An investigation of range of motion preservation in fusionless anterior double screw and cord constructs for scoliosis correction.

Purpose: To evaluate the motion-preserving properties of vertebral body tethering with varying cord/screw constructs and cord thicknesses in cadaveric thoracolumbar spines.

Methods: In vitro flexibility tests were performed on six fresh-frozen human cadaveric spines (T1-L5) (2 M, 4F) with a median age of 63 (59-to-80). An ± 8 Nm load was applied to determine range of motion (ROM) in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) in the thoracic and lumbar spine.

Best Practice Guidelines for Surgical Site Infection in High-risk Pediatric Spine Surgery: Definition, Prevention, Diagnosis, and Treatment.

Background: Prior "best practice guidelines" (BPG) have identified strategies to reduce the risk of acute deep surgical site infection (SSI), but there still exists large variability in practice. Further, there is still no consensus on which patients are "high risk" for SSI and how SSI should be diagnosed or treated in pediatric spine surgery. We sought to develop an updated, consensus-based BPG informed by available literature and expert opinion on defining high-SSI risk in pediatric spine surgery and on prevention, diagnosis, and treatment of SSI in this high-risk population.

A Systematic Review of the Scientific Literature for Rehabilitation/Habilitation Among Individuals With Pediatric-Onset Spinal Cord Injury.

Objectives: To conduct a systematic review to examine the scientific literature for rehabilitation/habilitation among individuals with pediatric-onset spinal cord injury (SCI).

Methods: A literature search of multiple databases (i.e.

Are patients who return for 10-year follow-up after AIS surgery different from those who do not?

Purpose: To evaluate the impact of patients lost to follow-up on outcomes of surgery for adolescent idiopathic scoliosis (AIS) at 10-year postoperative.

Methods: Preoperative, 2-year, and 5-year postoperative demographic, radiographic, and SRS-22 data from a prospective multi-center registry were compared between patients with a 10-year follow-up visit versus those without. A second analysis utilized variables that were different between the groups, along with SRS scores, in a cohort of patients with preoperative, 2-, 5-, and 10-year postoperative SRS scores (complete cohort) to impute missing 10-year data (imputed cohort) utilizing Markov chain Monte Carlo simulation.

Assessing clinical trunk change with surface topography: anterior scoliosis correction as a model to evaluate curve progression.

Purpose: Previous work has suggested that surface topography can be used for repeated measurements of deformity during curve monitoring following an initial radiograph. Changes in deformity during natural curve progression may be subtle. An important preemptive question to answer is whether topography can follow a large change in spine deformity, as in scoliosis correction.

Evaluation of shoulder balance in early onset scoliosis after definitive fusion and comparison with adolescent idiopathic scoliosis shoulder balance.

Study Design: The Children Spine Study Group registry was queried for early onset scoliosis (EOS) patients who had final definitive spinal fusion after their scoliosis was managed with either growing rods or VEPTR. The Harms Study Group registry was queried for adolescent idiopathic scoliosis (AIS) patients who had definitive fusion OBJECTIVE: The goal is to assess shoulder alignment in EOS patients after a definitive fusion and how these radiographic outcomes relate to the more familiar situation of post-definitive fusions shoulder alignment in AIS patients.

Background: EOS is a challenging pathology to manage.

Prospective Follow-up Report on Anterior Vertebral Body Tethering for Idiopathic Scoliosis: Interim Results from an FDA IDE Study.

Background: Anterior vertebral body tethering (aVBT) has emerged as a novel treatment option for patients with idiopathic scoliosis. We present the results from the first U.S.

Complete paraplegia 36 h after attempted posterior spinal fusion for severe adolescent idiopathic scoliosis: a case report.

Introduction: The incidence of neurologic complications with spinal surgery for adolescent idiopathic scoliosis (AIS) has been reported to be 0.69%. This rare complication typically occurs during surgery or immediately postoperatively.

Restoration of Thoracic Kyphosis in Adolescent Idiopathic Scoliosis Over a Twenty-year Period: Are We Getting Better?

