LIV selection in 'tweener' patients treated with magnetically controlled growing rods vs. posterior spinal fusion.

Purpose: The purpose of this study was to compare the LIV selection in 'tweener' patients treated with MCGR or PSF.

Methods: A multicenter pediatric spine database was queried for ambulatory patients ages 8-11 years treated by MCGR or PSF with at least 2-year follow-up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed.

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.

Impact of Spinal Deformity and Surgery on Health-Related Quality of Life in Cerebral Palsy: A Multicenter Prospective Controlled Trial.

Background: Spinal fusion for scoliosis associated with cerebral palsy (CP) is challenging to study because specialized outcome measures are needed. Therefore, evidence in favor of the benefits of surgery has not been firmly established. This study aimed to determine if corrective spinal fusion improves health-related quality of life (HRQoL) in children with CP scoliosis at 2 years.

Representation and Race in Adolescent Idiopathic Scoliosis Research: Disparities in Curve Magnitude and Follow-Up.

Study Design: Prospective Cohort Study.

Objective: The present study aims to determine if the racial representation of patients enrolled in a large prospective scoliosis registry is reflective of the general United States population. Further, we studied whether there was an association between race, pre-operative parameters, outcomes and loss to follow-up.

Proximal foundation anchor variations and their correlation with unplanned return to the operating room (UPROR) in children with EOS treated with magnetically controlled growing rods (MCGR).

Introduction: The evolution of MCGR technique has led to modifications in the configuration of the proximal construct to decrease the incidence of implant-related complications (IRC) and revision surgeries. However, there is no data characterizing the performance of the most used configurations reducing the risk of complications.

Methods: 487 patients were identified from an international multicenter EOS database.

Learning Curve Associated With Thoracoscopic Anterior Vertebral Body Tether and Double Anterior Vertebral Body Tether for Idiopathic Scoliosis: Analysis of Three Independent Surgeons.

Background And Objectives: Anterior vertebral body tether (VBT) is a fusionless approach to treat idiopathic scoliosis, and surgeons are beginning to implement the technique into current practice. This study aims to evaluate the learning curve for single and double VBT.

Methods: A retrospective review of 3 surgeons' first 40 single and 20 double VBT was performed.

Association between structural rib autograft and the rate of arthrodesis in children undergoing occiput-C2 instrumentation and fusion.

Objective: The purpose of this study was to identify factors associated with fusion success among pediatric patients undergoing occiput-C2 rigid instrumentation and fusion.

Methods: The Pediatric Spine Study Group registry was queried to identify patients ≤ 21 years of age who underwent occiput-C2 posterior spinal rigid instrumentation and fusion and had a 2-year minimum clinical and radiographic (postoperative lateral cervical radiograph or CT scan) follow-up. Fusion failure was defined clinically if a patient underwent hardware revision surgery > 30 days after the index procedure or radiographically by the presence of hardware failure or screw haloing on the most recent follow-up imaging study.

Lowest instrumented vertebrae in early onset scoliosis: is there a role for a more selective approach?

Purpose: This purpose of this study was to assess the impact of patient and implant characteristics on LIV selection in ambulatory children with EOS and to assess the relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), the sagittal stable vertebrae (SSV), and the LIV.

Methods: A multicenter pediatric spine database was queried for patients ages 2-10 years treated by growth friendly instrumentation with at least 2-year follow up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed.

Lumbar Vertebral Body Tethering: Single Center Outcomes and Reoperations in a Consecutive Series of 106 Patients.

Study Design: Retrospective cohort study.

Objective: To evaluate the outcomes and reoperation rates in patients with adolescent idiopathic scoliosis undergoing lumbar anterior vertebral body tethering (AVBT).

Background: AVBT is a viable option for growing children.

Paediatric syndromic scoliosis: proceedings of the half-day course at the 57th annual meeting of the Scoliosis Research Society.

There are some syndromes that present with unique manifestations pertaining to the spinal column. A good working understanding of these common syndromes is useful for the spinal deformity surgeons and related healthcare providers. This review attempts to encompass these unique features and discuss them in three broad groups: hypermobility syndromes, muscle pathology-related syndromes, and syndromes related to poor bone quality.

