Spine deformity最新文献

{"title":"Utility of flexibility assessment by preoperative fulcrum-side bending for distal adding-on after posterior corrective fixation in adolescent idiopathic scoliosis Lenke types 1 and 2.","authors":"Tetsutaro Abe, Masashi Miyazaki, Noriaki Sako, Nobuhiro Kaku","doi":"10.1007/s43390-025-01104-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01104-0","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the factors associated with distal adding-on (DAO) in Lenke type 1, 2 adolescent idiopathic scoliosis (AIS), particularly concerning flexibility assessment using preoperative fulcrum side bending (FSB). In addition, a secondary aim of this study was to compare the effectiveness of Fulcrum Side Bending (FSB) and Active Side Bending (ASB) radiographs, obtained in standing and supine positions, in assessing the flexibility of the main curve.</p><p><strong>Methods: </strong>We analysed 32 patients who underwent posterior corrective fixation for Lenke type 1, 2 AIS. Correction was performed using the all-pedicle screw method and the fixed caudal end was the last touching vertebra (LTV). Radiographic parameters, such as the standing Cobb angle (proximal thoracic, PT; main thoracic, MT; thoracolumbar, TL), were measured before surgery, after surgery and 2 years postoperatively. The Cobb angle was also evaluated under stress conditions of ASB and FSB, and the difference from the standing Cobb angle was calculated as ΔASB and ΔFSB. Patients were grouped based on the occurrence of DAO.</p><p><strong>Results: </strong>DAO occurred in 12 patients (37.5%); comparing the DAO and non-DAO groups, ΔFSB(PT) (11.2 ± 6.0 vs. 6.9 ± 5.8, p = 0.04) and ΔFSB(MT) (43.9 ± 13.1 vs. 35.9 ± 6.7, p = 0.02) and correction rate (MT) (81.2 ± 8.4 vs. 73.6 ± 9.8, p = 0.02) were significantly greater. Logistic regression analysis showed that the risk factors for DAO were ΔFSB (MT) (odds ratio 1.23 ± 0.098, p = 0.03) and correction rate (MT) (odds ratio 1.17 ± 0.083, p = 0.04).</p><p><strong>Conclusions: </strong>ΔFSB and correction rate in MT were a risk factor for DAO. In cases with large MT corrections, the coronal plane was overbalanced in the TL, which could cause DAO during the postoperative course. Care should be taken in the setting of the lowest instrumented vertebra (LIV) to prevent DAO in patients with significant MT correction on preoperative FSB.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046041","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":"Predictors of massive transfusion of allogenic blood products during posterior spinal fusion in patients with cerebral palsy.","authors":"Ali Asma, Nicholas Gajewski, Suken A Shah, Armagan Can Ulusaloglu, Denver B Kraft, Petya K Yorgova, Paul D Sponseller, Amit Jain, Burt Yaszay, Amer F Samdani, Firoz Miyanji","doi":"10.1007/s43390-025-01091-2","DOIUrl":"10.1007/s43390-025-01091-2","url":null,"abstract":"<p><strong>Purpose: </strong>This article aimed to determine modifiable risk factors to prevent massive blood transfusion of blood products (MTBP) during spinal fusion in patients with cerebral palsy.</p><p><strong>Methods: </strong>Patient data were queried from a prospectively collected multicenter database. Perioperative MTBP was defined as the administration of allogenic blood products equaling at least half (50%) of the patients' preoperative blood volume during the surgical procedure. Univariate and multivariate logistic regression was used for statistical analysis.</p><p><strong>Results: </strong>Three hundred thirty-three patients were included. Ninety-four percent of patients were Gross Motor Classification System IV and V. The incidence of MTBP was 29.7% (99/333). The lack of antifibrinolytic use was significant at univariate analysis. Preoperative low weight, blood volume loss, hybrid system, and unit rod use remained significant after the adjustment in multivariate analysis. Loss of more than 68% of patient blood volume was the threshold for MTBP. Patients receiving MTBP had increased hospital (P = 0.006) and intensive care unit (P < 0.001) stays. However, surgical site complications, deep wound infections, and reoperation rate were not different (P = 0.12, P = 0.46, P = 0.22, respectively). There was a significant decrease in MTBP incidence from 2008 (53%) to 2016 (11%) (P < 0.001) with routine administration of antifibrinolytics.</p><p><strong>Conclusion: </strong>The incidence of MTBP in patients with cerebral palsy undergoing PSF during the study period was 29.7% and this rate has decreased over time, making the surgery safer. Optimization of preoperative nutrition status, use of pedicle screw constructs when possible, and use of antifibrinolytics when not contraindicated is recommended to reduce the risk of perioperative MTBP.