Study Design: A multicenter, prospectively collected database of 20 years of operatively treated adolescent idiopathic scoliosis (AIS) was utilized to retrospectively examine pre- and postoperative thoracic kyphosis at 2-year follow-up.

Objective: To determine if the adoption of advanced three-dimensional correction techniques has led to improved thoracic kyphosis correction in AIS.

Summary Of Background Data: Over the past 20 years, there has been an evolution of operative treatment for AIS, with more emphasis on sagittal and axial planes.

Vertebral growth modulation by posterior dynamic deformity correction device in skeletally immature patients with moderate adolescent idiopathic scoliosis.

Study Design: Retrospective, comparative, multicenter.

Introduction: Growth modulating spinal implants are used in the management of scoliosis such as anterior vertebral body tethering. A motion-sparing posterior device (PDDC) was recently approved for the treatment of moderate AIS.

The Relationship Between 3-dimensional Spinal Alignment, Thoracic Volume, and Pulmonary Function in Surgical Correction of Adolescent Idiopathic Scoliosis: A 5-year Follow-up Study.

Study Design: Retrospective review of a prospective multicenter database.

Objective: The aim of this study was to study the effects of thoracic kyphosis (TK) restoration in adolescent idiopathic scoliosis (AIS) Type 1 and 2 curves on postoperative thoracic volume (TV) and pulmonary function.

Summary Of Background Data: Surgical correction of AIS is advocated to preserve or improve pulmonary function, prevent progressive deformity and pain, and improve self-appearance.

Progressive double major scoliotic curve with concurrent lumbosacral spondylolisthesis in a skeletally immature patient with Marfan syndrome treated with anterior scoliosis correction.

Study Design: Case report (review of patient records, imaging, and pulmonary function tests) and literature review.

Objectives: To describe the case of a skeletally immature patient with Marfan syndrome who underwent anterior scoliosis correction (ASC) and muscle-sparing posterior far lateral interbody fusion (FLIF) in a two-stage procedure to correct progressive severe double major scoliosis and spondylolisthesis. Patients with Marfan syndrome suffer from rapidly progressive scoliosis and spondylolisthesis.

Prospective 10-year follow-up assessment of spinal fusions for thoracic AIS: radiographic and clinical outcomes.

Study Design: Prospective registry. The evolution of spinal instrumentation has provided better outcomes in adolescent idiopathic scoliosis (AIS); however, there is a paucity of reliable prospective information on 10-year post-operative outcomes of modern surgical techniques.

Methods: A prospective multicenter registry of patients who had surgical correction of AIS was reviewed.

Surgical management of moderate adolescent idiopathic scoliosis with a fusionless posterior dynamic deformity correction device: interim results with bridging 5-6 disc levels at 2 or more years of follow-up.

Objective: A posterior dynamic deformity correction (PDDC) system was used to correct adolescent idiopathic scoliosis (AIS) without fusion. The preliminary outcomes of bridging only 3-4 discs in patients with variable curve severity have previously been reported. This paper examines a subgroup of patients with the authors' proposed current indications for this device who were also treated with a longer construct.

Incidence of complications in the management of non-ambulatory neuromuscular early-onset scoliosis with a rib-based growing system: high- versus low-tone patients.

Purpose: The purpose of this study is to evaluate whether patients with high-tone neuromuscular early-onset scoliosis have different surgical outcome and complication rate, when compared to patients with low-tone neuromuscular early-onset scoliosis treated with a rib-to-pelvis rib-based dual growing system.

Methods: This is a retrospective cohort study of 67 neuromuscular early-onset scoliosis patients, collected from a multicenter database, treated with a rib-to-pelvis rib-based dual growing system. All patients were divided into two groups: high tone and low tone.

Brace treatment in adolescent idiopathic scoliosis: risk factors for failure-a literature review.

Brace treatment is the most common nonoperative treatment for the prevention of curve progression in adolescent idiopathic scoliosis. The success reported in level 1 and 2 clinical trials is approximately 75%. The aim of this review was to identify the main risk factors that significantly reduce success rate of brace treatment.

