Percutaneous endoscopic lumbar discectomy in lumbar disc herniation with posterior ring apophysis fracture: A case report in a 15-year-old child.

Rationale: Lumbar disc herniation (LDH) with posterior ring apophysis fracture (PRAF) is rather rare in children, and in all age-stratified LDH patients, the incidence of RAF was 5.3% to 7.5%.

Scoliosis in osteogenesis imperfecta: identifying the genetic and non-genetic factors affecting severity and progression from longitudinal data of 290 patients.

Background: Scoliosis is widely prevalent among osteogenesis imperfecta (OI) patients, and is progressive with age. However, factors affecting scoliosis in OI are not well known.

Methods: We retrospectively retrieved longitudinal radiographic and clinical records of consecutive OI patients seeking treatments at our hospital from 2014 to 2022, graded their pre-operative spinal conditions into four outcome groups, estimated their progression rates, and descriptively and inferentially analyzed the genetic and non-genetic factors that may affect the outcomes and progression rates.

An intelligent composite model incorporating global / regional X-rays and clinical parameters to predict progressive adolescent idiopathic scoliosis curvatures and facilitate population screening.

Background: Adolescent idiopathic scoliosis (AIS) affects up to 5% of the population. The efficacy of school-aged screening remains controversial since it is uncertain which curvatures will progress following diagnosis and require treatment. Patient demographics, vertebral morphology, skeletal maturity, and bone quality represent individual risk factors for progression but have yet to be integrated towards accurate prognostication.

Mechanical characterization and design of biomaterials for nucleus pulposus replacement and regeneration.

Biomaterials for nucleus pulposus (NP) replacement and regeneration have great potential to restore normal biomechanics in degenerated intervertebral discs following nucleotomy. Mechanical characterizations are essential for assessing the efficacy of biomaterial implants for clinical applications. While traditional compression tests are crucial to quantify various modulus values, relaxation behaviors and fatigue resistance, rheological measurements should also be conducted to investigate the viscoelastic properties, injectability, and overall stability upon deformation.

Reliability of a three-dimensional spinal proprioception assessment for patients with adolescent idiopathic scoliosis.

Purpose: Although it is evident that some patients with adolescent idiopathic scoliosis (AIS) have proprioceptive deficit in peripheral joints, knowledge on the proprioceptive function of the deformed spine is limited. Nonetheless, spinal proprioception in AIS may be affected three-dimensionally, prior studies only focussed on evaluating peripheral proprioception in single plane. Therefore, this study aimed to develop a novel spinal proprioception assessment using three-dimensional motion analysis in patients with AIS.

SARS-CoV-2 infection induces inflammatory bone loss in golden Syrian hamsters.

Extrapulmonary complications of different organ systems have been increasingly recognized in patients with severe or chronic Coronavirus Disease 2019 (COVID-19). However, limited information on the skeletal complications of COVID-19 is known, even though inflammatory diseases of the respiratory tract have been known to perturb bone metabolism and cause pathological bone loss. In this study, we characterize the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on bone metabolism in an established golden Syrian hamster model for COVID-19.

Application of deep learning upon spinal radiographs to predict progression in adolescent idiopathic scoliosis at first clinic visit.

Background: Prediction of curve progression risk in adolescent idiopathic scoliosis (AIS) remains elusive. Prior studies have revealed the potential for three-dimensional (3D) morphological parameters to prognosticate progression, but these require specialized biplanar imaging equipment and labor-intensive software reconstruction. This study aimed to formulate a deep learning model with standing posteroanterior (PA) X-rays at first clinic visit to differentiate between progressive (P) and non-progressive (NP) curves.

Learning-based fully automated prediction of lumbar disc degeneration progression with specified clinical parameters and preliminary validation.

Background: Lumbar disc degeneration (LDD) may be related to aging, biomechanical and genetic factors. Despite the extensive work on understanding its etiology, there is currently no automated tool for accurate prediction of its progression.

Purpose: We aim to establish a novel deep learning-based pipeline to predict the progression of LDD-related findings using lumbar MRIs.

Stratifying outcome based on the Oswestry Disability Index for operative treatment of adult spinal deformity on patients 60 years of age or older: a multicenter, multi-continental study on Prospective Evaluation of Elderly Deformity Surgery (PEEDS).

Background Context: Patients with adult spinal deformity suffer from disease related disability as measured by the Oswestry Disability Index (ODI) for which surgery can result in significant improvements.

Purpose: The purpose of this study was to show the change in overall and individual components of the ODI in patients aged 60 years or older following multi-level spinal deformity surgery.

Study Design: Prospective, multicenter, multi-continental, observational longitudinal cohort study PATIENT SAMPLE: Patients ≥60 years undergoing primary spinal fusion surgery of ≥5 levels for coronal, sagittal or combined deformity.

Concomitant atlantoaxial and atlanto-occipital rotatory dislocation in children: Radiological features, diagnostic pitfalls, and long-term outcome.

While the pathological manifestation of atlantoaxial rotatory dislocation has been well described in the medical literature, the combined dislocation of the atlantoaxial and atlanto-occipital joints, or OAARD - short for occipital-atlantoaxial rotatory dislocation - is a condition which has been poorly elucidated and probably underdiagnosed. We believe that the pathogenesis of combined atlantoaxial and atlanto-occipital dislocation is most likely a result of untreated atlantoaxial rotatory dislocation leading to chronic secondary compensation measures occurring at the occiput-C1 joints. Unique clinical and radiological features lead to difficulty in diagnosis, and conventional treatment algorithms may not apply.

