Can Artificial Intelligence Deceive Residency Committees? A Randomized Multicenter Analysis of Letters of Recommendation.

Introduction: The introduction of generative artificial intelligence (AI) may have a profound effect on residency applications. In this study, we explore the abilities of AI-generated letters of recommendation (LORs) by evaluating the accuracy of orthopaedic surgery residency selection committee members to identify LORs written by human or AI authors.

Methods: In a multicenter, single-blind trial, a total of 45 LORs (15 human, 15 ChatGPT, and 15 Google BARD) were curated.

Relative Citation Ratio Among Pediatric Orthopaedic Surgeons: Examining the Factors Associated With Higher Scores.

Introduction: Academic scholarship is often valued by clinicians, peers, and intuitions. Quantifying the effect of research publications is challenging. Various metrics have been used to assess this.

A team approach to improve outcomes in pediatric scoliosis surgery: a review of the current literature.

Study Design: Review article.

Objective: To review the literature on the effect of specialized pediatric spine teams on clinical outcomes.

Results: Thirty-eight studies were identified in the review.

Goldenhar syndrome associated with increased risk of respiratory failure and reoperations following spinal deformity surgery.

Background: Goldenhar syndrome is a rare congenital disease that presents with a spectrum of clinical sequelae related to the vertebrae and other organs. The spinal manifestations of the syndrome are associated with scoliosis for which fusion may be considered. The current study aimed to evaluate the risks of adverse events and reoperations following posterior spinal fusion for those with Goldenhar syndrome relative to those with adolescent idiopathic scoliosis (AIS).

Pre-contoured patient-specific rods result in superior immediate sagittal plane alignment than surgeon contoured rods in adolescent idiopathic scoliosis.

Background: Adolescent idiopathic scoliosis (AIS) surgery typically involves posterior spinal fusion (PSF) using rods contoured by the surgeon, which may be time-consuming and may not reliably restore optimal sagittal alignment. However, pre-contoured patient-specific rods may more optimally restore sagittal spinal alignment. This study evaluates the radiographic outcomes of AIS patients who underwent PSF utilizing surgeon contoured pre-contoured rods.

Impact of a quality improvement initiative and monthly multidisciplinary meetings on outcomes after posterior spinal fusion for adolescent idiopathic scoliosis.

Introduction: Several studies have demonstrated the benefits of enhanced recovery after surgery (ERAS) protocols for patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal instrumented fusion (PSIF). However, there are relatively few studies investigating the effect of regular multidisciplinary team meetings on level selection, surgical performance parameters, and patient outcomes after PSIF for AIS. The aim of this study was to assess changes in intra- and postoperative outcomes following multidisciplinary team meeting implementation for patients undergoing PSIF for AIS.

Total spine MRI for the preoperative evaluation of adolescent idiopathic scoliosis: Part 2 - spinal cord tumors, dysraphisms, diastematomyelia, and vertebral anomalies.

Adolescent idiopathic scoliosis is a commonly encountered condition often diagnosed on screening examination. Underlying, asymptomatic neural axis abnormalities may be present at the time of diagnosis. At certain institutions, total spine MRI is obtained preoperatively to identify these abnormalities.

Total spine MRI for the preoperative evaluation of adolescent idiopathic scoliosis: part 1.

Adolescent idiopathic scoliosis is a commonly encountered condition often diagnosed on screening examination. Underlying, asymptomatic neural axis abnormalities may be present at the time of diagnosis. At certain institutions, total spine MRI is obtained preoperatively to identify these abnormalities.

Performance and reliability assessment of a lower dose, task-based scoliosis radiography protocol in pediatric patients.

Background: Follow-up scoliosis radiographs are performed to assess the degree of spinal curvature and skeletal maturity, which can be done at lower radiation exposures than those in standard-dose radiography.

Objective: Describe and evaluate a protocol that reduced the radiation in follow-up frontal-view scoliosis radiographs.

Materials And Methods: We implemented a postero-anterior lower dose modified-technique for scoliosis radiography with task-based definition of adequate image quality and use of technique charts based on target exposure index and patient's height and weight.

3D printed pedicle screw guides reduce the rate of intraoperative screw revision in adolescent idiopathic scoliosis surgery.

Background Context: Pedicle screw fixation has become common in the treatment of adolescent idiopathic scoliosis (AIS). Malpositioned pedicle screws have significant complications and identifying surgical techniques to optimize screw placement accuracy is imperative.

Purpose: To compare the rate of intraoperative revision, replacement, or removal of pedicle screws placed utilizing 3D printed guides compared with pedicle screws placed utilizing a freehand technique.

Association Between Intravenous to Oral Opioid Transition Time and Length of Hospital Stay After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Background: Transitioning from intravenous (IV) to oral opioids after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) is necessary during the postoperative course. However, few studies have assessed the effects of longer transition times on hospital length of stay (LOS). This study investigated the impact of longer IV to oral opioid transition times on LOS after PSF for AIS.

Impact of insurance status on healthcare resource utilization and outcomes in adolescent patients presenting with spinal cord injuries.