Institutional Variability in Anesthesia Time for Mehta Casting in Early-Onset Scoliosis (EOS).

Purpose: Mehta casting is a potentially curative intervention for early-onset scoliosis (EOS) that typically requires multiple anesthetics. The Food and Drug Administration (FDA) reported that >3 hours of anesthesia under the age of 3 years old may alter brain development; however, no standard exists for the duration of anesthesia during casting. The purpose of this study is to quantify the variability in anesthesia during Mehta casting.

Prospectively Collected Comparison of Outcomes Between Surgically and Conservatively Treated Patients With Adolescent Idiopathic Scoliosis.

Study Design: Retrospective review of a prospectively collected multicenter registry.

Objective: To evaluate health-related quality of life (HRQOL) measures in an operative cohort of patients (OP) and compare them with a matched nonoperative cohort (NON).

Summary Of Background Data: Historically, the surgical outcomes of adolescent idiopathic scoliosis (AIS) have been radiographically evaluated.

Incidence of Tether Breakage in Anterior Vertebral Body Tethering.

Background: Thoracic anterior vertebral body tethering (TAVBT) is an emerging treatment for adolescent idiopathic scoliosis. Tether breakage is a known complication of TAVBT with incompletely known incidence. We aim to define the incidence of tether breakage in patients with adolescent idiopathic scoliosis who undergo TAVBT.

The Impact of Anterior Vertebral Body Tethering on Pulmonary Function.

Study Design: Retrospective, single-center study.

Objective: To examine pulmonary function tests (PFTs) in patients undergoing anterior vertebral body tethering (AVBT).

Summary Of Background Data: The effect of AVBT on pulmonary status remains unclear.

Does radiographic calibration affect linear radiographic measurements in a large pediatric spine registry?

Purpose: Large registries are increasingly at the forefront of modern pediatric spine research, with manual, centralized, trained radiographic measurement serving as the gold standard for spine research. However, there is limited data regarding the reliability of registry measurements which may be subject to differences in radiographic calibration. We undertook this study to evaluate reliability of T1-T12 height, L1-S1 height, and coronal balance measurements for a large registry of early onset scoliosis patients.

Results of posterior spinal fusion after failed anterior vertebral body tethering.

Purpose: In patients with adolescent idiopathic scoliosis (AIS) undergoing anterior vertebral tethering (AVBT), some will subsequently require posterior spinal fusion (PSF). Limited data exist on clinical and radiographic outcomes of fusion after tether failure.

Methods: 490 patients who underwent AVBT were retrospectively analyzed.

Pain After Anterior Vertebral Body Tethering: Incidence, Risk Factors, and Timing.

Study Design: Retrospective case series.

Objective: To examine the incidence and risk factors for postoperative pain following anterior vertebral body tethering (AVBT) for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Up to 78% of patients with AIS report preoperative pain; it is the greatest patient concern surrounding surgery.

Machine Learning for Benchmarking Adolescent Idiopathic Scoliosis Surgery Outcomes.

Study Design: Retrospective cohort.

Objective: The aim of this study was to design a risk-stratified benchmarking tool for adolescent idiopathic scoliosis (AIS) surgeries.

Summary Of Background Data: Machine learning (ML) is an emerging method for prediction modeling in orthopedic surgery.

Autofusion With Magnetically Controlled Growing Rods: A Case Report.

Magnetically controlled growing rods (MCGRs) are an effective alternative to traditional growing rods (TGRs) in the treatment of early-onset scoliosis (EOS), with comparable deformity correction despite fewer planned reoperations. This case report presents a unique case of autofusion in a patient with tetraplegic cerebral palsy, thoracic myelomeningocele, and EOS who was treated with dual MCGR instrumentation and underwent serial lengthening procedures for four years. We detail the operative and radiographic findings in a novel case of autofusion encountered after MCGR placement to treat EOS.

Perioperative Complications and Health-related Quality of Life Outcomes in Severe Pediatric Spinal Deformity.

Study Design: Prospective multicenter cohort study.

Objective: To evaluate perioperative complications and mid-term outcomes for severe pediatric spinal deformity.

Summary Of Background Data: Few studies have evaluated the impact of complications on health-related quality of life (HRQoL) outcomes in severe pediatric spinal deformity.