</p><p><strong>Level of evidence: </strong>Level III-Retrospective cohort study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029053","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 outcomes for moderate adolescent idiopathic scoliosis in boys and girls: should we counsel them the same?","authors":"Julia Todderud, Michelle C Marks, Daniel Sucato, Nicholas Fletcher, Peter Newton, Michael Kelly, Keith Bachmann, Stefan Parent, Firoz Miyanji, Burt Yaszay, Patrick Cahill, A Noelle Larson","doi":"10.1007/s43390-025-01096-x","DOIUrl":"10.1007/s43390-025-01096-x","url":null,"abstract":"<p><strong>Purpose: </strong>With this study, we aim to evaluate and compare the perioperative outcomes of PSF for girls and boys. We hypothesize that female patients will have better curve correction and lower rates of complications when compared to male patients.</p><p><strong>Methods: </strong>This study employed a retrospective review of AIS patients who underwent PSF at 23 sites between 2011 and 2021, limited to preoperative curves between 40 and 60° and stratified based on sex assigned at birth. All patients had preoperative and 2-year follow-up and were evaluated for correction, complications, surgery metrics, and patient reported outcomes.</p><p><strong>Results: </strong>1714 patients were included in this study: 1381 girls, 333 boys. At time of surgery, the mean age was 15.4 ± 2 years for girls and 16.4 ± 2 years for boys. Boys were significantly taller and heavier than the girls. The preoperative curve magnitude was equivalent (major Cobb 50° in girls and boys, p = 0.799). Boys and girls had median 10 levels instrumented [IQR 2] (p = 0.012). At 2-year follow-up, girls with primary thoracic curves had better coronal curve measurements (22° ± 7 vs 23° ± 8, p = 0.002) and percent correction (56% ± 14 vs 53% ± 16, p = 0.004). For primary lumbar curves, curve measurements and percent correction were not different. SRS scores for 2-year post-operative patient reported outcomes were not different in boys and girls. 191 girls experienced complications compared to 48 boys (14% of their cohorts, p = 0.31). 67 girls and 14 boys underwent reoperation (5% vs 4%, p = 0.61).</p><p><strong>Conclusions: </strong>At 2 years following spinal fusion for AIS, boys and girls with moderate curves exhibit similar postoperative curve correction and SRS scores. Complication rates had no difference by patient sex.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015723","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":"Can postoperative changes in pelvic incidence occur after adult spine deformity surgery? When do they occur, and what factors influence them? A systematic review with pooled analysis.","authors":"Marco Manzetti, Alberto Ruffilli, Giovanni Viroli, Matteo Traversari, Marco Ialuna, Chiara Ricci Petitoni, Cesare Faldini","doi":"10.1007/s43390-025-01103-1","DOIUrl":"https://doi.org/10.1007/s43390-025-01103-1","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic incidence (PI) is traditionally considered a constant anatomic parameter in adult spinal deformity (ASD) surgery. However, emerging evidence suggests that PI may change postoperatively, potentially influencing sagittal balance and mechanical complications. This study aims to systematically review the literature on postoperative PI variations in ASD patients, identifying potential radiologic and surgical predictors.</p><p><strong>Methods: </strong>Papers describing postoperative PI changes in ASD patients were included in the analysis. The rate of PI changes, in different subgroups of patients was considered for outcome measure. Meta-analyses were performed to determine the prevalence and factors influencing PI changes.</p><p><strong>Results: </strong>Thirteen studies (1055 patients) met the inclusion criteria. All included studies assessed spinopelvic parameters using standing full-spine X-rays, except for one that used full-body standing X-rays, demonstrating moderatehigh reproducibility in PI measurement (ICC: 0.71-0.96). While the mean absolute PI value remained stable postoperatively, 46.3% of patients experienced significant changes (> 5°). Factors associated with PI variations included fusion area, pelvic fixation type, preoperative sagittal imbalance, and extreme PI values. Sacropelvic fixation reduced PI instability, whereas prolonged anterior imbalance and compensatory pelvic retroversion increased the likelihood of PI shifts. Long-term follow-ups indicated that PI changes could not recover or increase in patients without sacropelvic fixation and in patients with higher preoperative PI values if they experience a decrease in PI postoperatively.