首页 > 最新文献

Spine deformity最新文献

英文 中文
Cervical kyphoscoliosis due to substance abuse: a case series on introduction and neurosurgical treatment. 药物滥用导致的颈椎脊柱侧弯:介绍和神经外科治疗的系列病例。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-22 DOI: 10.1007/s43390-024-00989-7
Majid Rezvani, Mohammadreza Mehrabanian, Omid R Hariri, Colin Son, Noushin Vahdat, Mina Foroughi, Ariel Takayanagi, Sara Mirza, Sadegh Baradaran Mahdavi, Arman Sourani

Study design: A prospective case series.

Objective: To investigate the possible associations of multi-directional cervical kyphoscoliosis (CKS) with substance abuse and evaluate treatment outcomes. CKS is a rare medical situation without a well-established pathology. Still there are many obscurities in treatment paradigms and outcomes. To our knowledge, there is no published report on the association between CKS with addiction. Besides the novel report of such a rare etiology for CSK, the complexity of the neurosurgical treatment makes this report the first of its kind.

Methods: In this series, we presented three patients with a history of crack cocaine addiction who suffered CKS due to prolonged hand-over-neck posture and treated all of them with a complex neurosurgical protocol.

Results: All cases were operated on and restored their normal spine alignment. Their long-term outcomes showed independent neurological status with no major surgical complications.

Conclusion: Crack cocaine addiction might be associated with CKS in long-term cocaine abuse. A complex neurosurgical approach can achieve a sustainable clinical outcome.

研究设计前瞻性病例系列:调查多向性颈椎脊柱侧弯症(CKS)与药物滥用的可能关联,并评估治疗效果。颈椎脊柱侧弯症是一种罕见的病症,没有明确的病理机制。在治疗范例和结果方面仍有许多模糊之处。据我们所知,目前还没有关于 CKS 与成瘾关系的公开报道。除了对 CSK 这种罕见病因的新颖报道外,神经外科治疗的复杂性也使本报告成为同类报告中的首例:在这组病例中,我们介绍了三位有快克可卡因成瘾史的患者,他们因长时间的手捂颈姿势而患上了 CKS,我们采用了复杂的神经外科方案对他们进行了治疗:结果:所有病例均接受了手术治疗,恢复了正常的脊柱排列。结果:所有病例均接受了手术治疗,恢复了正常的脊柱排列,其远期疗效显示神经功能状态良好,无重大手术并发症:结论:长期吸食可卡因可能与快克可卡因成瘾有关。复杂的神经外科手术方法可实现可持续的临床疗效。
{"title":"Cervical kyphoscoliosis due to substance abuse: a case series on introduction and neurosurgical treatment.","authors":"Majid Rezvani, Mohammadreza Mehrabanian, Omid R Hariri, Colin Son, Noushin Vahdat, Mina Foroughi, Ariel Takayanagi, Sara Mirza, Sadegh Baradaran Mahdavi, Arman Sourani","doi":"10.1007/s43390-024-00989-7","DOIUrl":"https://doi.org/10.1007/s43390-024-00989-7","url":null,"abstract":"<p><strong>Study design: </strong>A prospective case series.</p><p><strong>Objective: </strong>To investigate the possible associations of multi-directional cervical kyphoscoliosis (CKS) with substance abuse and evaluate treatment outcomes. CKS is a rare medical situation without a well-established pathology. Still there are many obscurities in treatment paradigms and outcomes. To our knowledge, there is no published report on the association between CKS with addiction. Besides the novel report of such a rare etiology for CSK, the complexity of the neurosurgical treatment makes this report the first of its kind.</p><p><strong>Methods: </strong>In this series, we presented three patients with a history of crack cocaine addiction who suffered CKS due to prolonged hand-over-neck posture and treated all of them with a complex neurosurgical protocol.</p><p><strong>Results: </strong>All cases were operated on and restored their normal spine alignment. Their long-term outcomes showed independent neurological status with no major surgical complications.</p><p><strong>Conclusion: </strong>Crack cocaine addiction might be associated with CKS in long-term cocaine abuse. A complex neurosurgical approach can achieve a sustainable clinical outcome.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gut microbiota alterations in adolescent idiopathic scoliosis: a comparison study with healthy control and congenital scoliosis. 青少年特发性脊柱侧弯症的肠道微生物群变化:与健康对照组和先天性脊柱侧弯症的比较研究。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-22 DOI: 10.1007/s43390-024-00988-8
Yinyu Fang, Zhen Tian, Weibiao Li, Dongyue Li, Jie Li, Zongshan Hu, Yong Qiu, Zezhang Zhu, Zhen Liu

Purpose: This study aims to compare the composition of GM isolated from individuals with AIS or congenital scoliosis (CS) and age-matched control (Ctr).

Methods: A total of 48 patients with AIS, 24 patients with CS, and 31 healthy individuals were recruited as the discovery cohort, and 9 pairs of siblings where one was affected by AIS were recruited as the validation cohort. The GM profile was determined with 16S rRNA sequencing, and the alpha-diversity and beta-diversity metrics were performed with Mothur. Linear discriminant analysis (LDA) analysis was performed to identify the enriched species.

