction > 10° (10% vs. 3%, p = 0.03). Rates of reoperation were 15.9% in the girls and 15.7% in the boys (p = 0.972).</p><p><strong>Conclusion: </strong>Our study found that boys on average had higher body weight than girls and also higher rates of tether cord breakage and loss of correction. Despite these differences, curve correction, modulation, and reoperation rates were similar in both groups. Further work is needed to determine the relative impact of patient gender and weight on incidence of tether breakage.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984439","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":"Prevalence of metal hypersensitivity in pediatric spine surgery.","authors":"A Scott Emmert, Tiffany Ruan, Michael G Sherenian, Amal H Assa'ad, Nichole Leitsinger, Lindsay Schultz, Viral V Jain, Peter F Sturm, Alvin C Jones","doi":"10.1007/s43390-024-01030-7","DOIUrl":"https://doi.org/10.1007/s43390-024-01030-7","url":null,"abstract":"<p><strong>Purpose: </strong>Delayed metal hypersensitivity reactions can cause complications in spine surgery. Currently, there is no information on the prevalence of metal hypersensitivity in pediatric patients undergoing spine surgery. The objective of this study is to determine the prevalence of metal hypersensitivity in pediatric patients undergoing spinal instrumentation.</p><p><strong>Methods: </strong>Retrospective chart review of patients who underwent spinal instrumentation with or without fusion at a single institution, from January 1, 2014, to December 31, 2020, was performed. Patients were pre-screened for history of allergic diseases, including previous reaction to metals, prior to surgery. Patch metal allergy testing (PMAT) for metal hypersensitivity was also performed.</p><p><strong>Results: </strong>Of the 796 pediatric patients who underwent spinal instrumentation procedures from 2014 to 2020, 118 (15%) screened positive for metal hypersensitivity. However, the number of patients with documented evidence of metal hypersensitivity diminished to 26 (3%) after PMAT verification. Nickel hypersensitivity was most prevalent, with 20 patients (16.9% of positive screening; 2.5% of all instrumented patients) demonstrating positive skin patch tests. The other most prevalent metal hypersensitivities included cobalt in 9 patients (7.6%; 1.1%), manganese in 3 patients (2.5%; 0.4%), and copper in 1 patient (0.8%; 0.1%). with a number needed to treat (NNT) of 5.</p><p><strong>Conclusions: </strong>This study suggests that routine pre-operative PMAT is not necessary in all pediatric spine patients yet should be considered if patients report a history of prior metal hypersensitivity reactions.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979725","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":"Back pain disability and PROMIS scores in children with hyperkyphosis are worse than children with idiopathic scoliosis.","authors":"Karina Amani Zapata, Caitlin Nadolny, Eliza Lovrich, Yuhan Ma, Brandon A Ramo","doi":"10.1007/s43390-024-01028-1","DOIUrl":"https://doi.org/10.1007/s43390-024-01028-1","url":null,"abstract":"<p><strong>Purpose: </strong>To compare health-related quality-of-life (HRQOL) between children with hyperkyphosis and idiopathic scoliosis using 9-item Oswestry Disability Index (ODI-9) and Patient Reported Outcome Measurement Information System (PROMIS) Pain Interference, Mobility, and Anxiety.</p><p><strong>Methods: </strong>Children with hyperkyphosis, idiopathic scoliosis, and controls with no structural diagnosis ages 10-18 years who completed the PROMIS Pediatric Pain Interference, Mobility, and Anxiety domains were retrospectively evaluated from April 2021 to June 2023. Comparisons were made between hyperkyphosis, idiopathic scoliosis, and control groups. Within the hyperkyphosis group, comparisons were made between Scheuermann kyphosis and postural kyphosis subgroups.</p><p><strong>Results: </strong>304 children with hyperkyphosis, 1134 with idiopathic scoliosis, and 1493 controls were included. Children with hyperkyphosis had increased age, male sex, BMI percentile, Spanish than English speakers, and public insurance type. They also had worse ODI-9, PROMIS Pain Interference and Mobility scores which remained significant after multivariate regression analysis included age, sex, BMI percentile, language, insurance type, and race/ethnicity (p < 0.01). The Scheuermann kyphosis (n = 67) subgroup had increased age, male sex, area deprivation index (ADI), BMI percentile, concern by their appearance, and worse PROMIS Pain Interference and Mobility scores than the postural kyphosis (n = 237) subgroup. However, Scheuermann kyphosis subgroup score differences did not remain significant after considering age, sex, ADI, and BMI percentile.</p><p><strong>Conclusion: </strong>Children with hyperkyphosis (both Scheuermann and postural kyphosis subtypes) have worse HRQOL scores than their peers with idiopathic scoliosis. Worse ODI-9, PROMIS Pain Interference and Mobility scores remained significant only in the hyperkyphosis group as a whole after adjusting for confounding variables, but not between hyperkyphosis subgroups.