</p><p><strong>Conclusion: </strong>The current literature challenges the traditional belief that PI is a static parameter in ASD surgery, particularly in severely imbalanced patients or those with extreme PI values. Acknowledging that PI may change under certain preoperative conditions could help optimize postoperative sagittal realignment in selected groups of ASD patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of thoracic structure and function using CT and dynamic MRI in pediatric thoracic insufficiency syndrome with and without neuromuscular disease.","authors":"Sara Hassani, Yubing Tong, Nima Broomand Lomer, Jayaram K Udupa, Caiyun Wu, Joseph M McDonough, Samantha Gogel, Oscar H Mayer, David M Biko, Patrick J Cahill, Jason B Anari, Drew A Torigian","doi":"10.1007/s43390-025-01095-y","DOIUrl":"https://doi.org/10.1007/s43390-025-01095-y","url":null,"abstract":"<p><strong>Purpose: </strong>Thoracic insufficiency syndrome (TIS) impairs normal respiration and lung growth. In pediatric patients with or without neuromuscular disease (NMD), the relationship between thoracic structure and regional respiratory function remains understudied. We aimed to evaluate these interrelationships using dynamic magnetic resonance imaging (dMRI) and computed tomography (CT).</p><p><strong>Methods: </strong>This study included 25 pediatric TIS patients: 8 with NMD and 17 without NMD. Thoracic dMRI and CT images were analyzed to quantify intercostal muscle (ICM) volume, skeletal muscle (SM) volume, lung volumes at end-inspiration and end-expiration, chest wall excursion volume, and diaphragm excursion volume. Right-to-left volumetric symmetry ratios were compared using unpaired t-testing, and correlations between structural and functional parameters were assessed using Pearson correlation analysis.</p><p><strong>Results: </strong>Lung and muscle volumes were generally larger in the TIS-NMD compared to TIS non-NMD, reflecting age-related differences, although lung tidal volumes and diaphragmatic and chest wall excursion volumes were generally similar. The degree of asymmetry reflected by diaphragmatic respiratory function symmetry ratios exceeded that of chest wall symmetry ratios in both groups, with greater disparity in TIS-NMD (3.6 vs 1.8 in TIS-NMD compared to 2.8 vs 2.5 in TIS non-NMD). Correlation between thoracic SM volume and tidal volume was stronger than the correlation between ICM volume and tidal volume in both groups. TIS-NMD patients demonstrated unique compensatory dynamics, including a negative correlation between SM volume and diaphragmatic excursion volume.</p><p><strong>Conclusion: </strong>Distinct interrelationships exist between thoracic structure and function in TIS patients with and without NMD. These findings suggest that NMD significantly influences respiratory mechanics, emphasizing the role of SM and diaphragm interaction.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032780","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":"What happens to the hip after scoliosis surgery in neuromuscular patients? Analyzing factors linked to pain, displacement, and need for surgery.","authors":"Carmen Martínez-González, María Galán-Olleros, Laura Olías-Ortiz, Ana Ramírez-Barragán, Rosa M Egea-Gámez, Rafael González-Díaz, Ignacio Martínez-Caballero","doi":"10.1007/s43390-025-01097-w","DOIUrl":"https://doi.org/10.1007/s43390-025-01097-w","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with neuromuscular diseases frequently develop hip displacement (HD) and scoliosis, creating complex challenges in determining the optimal treatment strategy and sequence. This study aims to assess the frequency of new hip problems, including pain and HD progression, as well as the need for additional hip surgery following scoliosis correction in neuromuscular patients, and to identify predictive factors for these issues.</p><p><strong>Methods: </strong>This retrospective study included 71 neuromuscular patients (142 hips) who underwent posterior spinal fusion (PSF) at a specialized center between 2015 and 2022. Clinical data such as age, sex, underlying pathology, ambulatory status, and prior hip surgeries were collected. Radiological parameters, including curve characteristics, coronal imbalance, Cobb angle, pelvic obliquity (PO), and migration percentage (MP), were measured pre- and post-operatively. Descriptive, comparative, and multivariate analyses, including logistic regression, were performed to identify significant predictors and determine optimal cutoff points.</p><p><strong>Results: </strong>The mean age of patients was 15 ± 2 years, with 59% female and 84.5% nonambulatory. After scoliosis surgery, 15.5% of hips developed new hip problems: 20 hips experienced pain and 9 had HD progression, with 7 requiring additional surgery (3 reconstructive and 4 palliative). Factors including a preoperative up-hip and increased MP, with a cutoff > 25%, were strong predictors of hip pain. HD progression was linked to a postoperative up-hip and increased MP, with MP > 60% emerging as a critical predictor. The need for additional hip surgery was associated with cerebral palsy (CP) and with increased MP.