One is not like the other: health quality of life scores vary in neuromuscular EOS by diagnosis.

Purpose: 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.

Magnetically controlled growing rods increase 3D true spine length in idiopathic early onset scoliosis patients: results from a multicenter study.

Purpose: To determine, at 2 year follow-up, 3D spine growth for idiopathic early onset scoliosis (iEOS) patients treated with magnetically controlled growing rods (MCGR).

Methods: From an international EOS registry, patients with iEOS treated with MCGR were identified. Scoliosis, kyphosis, traditional coronal height, and 3D true spine length (3D-TSL) were measured pre-index surgery, post-index, and at 2 year follow-up.

Actuator Size of Magnetic Controlled Growth Rod (7 cm vs. 9 cm) is Not Predictive of Unplanned Return to the Operating Room: A Retrospective Multicenter Comparative Cohort Study.

Background: Magnetic controlled growth rods (MCGR) are the most common type of implant used for operative treatment of patients with early-onset scoliosis (EOS). Rods can have either a 7-cm actuator, allowing 2.8 cm of potential expansion, or a 9-cm actuator which allows 4.

Breaking the "law of diminishing returns" with novel, staged, unilateral magnetically controlled growing rods to guided growth surgery for severe, progressive infantile scoliosis.

Purpose: Infantile scoliosis presents a significant challenge due to high risk of pulmonary complications and morbidity. While dual growing rod constructs are often utilized, they are not always feasible in a young patient with a severe curve. In this study, we present a series of eight patients treated with a unilateral magnetically controlled growing rod (uMCGR) construct later converted to guided growth surgery (GGS).

Changes in sagittal balance and pre-existing junctional angle influence development of proximal junctional kyphosis in growth guidance systems for early-onset scoliosis.

Purpose: Proximal junctional kyphosis (PJK) has been reported to occur at a rate of about 30% in traditional growing rods (GR) and magnetically controlled growing rods (MCGR). Growth guidance systems (GGS) have non-rigid, gliding fixation along rods, which may mitigate PJK. There have been no studies done in shilla around PJK, hence this study aimed to assess the occurrence, risk factors, and timeline of PJK.

The adjunct use of descending neurogenic-evoked potentials when transcranial motor-evoked potentials degrade into warning criteria in pediatric spinal deformity surgery: minimizing false-positive events.

Purpose: This studies objective was to evaluate the utility of descending neurogenic-evoked potentials (DNEPs) in the setting of transcranial motor-evoked potentials (TCeMEPs) degradation into warning criteria during pediatric spinal deformity surgery.

Methods: An institutional spinal cord monitoring database was queried to identify all primary and revision pediatric spinal deformity cases, < / = 21 years of age performed from 1/2006 to 12/2021, in which TCeMEPs were the primary motor tract assessment modality which degraded into warning criteria, with subsequent initiation of adjunct DNEPs.

Results: Fourteen surgical cases (0.

Posterior spinal fusion with lowest instrumented vertebra at L4 in idiopathic scoliosis: optimizing radiographic outcomes using pre-operative flexibility radiographs.

Purpose: In idiopathic scoliosis (IS), there is general agreement ending PSFs at L3 or more cranial is preferred to optimize spinal motion, and extending PSFs to L4 may be necessary; however, this may also cause coronal imbalance or caudal disc wedging post-operatively due to leveling of L4 tilt. The purpose of this study was to identify a pre-operative radiographic measurement, which can be used to quantify the optimal amount of L4 tilt for ideal post-operative radiographic alignment.

Methods: The study was a retrospective analysis of IS patients who underwent PSF to L4, with minimum 2-year follow-up post-operatively.

Rib-to-spine and rib-to-pelvis magnetically controlled growing rods: does the law of diminishing returns still apply?

Purpose: The Law Of Diminishing Returns (LODR) has been demonstrated for traditional growing rods, but there is conflicting data regarding the lengthening behavior of Magnetically Controlled Growing Rods (MCGR). This study examines a cohort of patients with early-onset scoliosis (EOS) with rib-to-spine or rib-to-pelvis-based MCGR implants to determine if they demonstrate the LODR, and if there are differences in lengthening behaviors between the groups.