Progressive Neuromuscular Scoliosis Secondary to Spinal Cord Injury in a Young Patient Treated With Nonfusion Anterior Scoliosis Correction.

Ninety-eight percent of skeletally immature patients with spinal cord injury (SCI) suffer from progressive neuromuscular scoliosis (NMS). Operative treatment has typically been limited to posterior spinal fusion (PSF), but a newer technique as described may be less invasive and preserve more function. A PSF of the entire spine to the pelvis is standard of care.

Progressive decline in pulmonary function 5 years post-operatively in patients who underwent anterior instrumentation for surgical correction of adolescent idiopathic scoliosis.

Purpose: To evaluate changes in pulmonary function tests (PFT) at 5 years post-operatively in patients with adolescent idiopathic scoliosis (AIS) and to determine whether these changes are progressive or static after 2 years.

Methods: AIS surgical patients with pre-operative and 5 year post-operative forced expiratory volume (FEV) and forced vital capacity (FVC) were included. The percentage of patients with pulmonary impairment at 5 years was calculated.

Surgeon and Caregiver Agreement on the Goals and Indications for Scoliosis Surgery in Children With Cerebral Palsy.

Study Design: Prospective multicenter comparative study.

Objectives: We aimed 1) to survey surgeons and caregivers to rank the surgical indications for spinal fusion of pediatric patients with neuromuscular scoliosis secondary to cerebral palsy in order of importance and 2) to characterize the agreement of surgeons and caregivers on major (top three) indications.

Summary Of Background Data: Surgery for spinal deformity in children with cerebral palsy is a multifaceted and individualized decision that may lead to miscommunication during informed consent.

Disc Degeneration in Unfused Caudal Motion Segments Ten Years Following Surgery for Adolescent Idiopathic Scoliosis.

Hypothesis: The frequency of disc degeneration (DD) in the distal mobile segments will increase over time following surgery for adolescent idiopathic scoliosis (AIS).

Design: Retrospective review of a prospective AIS registry.

Introduction: Durability of surgical outcomes is essential for maintenance of quality of life as well as for family decision making and for assessment of the value of a healthcare intervention.

Agreement Between Manual and Computerized Designation of Neutral Vertebra in Idiopathic Scoliosis.

Study Design: Survey-based cross-sectional study.

Objectives: To describe interobserver agreement among experienced spine surgeons in choosing neutral vertebra (NV) based on manual measurements from radiographs. Secondarily, to use axial vertebral rotation (AVR) values obtained from low-dose stereoradiography (SR) post-processing software (SterEOS 2D/3D) to separately designate the NV in subject cases and to compare manually derived and software-derived NV designations.

Ponte Osteotomies Increase the Risk of Neuromonitoring Alerts in Adolescent Idiopathic Scoliosis Correction Surgery.

Study Design: Observational cohort study of prospective database registry.

Objective: To determine the incidence of neurological complications in AIS patients undergoing surgical treatment with PO.

Summary Of Background Data: Despite the widespread use of Ponte Osteotomies (PO) in adolescent idiopathic scoliosis (AIS) correction, outcomes and complications in patients treated with this technique have not been well characterized.

Assessment of Proximal Junctional Kyphosis and Shoulder Balance With Proximal Screws versus Hooks in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Study Design: A retrospective review of a prospectively collected multicenter database.

Objective: To assess the effect of proximal hooks versus screws on proximal junctional kyphosis (PJK) as well as shoulder balance in otherwise all pedicle screw (>80%) posterior spinal fusion (PSF) constructs in adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Less rigid forms of fixation at the top of constructs in degenerative lumbar PSF have been postulated to decrease the risk of PJK.

Reciprocal Changes in Sagittal Alignment With Operative Treatment of Adolescent Scheuermann Kyphosis-Prospective Evaluation of 96 Patients.

Introduction: Sagittal alignment abnormalities in Scheuermann kyphosis (SK) strongly correlate with quality of life measures. The changes in spinopelvic parameters after posterior spinal fusion have not been adequately studied. This study is to evaluate the reciprocal changes in spinopelvic parameters following surgical correction for SK.