</p><p><strong>Conclusions: </strong>Approximately 1 in 7 hips developed new-onset problems following PSF in neuromuscular patients. Factors including a preoperative up-hip and increased MP were significant predictors of adverse outcomes, underscoring the importance of thorough preoperative assessment, personalized surgical planning, and proactive counseling regarding potential postoperative complications.</p><p><strong>Level of evidence: </strong>Level IV, retrospective cohort study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045349","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 retrospective analysis of patients deemed ineligible for surgery in a multidisciplinary complex spine conference.","authors":"Patricia Lipson, Rafael Garcia de Oliveira, Takeshi Fujii, Jean-Christophe Leveque, Venu M Nemani, Philip K Louie, Rajiv K Sethi","doi":"10.1007/s43390-025-01099-8","DOIUrl":"https://doi.org/10.1007/s43390-025-01099-8","url":null,"abstract":"<p><strong>Purpose: </strong>Assess patient experiences and outcomes following a multidisciplinary conference recommendation against surgery, including the proportion who later pursued surgery elsewhere and their outcomes.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients advised against surgery during our internal multidisciplinary ASD conference. A phone-based survey gathered on patient satisfaction, effectiveness of alternative treatments, rates of operations at outside hospitals, and subsequent rates of complications, reoperations, and readmissions among those who underwent surgery.</p><p><strong>Results: </strong>One hundred one patients had an evaluation by a multidisciplinary conference from 2015 to 2024 with an initial recommendation against surgery; 9 later met surgical criteria and underwent surgery with our group, while 17 died before this study. Of the remaining 75, 2 were unable to participate due to medical reasons, and 33 were unreachable, leaving 40 survey participants. Nine declined to answer, and thirty-one completed the survey. Among respondents, 71% were satisfied with the recommendation against surgery, and 38.7% sought a second opinion. Of those, 41.7% (5/12) were recommended surgery, and 33% (4/12) underwent surgery elsewhere with minimal complications. Most respondents rated their quality of life as 'acceptable' and used physical therapy and pain management for symptom control.</p><p><strong>Conclusion: </strong>While most patients were satisfied with our recommendation against surgery, a notable subset sought second opinions, and some ultimately underwent successful surgery. These findings highlight the need for periodic reassessment of multidisciplinary conference criteria to ensure optimal patient outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034619","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":"\"Cured\" patients with early-onset idiopathic scoliosis after serial casting are at risk of recurrence at intermediate follow-up.","authors":"Rayyan Abid, Abigail E Manning, Peter F Sturm, Ying Li, Craig M Birch, Michal Szczodry, Michael P Glotzbecker","doi":"10.1007/s43390-025-01092-1","DOIUrl":"https://doi.org/10.1007/s43390-025-01092-1","url":null,"abstract":"<p><strong>Purpose: </strong>Serial casting limits curve progression while preserving spinal growth, delaying or even eliminating the need for surgery. Some patients with EOIS can be \"cured\" with curve reduction under 15°. However, no long-term studies have defined whether \"cured\" patients maintain small curves or if they are at risk of progression. We examined if casting patients remained \"cured\" following treatment.</p><p><strong>Methods: </strong>We identified 40 EOIS patients who were treated with serial casting, achieved curves under 15° and had minimum 2 years of follow-up after completing the treatment. Failure was defined as an increase > 6° resulting in a curve magnitude > 15° at any point during follow-up, requiring cast/brace treatment after cessation of initial cast/brace, or undergoing surgery. Average curve magnitude at the time of cure was 11.1°. Kaplan-Meier survival analysis was used to identify failure rates over time.</p><p><strong>Results: </strong>10 patients (25.0%) met criteria for failure. Mean time from cure to last follow-up was 4.3 years. 3 patients (7.5%) completed bracing and were later re-braced while 2 (5.0%) required surgery. Mean curve magnitude of \"failed\" patients was 27.4° with an average increase of 15.6°. At 5.1 years, probability of successful treatment is 64.2%. For \"failed\" patients, median time to failure was 2.4 years. Successful patients were braced for median 1.4 years, while \"failed\" patients had a median of 1 year.</p><p><strong>Conclusion: </strong>While EOIS patients may be \"cured\" with serial casting, this may not be sustained. The percentage of \"failures\" likely will increase with longer follow-up through skeletal maturity, and patients must be closely monitored after concluding casting/bracing.