Where does the tether break in vertebral body tethering cases? Clinical insights from revision cases after tether breakage.

Purpose: To evaluate the sites where the tether breaks in vertebral body tethering (VBT) cases.

Methods: Intraoperative evaluation of broken tethers in patients who had anterior revision.

Inclusion Criteria: anterior revision of VBT cases with explantation of the full implant and photo documentation.

Outcomes and complications of vertebral body tethering by patient gender.

Purpose: 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.

Machine learning can predict surgical indication: new clustering model from a large adult spine deformity database.

Purpose: The choice of the best management for Adult Spine Deformity (ASD) is challenging. Health-related quality of life (HRQoL), comorbidities, symptoms and spine geometry, along with surgical risk and potential residual disability play a role, and a definite algorithm for patient management is lacking. Machine learning allows to analyse complex settings more efficiently than other available statistical tools.

The use of machine learning for the prediction of response to follow-up in spine registries.

Background: One of the main challenges in the maintenance of registries is to keep a high follow-up rate and a reliable strategy to limit dropout is currently lacking. Aim of this study was to utilize machine learning (ML) models to highlight the characteristics of patients who are most likely to drop out, and to evaluate the potential cost effectiveness of the implementation of a follow-up system based on the obtained data.

Methods: All patients recruited in the local spine surgery registry were included and demographic, peri- and postoperative data were collected.

Prognostic Factors in Patients Undergoing Physiotherapy for Chronic Low Back Pain: A Level I Systematic Review.

: Low back pain is common. For patients with mechanic or non-specific chronic LBP (cLBP), the current guidelines suggest conservative, nonpharmacologic treatment as a first-line treatment. Among the available strategies, physiotherapy represents a common option offered to patients presenting with cLBP.

Should the pelvis be included? An analysis of distal junctional failure risk factors in correcting adult spinal deformity in women with fusion to L5.

Purpose: To identify the risk factors for distal junctional failure (DJF) in women treated for adult spine deformity with fusion to L5 and to highlight the significance of preoperative assessment, surgical decision-making, and postoperative care.

Methods: This is a retrospective study of data collected prospectively on the local institutional spine surgery registry (2016-2021). All patients, women older than 18 years, with a diagnosis of adult spine deformity who underwent long posterior instrumentation to L5 and had a minimum of 2-years follow-up were included in the study (two groups: with or without DJF).

Calculation of the minimal clinically important difference in operated patients with adult spine deformity: advantages of the ROC method and significance of prevalence in threshold selection.

Purpose: The Minimal Clinically Important Difference (MCID) is crucial to evaluate management outcomes, but different thresholds have been obtained in different works. Part of this variability is due to measurement error and influence of the database, both essential for calculating the MCID. The aim of this study was to introduce the association of the ROC method in the anchor-based MCID calculation for ODI, SRS-22r, and SF-36, to objectively set the threshold for the anchor-based MCID in an adult spine deformity (ASD) population.

Physiotherapeutic and non-conventional approaches in patients with chronic low-back pain: a level I Bayesian network meta-analysis.

Chronic low back pain (cLBP) is a major cause of disability and healthcare expenditure worldwide. Its prevalence is increasing globally from somatic and psychosocial factors. While non-pharmacological management, and in particular physiotherapy, has been recommended as a first-line treatment for cLBP, it is not clear what type of physiotherapeutic approach is the most effective in terms of pain reduction and function improvement.

Predictors of success of pharmacological management in patients with chronic lower back pain: systematic review.

Background: Conservative management is recommended as the first therapeutic step in chronic low back pain (LBP), but there is no available evidence regarding the possible effect of patients' baseline characteristics on the therapeutic outcomes. A systematic review of the literature was performed to investigate this point.

Methods: In February 2024, all the level I studies investigating the role of pharmacological management for chronic LBP were accessed.

Primary Pelvic Anteversion: Definition, Relevance, and History After Surgery for Adult Spine Deformity.

Study Design: Retrospective analysis of prospectively collected data.

Objective: To identify the best definition of primary anteverted pelvis in the setting of adult spine deformity (ASD), and to investigate whether this is a pathologic setting that requires surgical correction.

Summary Of Background Data: While pelvic retroversion has been thoroughly investigated, pelvic anteversion (AP) is a far lesser discussed topic.

Obesity increases the odds of intervertebral disc herniation and spinal stenosis; an MRI study of 1634 low back pain patients.

Purpose: The objective of this study was to examine the relationships between BMI and intervertebral disc degeneration (DD), disc herniation (DH) and spinal stenosis (SS) using a large, prospectively recruited and heterogeneous patient population.

Methods: Patients were recruited through the European Genodisc Study. An experienced radiologist scored MRI images for DD, DH and SS.

Clinical experience and complications with limited pleural dissection combined with a novel, simplified technique for thoracic Redon-like drain in vertebral body tethering.