A novel scoliosis instrumentation using special superelastic nickel-titanium shape memory rods: a biomechanical analysis using a calibrated computer model and data from a clinical trial.

Study Design: Biomechanical analysis of scoliosis instrumentation using superelastic Nickel-titanium shape memory (SNT) rods.

Objective: To compare SNT with conventional Titanium (Ti) and Cobalt-chrome (Co-Cr) rods. A clinical trial has documented comparable efficacy between two adolescent idiopathic scoliosis (AIS) cohorts instrumented using SNT versus conventional Ti rods.

Current status of the magnetically controlled growing rod in treatment of early-onset scoliosis: What we know after a decade of experience.

The magnetically controlled growing rod (MCGR) has had approximately 10 years of clinical experience worldwide. Clinical effectiveness to control early-onset scoliosis is consistent even at final surgery. MCGRs have significantly lower relative percentage of infection or wound complications as compared to traditional growing rods.

IVD progenitor cells: a new horizon for understanding disc homeostasis and repair.

Intervertebral disc (IVD) degeneration is associated with low back pain. In IVDs, a high mechanical load, high osmotic pressure and hypoxic conditions create a hostile microenvironment for resident cells. How IVD homeostasis and function are maintained under stress remains to be understood; however, several research groups have reported isolating native endogenous progenitor-like or otherwise proliferative cells from the IVD.

Clinical trials of intervertebral disc regeneration: current status and future developments.

Intervertebral disc (IVD) degeneration (IDD) is considered as one of the major causes for low back pain (LBP). However, conventional surgical approaches for treating LBP do not aim to counter the degeneration. Biological interventions have been investigated with an attempt to regenerate the IVD by restoring its matrices and cell activities.

Trans-Ethnic Polygenic Analysis Supports Genetic Overlaps of Lumbar Disc Degeneration With Height, Body Mass Index, and Bone Mineral Density.

Lumbar disc degeneration (LDD) is age-related break-down in the fibrocartilaginous joints between lumbar vertebrae. It is a major cause of low back pain and is conventionally assessed by magnetic resonance imaging (MRI). Like most other complex traits, LDD is likely polygenic and influenced by both genetic and environmental factors.

External Validation of the Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) in the Scoli-RISK-1 Patient Database.

Study Design: Analysis of a prospective multicenter database.

Objective: To assess the ability of the recently created Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) to predict odds of major complications and length of hospital stay for patients who had more severe preoperative deformity and underwent more invasive ASD surgery compared with patients in the database used to create the index.

Summary Of Background Data: Accurate preoperative estimates of risk are necessary given the high complication rates currently associated with ASD surgery.

Mechanical and Clinical Evaluation of a Shape Memory Alloy and Conventional Struts in a Flexible Scoliotic Brace.

Smart materials have attracted considerable attention in the medical field. In particular, shape memory alloys (SMAs) are most commonly utilized for their superelasticity (SE) in orthopaedic treatment. In this study, the resin struts of a flexible brace for adolescent idiopathic scoliosis (AIS) are replaced with different conventional materials and an SMA.

Reliability of Rod Lengthening, Thoracic, and Spino-Pelvic Measurements on Biplanar Stereoradiography in Patients Treated With Magnetically Controlled Growing Rods.

Study Design: Cross-sectional study.

Objective: To assess the inter- and intraobserver reliability of thoracic, spino-pelvic, and rod lengthening measurements made on biplanar spinal stereoradiography (EOS imaging) in children treated with magnetically controlled growing rod (MCGR).

Summary Of Background Data: MCGR treatment aims to gain spine length while gradually correcting the spinal deformity.

An effective assessment method of spinal flexibility to predict the initial in-orthosis correction on the patients with adolescent idiopathic scoliosis (AIS).

Background: Spinal flexibility is an essential parameter for clinical decision making on the patients with adolescent idiopathic scoliosis (AIS). Various methods are proposed to assess spinal flexibility, but which assessment method is more effective to predict the effect of orthotic treatment is unclear.

Objective: To investigate an effective assessment method of spinal flexibility to predict the initial in-orthosis correction, among the supine, prone, sitting with lateral bending and prone with lateral bending positions.

An international consensus on the appropriate evaluation and treatment for adults with spinal deformity.

Purpose: Evaluation and surgical management for adult spinal deformity (ASD) patients varies between health care providers. The purpose of this study is to identify appropriateness of specific approaches and management strategies for the treatment of ASD.

Methods: From January to July 2015, the AOSpine Knowledge Deformity Forum performed a modified Delphi survey where 53 experienced deformity surgeons from 24 countries, rated the appropriateness of management strategies for multiple ASD clinical scenarios.

A randomized double-blinded clinical trial to evaluate the safety and efficacy of a novel superelastic nickel-titanium spinal rod in adolescent idiopathic scoliosis: 5-year follow-up.

Purpose: To evaluate the safety and efficacy of a superelastic shape-memory alloy (SNT) rod used in the treatment of adolescent idiopathic scoliosis (AIS).

Methods: AIS Patients with Lenke 1 curves undergoing fusion surgery were randomized (1:1) at the time of surgery to receive either the SNT or a conventional titanium alloy (CTA) rod. Radiographs were obtained preoperatively and postoperatively up to 5 years of follow-up.

Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis.

Study Design: Longitudinal cohort.

Objectives: To identify variables that predict 2-year Short Form-36 Physical Composite Summary Score (SF-36PCS) and the Scoliosis Research Society-22R (SRS22-R) Total score after surgery for complex adult spinal deformity.

Summary Of Background Data: Increasingly, treatment effectiveness is assessed by the extent to which the procedure improves a patient's health-related quality of life (HRQOL).