Methods: A prospectively collected multicenter EOS registry was queried for patients with MCGR with a minimum 2-year follow-up.

Isolated main thoracic curve fusion in idiopathic scoliosis: optimizing radiographic outcomes using lumbar modifiers to guide correction.

Purpose: Does differential correction of main thoracic curve (MTC) and instrumented LIV angulation based on lumbar modifiers affect radiographic outcomes, and can preoperative supine AP radiograph be used to guide correction for optimal final radiographic alignment.

Methods: Retrospective analysis of idiopathic scoliosis patients who underwent selective thoracic fusions (LIV T11-L1) for Lenke 1 and 2 curve patterns, < 18 years of age. 2-year minimum follow-up.

The natural history of curve behavior after brace removal in adolescent idiopathic scoliosis: a literature review.

Purpose: Brace treatment is the most common nonoperative treatment to prevent curve progression in adolescent idiopathic scoliosis (AIS). The goal of this review and analysis is to characterize curve behavior after completion of brace treatment and to identify factors that may facilitate the estimation of long-term curve progression.

Method: A review of the English language literature was completed using the MEDLINE (PUBMED) database of publications after 1990 until September 2020.

Lengthening Behavior of Magnetically Controlled Growing Rods in Early-Onset Scoliosis: A Multicenter Study.

Background: The "law of diminishing returns" is described for traditional growing rods. Magnetically controlled growing rods (MCGRs) have become a preferred implant for the surgical treatment of early-onset scoliosis (EOS). We examined a large cohort of patients with EOS to determine whether the law of diminishing returns applies to MCGRs.

Evaluating the Efficacy of Rib-to-pelvis Growth-friendly Surgery for the Treatment of Non-ambulatory Early-Onset Scoliosis Myelomeningocele Patients.

Introduction: Early-onset scoliosis (EOS) is a well-known orthopaedic manifestation in patients with myelomeningocele. The rib-based growing system (RBGS) has been proposed as an alternative for these individuals because of the poor outcomes with traditional surgical techniques. We aimed to describe the effect of RBGS in patients with nonambulatory EOS myelomeningocele.

The Use of Biomarkers in the Early Diagnosis of Septic Arthritis and Osteomyelitis-A Pilot Study.

Background: The diagnosis of septic arthritis (SA) and osteomyelitis (OM) has remained challenging in the pediatric population, often accompanied by delays and requiring invasive interventions. The purpose of this pilot study is to identify a novel panel of biomarkers and cytokines that can accurately differentiate SA and OM at initial presentation using serum alone.

Methods: Twenty patients below 18 years old whose working diagnosis included SA (n=10) and OM (n=10) were identified.

Predicting the impact of intraoperative halo-femoral traction from preoperative imaging in neuromuscular scoliosis.

Purpose: Intraoperative traction (ITx) has been demonstrated to be a useful adjunct intervention at the time of posterior spinal fusion (PSF) for the treatment of severe neuromuscular scoliosis (NMS) to improve the coronal spinal deformity and pelvic obliquity. The purpose of this study is to determine if preoperative flexibility radiographs can predict the amount of spinal deformity and pelvic obliquity correction at final follow-up.

Methods: This was a retrospective analysis of a single-surgeon series who underwent PSF to the pelvis with adjunct ITx for NMS.

Ogden Type I to III tibial tubercle fractures in skeletally immature patients: is routine anterior compartment fasciotomy of the leg indicated?

Purpose: Determine the frequency of compartment syndrome of the leg after displaced, operatively treated modified Ogden I to III tibial tubercle fractures (TTFxs), evaluate the preoperative assessment and use of advanced imaging, and need for prophylactic fasciotomies.

Methods: Retrospective analysis of operatively treated, displaced modified Ogden I to III TTFxs, at our level 1 paediatric trauma centre between 2007 and 2019. Modified Ogden Type IV and V fracture patterns were excluded.

Positive security screening episodes of patients with spinal implants are influenced by detector type and not implant material.

Background Context: Previous research on rates of spinal detection showed a low frequency of patients (5%) experienced delays and additional screening going through airport security. With continuous technology advances in screenings and the rise in cobalt chrome implantation, updated data on patient experiences was needed.