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035342","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 roommate: does double-occupancy rooming impact recovery from pediatric spinal fusion surgery?","authors":"Alexa P Bosco, Margaret L Sullivan, Daniel Gabriel, Shanika De Silva, Daniel J Hedequist, Michael T Hresko, Craig M Birch, Grant D Hogue","doi":"10.1007/s43390-025-01093-0","DOIUrl":"https://doi.org/10.1007/s43390-025-01093-0","url":null,"abstract":"<p><strong>Purpose: </strong>Single occupancy inpatient recovery rooms are perceived by health care professionals to positively influence patients' experience, while double rooms are associated with higher noise levels, sleep disturbances, and a lack of privacy. These differing physical environments may manifest in differing length of stay, pain scores, and opioid use. When bed space is scarce, identifying ideal populations for double occupancy rooming is important. This study aims to assess how inpatient room assignment impacts recovery time, opioid consumption, and patient reported pain for adolescent idiopathic scoliosis (AIS) patients undergoing a posterior spinal fusion (PSF).</p><p><strong>Methods: </strong>A retrospective cohort study of AIS patients who underwent PSF from 2011 to 2017 at a single center was conducted. Demographics and baseline radiographic measurements were summarized using appropriate statistics. Intraoperative and postoperative outcomes, as well as numerical ranking scale (NRS) pain scores and total daily opioid administration, were compared across room types using t tests, Wilcoxon rank sum tests, Chi-squared tests, or Fisher's exact tests, as appropriate. GEE models were constructed to examine the influence of room type and days since surgery on outcomes.</p><p><strong>Results: </strong>The cohort included 635 patients: 448 (71%) assigned to a double room and 187 (29%) to a single room. The mean age was 15 ± 2 years and 83% of patients were female. Length of hospital stay, complication rates, 2-year outcomes, inpatient pain scores, and daily opioid usage did not significantly differ between room types (all p > 0.05). Adjusted GEE models revealed no significant associations between room type and pain scores (p = 0.9) or between room type and total opioid dosage (p = 0.95).</p><p><strong>Conclusion: </strong>When bed space is scarce, double occupancy rooming for pediatric patients after PSF surgery for AIS can serve as a relief valve to continue elective practices without compromising post-operative outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998125","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":"Current practices in MRI screening in early onset scoliosis.","authors":"Austin W Li, Alexander Chang, Joshua S Murphy, Ying Li, Benjamin Roye, Christina K Hardesty, Michael P Glotzbecker","doi":"10.1007/s43390-024-01033-4","DOIUrl":"10.1007/s43390-024-01033-4","url":null,"abstract":"<p><strong>Purpose: </strong>Early onset scoliosis (EOS) has traditionally been an indication for MRI because of its association with neural axis abnormalities (NAAs). Because these abnormalities are often clinically silent and concerns regarding sedation in young children are growing, routine MRI for EOS is debated. This study investigates the current practices of EOS MRI screening among surgeons in the Pediatric Spine Study Group (PSSG).</p><p><strong>Methods: </strong>A survey assessing EOS MRI practices was distributed to the PSSG. The survey presented scenarios that varied in age, curve size, and diagnosis and asked which scenarios would indicate an MRI. Respondents also ranked age, curve progression, etiology, and need for sedation by level of importance when considering to order MRI.</p><p><strong>Results: </strong>Age and curve progression were ranked as the most important factors when deciding to order MRI. For all non-congenital scoliosis, increased age and curve size were associated with increased rates of MRI among respondents. For idiopathic EOS, more than 60% of respondents would order MRI for patients with curve magnitudes of 45° regardless of age. All respondents would order MRI for congenital EOS before surgery and for EOS caused by neurofibromatosis. For EOS secondary to cerebral palsy, 61% of respondents would order an MRI, and 34% believe that EOS and Prader-Willi syndrome require MRI.</p><p><strong>Conclusion: </strong>Our results indicate that the MRI screening practices for EOS vary greatly between physicians, as expected. Future research on the prevalence of NAAs in EOS and the clinical outcomes of routine MRI is needed to inform which MRI practices should be standard.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"961-966"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}