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971087","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":"One is not like the other: health quality of life scores vary in neuromuscular EOS by diagnosis.","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/s43390-024-01038-z","DOIUrl":"https://doi.org/10.1007/s43390-024-01038-z","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). In combining these etiology groups, we obligatorily lump together many disparate diagnoses, particularly true in the neuromuscular (NM) cohort. We sought to evaluate the influence of underlying neuromuscular diagnosis on the HrQOL at 5 years following surgery for EOS.</p><p><strong>Methods: </strong>A retrospective review of a multi-center EOS database was performed. Children treated with primary distraction-based, growth-friendly instrumentation (GFI) for EOS with complete baseline, 2-year, and 5-year post-surgical EOSQs were included. Neuromuscular scoliosis patients, as classified by the C-EOS system, were isolated and subdivided by underlying diagnosis into 5 groups. EOSQ domains and composite HrQOL score at presentation, 2-year, and 5-year follow-up were compared across underlying diagnosis.</p><p><strong>Results: </strong>A total of 65 neuromuscular EOS patients were identified (mean 7.6 ± 1.99 years of age, 50% female). Cerebral palsy was the most common underlying diagnosis (30%, N = 18), followed by spinal muscular atrophy (SMA, N = 16). There were differences in EOSQ domains with CP, SMA, and MD having significantly lower scores than Chiari/Syrinx patients at 2-year follow-up. Chiari/Syrinx patients demonstrated EOSQ scores statistically similar to idiopathic EOS patients at all time points (P > 0.05). CP patients were most likely to experience improvement in HrQOL at 5-year follow-up.</p><p><strong>Conclusion: </strong>Underlying NM diagnosis has direct implications on treatment response following GFI for EOS. Cerebral palsy patients demonstrate the best improvement in HrQOL at 5 years following surgery while others actually deteriorate over time. Children with EOS related to Chiari and Syringomyelia had similar HrQOL scores to idiopathic EOS and may not be best suited for inclusion in NM cohorts when assessing HrQOL scores following treatment. Increasing population-based HrQOL data may allow further refinement and prognostication of neuromuscular diagnoses over time.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971947","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":"Kyphectomy followed by self-sliding pedicle screw and translumbosacral rod impaction and fixation: a novel growth-friendly technique in myelomeningocele patients.","authors":"Alderico Girão Campos Barros, Diogo R Noronha, Luis E Carelli, David L Skaggs","doi":"10.1007/s43390-024-01036-1","DOIUrl":"https://doi.org/10.1007/s43390-024-01036-1","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital lumbar kyphosis is present in about 15% of patients with myelomeningocele. Worsening of deformity with complications such as chronic skin ulcers and bone exposure is common. In patients under 8 years of age, treatment becomes even more challenging: in addition to resecting the apex of the kyphotic deformity, we should ideally stabilize the spine with fixation methods that do not interrupt the growth of the rib cage, associated with the challenging pelvic fixation in this population. The emergence of growth-friendly techniques has greatly benefited patients with early-onset deformity, allowing for correction and control of deviation without interrupting trunk growth, which is often already compromised in these patients. We describe the surgical technique and present preliminary clinical outcomes for a novel approach which combines self-sliding screws that allow for trunk growth with impaction of translumbosacral rods for distal fixation.</p><p><strong>Methodology: </strong>Candidates for the technique were patients with myelomeningocele and congenital lumbar kyphosis, inability to assume supine position, and a history of skin ulcers, recurrent osteomyelitis and poor weight gain. They all lacked sensory or motor function below the level of the myelomeningocele. They underwent the same reconstruction technique after kyphectomy which combines self-sliding screws that allow for trunk growth with impaction of the translumbosacral rods for distal fixation.</p><p><strong>Results: </strong>Case 1: Female; 4.5 years old at surgery; 5 year follow-up. 1 complication: loosening of one blocker. The child is doing well and did not require surgical revision. Mean growth per year: 9.5 mm. Case 2: Male; 7.4 Years old at surgery; 4 year follow-up. 1 complication: post-surgical infection which required 2 debridements in the operating room and prolonged antibiotic therapy. Mean growth per year: 6 mm. Case 3: Female; 5.5 Years old at surgery; 27 month follow-up. No complications reported so far. Mean growth per year: 9.42 mm. None of the cases showed signs of sacral osteolysis or rod migration.</p><p><strong>Discussion / conclusion: </strong>To our knowledge, this is the first study that combines sliding screws with translumbosacral rod impaction. Although this technique has proven to be safe and effective, we are aware that the number of cases is limited and the follow-up is short. Further studies are necessary to confirm the method.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971695","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}