Purpose: 1) Assess the rates of detection and additional screening by traditional metal detectors and full body scanners in patients with metal spinal implants, 2) Compare the rates of detection of various metal types (Titanium and cobalt-chrome, titanium only, and stainless steel) STUDY DESIGN: Retrospective PATIENT SAMPLE: All spine surgical follow-ups over survey period.

Magnetically Controlled Growing Rods (MCGR) Versus Single Posterior Spinal Fusion (PSF) Versus Vertebral Body Tether (VBT) in Older Early Onset Scoliosis (EOS) Patients: How Do Early Outcomes Compare?

Study Design: Retrospective review of prospective data from multicenter registry.

Objective: Compare outcomes of posterior spinal fusion (PSF) versus magnetically controlled growing rods (MCGR) versus vertebral body tethers (VBT) in 8- to 11-year-old idiopathic early onset scoliosis (EOS) patients.

Summary Of Background Data: In EOS, it is unclear at what age the benefit of growth-sparing strategies outweighs increased risks of surgical complications, compared with PSF.

Single distraction-rod constructs in severe early-onset scoliosis: Indications and outcomes.

Background Context: Since the study of Thompson, et al in 2005, use of dual-growing rod constructs have become the gold standard for operative treatment in early-onset scoliosis. However, use of dual-growing rod constructs may not be possible, due to patient size and the type, location and severity of the spinal deformity.

Purpose: The purpose of this study is to: (1) describe the deformities treated with single-growing rod constructs, and (2) report the outcomes of single-growing rods since 2005.

Pilot Study Analysis of Serum Cytokines to Differentiate Pediatric Septic Arthritis and Transient Synovitis.

Background: In pediatric patients, the presentation of the nontraumatic acutely painful joint/limb poses a diagnostic dilemma due to the similarity of presentations of the most likely diagnoses [septic arthritis (SA), transient synovitis (TS), osteomyelitis]. Current tools employed to differentiate these diagnoses rely on nonspecific inflammatory markers, radiologic imaging, and arthrocentesis. Diagnostic algorithms utilizing these clinical, radiographic, and biochemical parameters have produced conflicting results.

The impact of segmental spinal alignment on the development of proximal junctional kyphosis after instrumented posterior spinal fusions for idiopathic scoliosis.

Purpose: To assess if the preservation of preoperative kyphosis within the cephalad two motion segments of instrumented posterior spinal fusions (PSF), for idiopathic scoliosis (IS), would be associated with lower frequency of proximal junctional kyphosis (PJK) at 2 years postoperatively. Previous studies on PJK in IS have reported conflicting findings; none has evaluated the relationship between segmental kyphosis within the cephalad instrumented construct and PJK.

Methods: One hundred consecutive patients undergoing PSF for IS by a single surgeon with minimum 2-year follow-up were evaluated.

Baseline patient reported outcome measurement information system (PROMIS) scores in children with idiopathic scoliosis and their relation to the SRS-22.

Purpose: PROMIS is becoming the most commonly utilized patient-reported outcome measure (PROM) in adult orthopaedics, but its adoption has lagged in pediatrics. Limited baseline data exists in pediatric-specific orthopaedic diagnoses. The objective of this study was to determine baseline PROMIS scores in patients with idiopathic scoliosis and to evaluate for correlations with the SRS-22.

Integrin-mediated interactions with a laminin-presenting substrate modulate biosynthesis and phenotypic expression for cells of the human nucleus pulposus.

With aging and pathology, cells of the nucleus pulposus (NP) de-differentiate towards a fibroblast-like phenotype, a change that contributes to degeneration of the intervertebral disc (IVD). Laminin isoforms are a component of the NP extracellular matrix during development but largely disappear in the adult NP tissue. Exposing human adult NP cells to hydrogels made from PEGylated-laminin-111 (PEGLM) has been shown to regulate NP cell behaviors and promote cells to assume a biosynthetically active state with gene/protein expression and morphology consistent with those observed in juvenile NP cells.

Utility of preoperative labs in posterior spinal fusions for idiopathic scoliosis.

Purpose: Review of 216 consecutive idiopathic scoliosis (IS) patients undergoing posterior spinal fusion (PSF) demonstrated 94.9% having abnormal lab values, but only 3.9% were referred for further evaluation.