Objective: Insurance disparities have been suggested to influence the medical and surgical outcomes of adult patients with spinal cord injury (SCI), with a paucity of studies demonstrating their impact on the outcomes of pediatric and adolescent SCI patients. The aim of this study was to assess the impact of insurance status on healthcare utilization and outcomes in adolescent patients presenting with SCI.

Methods: An administrative database study was performed using the 2017 admission year from 753 facilities using the National Trauma Data Bank.

Incisional Negative Pressure Wound Therapy Does Not Affect Deep Surgical Site Infection Rates in Neuromuscular Scoliosis Surgery.

Surgical site infection (SSI) is a devastating complication in patients with neuromuscular scoliosis (NMS) undergoing posterior spinal instrumented fusion (PSIF) for progressive scoliosis. Incisional negative pressure wound therapy (INPWT) has been used in other surgical fields to reduce SSI. Our purpose was to examine the prophylactic use of INPWT after NMS surgery to decrease SSI.

Management of dynamic cervical kyphosis with dorsal epidural lipomatosis: a Hirayama disease variant? Illustrative case.

Background: Hirayama disease, a cervical myelopathy characterized most commonly by a self-limiting atrophic weakness of the upper extremities, is a rare entity, scarcely reported in the literature. Diagnosis is made by spinal magnetic resonance imaging (MRI), which typically shows loss of normal cervical lordosis, anterior displacement of the cord during flexion, and a large epidural cervical fat pad. Treatment options include observation or cervical immobilization by collar or surgical decompression and fusion.

Prospective analysis of home narcotic consumption and management of excess narcotic prescription following adolescent idiopathic scoliosis surgery.

Purpose: The aim of this study was to identify factors associated with the outpatient narcotic intake of patients following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) and to introduce a safe and effective method of disposing of unused narcotics.

Methods: Following Institutional Review Board approval, retrospective review of prospectively collected data from patients undergoing PSF for AIS took place. Pain scores, narcotic use, patient demographic data, pre-, intra-, and postoperative parameters, and discharge data were gathered via chart review.

Three-dimensional printing versus freehand surgical techniques in the surgical management of adolescent idiopathic spinal deformity.

Background: Three-dimensional (3D) printed guides are finding increasing applications in the field of orthopaedic surgery and more recently spine surgery. This retrospective cohort study compares benefits and costs of 3D printed guides in surgical treatment of adolescent idiopathic scoliosis (AIS) compared to freehand techniques.

Methods: Intraoperative screw placement was conducted either with 3D printed guides (3D cohort) or traditional freehand technique (freehand cohort) for AIS patients undergoing spinal fusion at a single institution.

Racial Disparities in Health Care Resource Utilization After Pediatric Cervical and/or Thoracic Spinal Injuries.

Objective: This study aimed to investigate the impact of race on hospital length of stay (LOS) and hospital complications among pediatric patients with cervical/thoracic injury.

Methods: A retrospective cohort was performed using the 2017 admission year from 753 facilities utilizing the National Trauma Data Bank. All pediatric patients with cervical/thoracic spine injuries were identified using the ICD-10-CM diagnosis coding system.

A Two-Surgeon Approach Improves Performance for Young Surgeons in Adolescent Idiopathic Scoliosis.

Adolescent idiopathic scoliosis (AIS) is a complex 3-dimensional deformity. Previous studies have suggested a learning curve in the successful execution of this technically demanding procedure. A 2-surgeon model may be helpful for less experienced surgeons by facilitating greater consistency in surgical metrics.

Use of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider.

Purpose: The use of image-guided stereotactic navigation is increasing in use in treating AIS; however, no studies have investigated perioperative outcomes and short-term adverse events compared with non-navigated procedures. The aim of the present study is to use a large national pediatric database to assess the rate of utilization of intraoperative navigation in pediatric patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis (AIS) and to compare thirty-day outcomes of navigated vs. non-navigated surgery.

Surgical site infections after posterior spinal fusion for neuromuscular scoliosis: a thirty-year experience at a single institution.

Background: Surgical site infection is a serious complication of posterior spinal fusion for neuromuscular scoliosis, with a reported prevalence of 6% to 24%. A single-institution experience over a thirty-year period was reviewed to determine the prevalence of surgical site infection after posterior spinal fusion for neuromuscular scoliosis, and to identify patient and treatment-related risk factors.

Methods: Our retrospective review included all patients treated with posterior spinal fusion (alone or in combination with an anterior procedure) for neuromuscular scoliosis from 1980 to 2009 and followed for a minimum of two years.

Clinical and laboratory parameters associated with multiple surgeries in children with acute hematogenous osteomyelitis.

Background: In the era of methicillin-resistant Staphylococcus aureus, surgical intervention seems to be increasingly common as an adjunct to treatment for pediatric acute hematogenous osteomyelitis (AHO). The purpose of this study is to identify objective clinical and laboratory parameters that are associated with repeated surgical intervention during the acute phase of treatment.

Methods: Fifty-seven children who were consecutively evaluated and treated for AHO at a single institution during 2009 were studied retrospectively.