Purpose: To report on our experience with a simplified, suction-bottle-drain technique of thoracic drain (Redon-like) combined with fully thoracoscopic vertebral body tethering (VBT) and a limited pleural approach, with particular focus on the rate of pulmonary complications.

Methods: A retrospective study was performed on all consecutive patients who underwent VBT for adolescent idiopathic scoliosis. For all subjects, a 10G Redon drain, an active drain system consisting of a perforated tube and a suction bottle, was placed intrathoracically and tunneled under the skin.

Duloxetine for fibromyalgia syndrome: a systematic review and meta-analysis.

Introduction: The optimal dose of duloxetine in the management of fibromyalgia remains still controversial. Therefore, a systematic review and meta-analysis to investigate efficacy and safety of duloxetine was conducted. The outcomes of interests were to assess changes in Fibromyalgia Impact Questionnaire (FIQ), Brief Pain Inventory (BPI), and Clinical Global Impression (CGI).

Adolescent idiopathic scoliosis with concomitant spondylolysis: choice of fusion levels and evaluation of the outcomes obtained leaving the lytic level not instrumented.

Purpose: 7% of adolescent idiopathic scoliosis (AIS) patients also present with a pars defect. To date, there are no available data on the results of fusion ending proximal to a spondylolysis in the setting of AIS. The aim of this study was to analyze the outcomes of posterior spinal fusion (PSF) in this patient cohort, to investigate if maintaining the lytic segment unfused represents a safe option.

Quality Control for Spine Registries: Development and Application of a New Protocol.

Registries are gaining importance both in clinical practice and for research purposes. However, quality control is paramount to ensure that data are consistent and reliable. Quality control protocols have been proposed for arthroplasty registries, but these are not directly applicable to the spine setting.

The different applications of Vertebral Body Tethering - Narrative review and clinical experience.

Background: Vertebral body tethering (VBT) has been originally developed as a growth modulation technique for the surgical management of skeletally immature patients with adolescent idiopathic scoliosis (AIS). Given the positive results obtained in this setting, the use of VBT is gradually expanding to other patient categories, such as those with no or limited remaining growth or with non-idiopathic scoliosis. Aim of this manuscript is to offer an overview over the current applications of VBT, along with imaging and comments derived from the clinical experience.

Safety and Efficacy of Stand-Alone Bioactive Glass Injectable Putty or Granules in Posterior Vertebral Fusion for Adolescent Idiopathic and Non-Idiopathic Scoliosis.

Posterior spinal fusion (PSF) is the standard procedure for the treatment of severe scoliosis. PSF is a standard procedure that combines posterior instrumentation with bone grafting and/or bone substitutes to enhance fusion. The aim of this retrospective study was to evaluate and compare the post-operative safety and efficiency of stand-alone bioactive glass putty and granules in posterior spine fusion for scoliosis in a paediatric cohort.

Nonopioid pharmacological management of acute low back pain: A level I of evidence systematic review.

Acute low back pain (LBP) imposes a significant socioeconomical burden as it is the condition that, worldwide, cause the most disability. Nonetheless, the literature regarding the best pharmacological management of acute LBP is limited, and the indications available in the literature are conflicting. This work investigates whether the pharmacological management of acute LBP can effectively reduce pain and disability, and aims to identify which drugs show the highest efficacy.

The use of electronic conductivity devices can effectively reduce radiation exposure in vertebral body tethering.

Introduction: Vertebral body tethering (VBT) presents new challenges in respect to radiation exposure, as screws cannot be placed free-hand and the lateral positioning of the patients increases scattered radiation. To reduce radiation exposure, we introduced the use of electronic conductivity device (ECD). These are drilling probes send an audio signal when cortical bone is breached.

Surgical strategies for chondral defects of the patellofemoral joint: a systematic review.

Background: The management of chondral defects of the patellofemoral joint is debated, and definitive evidence is lacking. This study systematically updated and summarised the current literature on the surgical management of isolated chondral defects of the patellofemoral joint, discussing techniques, outcome, pitfalls, and new frontiers.

Methods: This systematic review was conducted according to the 2020 PRISMA statement.

The influence of total disc arthroplasty with Mobidisc prosthesis on lumbar spine and pelvic parameters: a prospective in vivo biomechanical study with a minimum 3 year of follow-up.

Background: This study examined the impact of Mobidisc implant on spinopelvic parameters, with particular focus on the preservation of the lumbar lordosis (LL) and on the segmental lordosis (SL) of the treated and adjacent segments.

Methods: A prospective study was conducted on 63 consecutive patients with symptomatic degenerative disc disease who underwent Mobidisc implantation at the Clinic for Spinal Diseases in Strasbourg, France. Based on the profile images of the whole, the following static spinopelvic parameters were measured and analysed: lumbar lordosis L1-S1 (LL), SL for L3-L4, L4-L5 and L5-S1, sacral slope (SS), pelvic tilt (PT) and pelvic incidence.