Results: The α diversity (Chao1 index) was significantly lower in AIS patients with low BMI (< 18.5) than those with normal BMI. The PcoA analysis showed a trend of clustering of GM in AIS compared to that in Ctr and CS groups (r2 = 0.0553, p = 0.001). METASTAT analysis showed Cellulomonadaceae was significantly enriched in AIS groups compared to CS and Ctr. LDA analysis showed 9 enriched species in AIS patients. Compared to Ctr, two species including Hungatella genus and Bacteroides fragilis were significantly enriched, while the Firmicutes versus Bacteroidetes (F/B) ratio and the Ruminococcus genus were significantly decreased in AIS but not CS groups. The significantly reduced F/B ratio and Ruminococcus genus in AIS were replicated in the validation cohort.

Conclusions: Our study elucidated an association between low BMI and GM diversity in AIS patients. The reduced F/B ratio and Ruminococcus genus in AIS patients were identified and validated in 9 pairs of AIS patients and their unaffected siblings. Our pilot results may help understand the anthropometric discrepancy in these patients and support a possible role of GM in the pathogenesis of AIS.

目的:本研究旨在比较从AIS或先天性脊柱侧弯症(CS)患者和年龄匹配对照组(Ctr)分离出的基因组的组成:方法:共招募了48名AIS患者、24名CS患者和31名健康人作为发现队列,并招募了9对兄弟姐妹作为验证队列,其中一人受AIS影响。利用 16S rRNA 测序确定基因组概况,并利用 Mothur 进行α-多样性和β-多样性度量。通过线性判别分析(LDA)确定富集物种:结果:低体重指数的 AIS 患者的 α 多样性(Chao1 指数)明显较低(2 = 0.0553,p = 0.001)。METASTAT 分析表明,与 CS 和 Ctr 相比,AIS 组中的 Cellulomonadaceae 明显富集。LDA分析显示,AIS患者中有9个富集物种。与 Ctr 相比,AIS 组中 Hungatella 属和 Bacteroides fragilis 这两个物种明显富集,而 AIS 组中的 Firmicutes 对 Bacteroidetes(F/B)比率和 Ruminococcus 属则明显下降,CS 组则没有。AIS中F/B比率和反刍球菌属的明显减少在验证队列中得到了复制:我们的研究阐明了低体重指数与 AIS 患者基因组多样性之间的关系。在 9 对 AIS 患者及其未受影响的兄弟姐妹中发现并验证了 AIS 患者的 F/B 比率和反刍球菌属减少。我们的试验结果可能有助于理解这些患者的人体测量差异,并支持基因改造在 AIS 发病机制中可能扮演的角色。
{"title":"Gut microbiota alterations in adolescent idiopathic scoliosis: a comparison study with healthy control and congenital scoliosis.","authors":"Yinyu Fang, Zhen Tian, Weibiao Li, Dongyue Li, Jie Li, Zongshan Hu, Yong Qiu, Zezhang Zhu, Zhen Liu","doi":"10.1007/s43390-024-00988-8","DOIUrl":"https://doi.org/10.1007/s43390-024-00988-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the composition of GM isolated from individuals with AIS or congenital scoliosis (CS) and age-matched control (Ctr).</p><p><strong>Methods: </strong>A total of 48 patients with AIS, 24 patients with CS, and 31 healthy individuals were recruited as the discovery cohort, and 9 pairs of siblings where one was affected by AIS were recruited as the validation cohort. The GM profile was determined with 16S rRNA sequencing, and the alpha-diversity and beta-diversity metrics were performed with Mothur. Linear discriminant analysis (LDA) analysis was performed to identify the enriched species.</p><p><strong>Results: </strong>The α diversity (Chao1 index) was significantly lower in AIS patients with low BMI (< 18.5) than those with normal BMI. The PcoA analysis showed a trend of clustering of GM in AIS compared to that in Ctr and CS groups (r<sup>2</sup> = 0.0553, p = 0.001). METASTAT analysis showed Cellulomonadaceae was significantly enriched in AIS groups compared to CS and Ctr. LDA analysis showed 9 enriched species in AIS patients. Compared to Ctr, two species including Hungatella genus and Bacteroides fragilis were significantly enriched, while the Firmicutes versus Bacteroidetes (F/B) ratio and the Ruminococcus genus were significantly decreased in AIS but not CS groups. The significantly reduced F/B ratio and Ruminococcus genus in AIS were replicated in the validation cohort.</p><p><strong>Conclusions: </strong>Our study elucidated an association between low BMI and GM diversity in AIS patients. The reduced F/B ratio and Ruminococcus genus in AIS patients were identified and validated in 9 pairs of AIS patients and their unaffected siblings. Our pilot results may help understand the anthropometric discrepancy in these patients and support a possible role of GM in the pathogenesis of AIS.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical treatment algorithm for thoracic and lumbar hyperkyphosis in pediatric population. 小儿胸椎和腰椎过度突出症的手术治疗算法。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-21 DOI: 10.1007/s43390-024-00986-w
Julián Calcagni, Carlos A Tello, Lucas Piantoni, Rodrigo Remondino, Eduardo Galaretto, Juan Pablo Arispe, Mariano Noel

Purpose: There is no standardized and universally accepted surgical treatment for thoracic and lumbar hyperkyphosis in children. A surgical treatment algorithm was developed to aid in the choice of the appropriate corrective technique.

Methods: A retrospective analysis was conducted of patients younger than 18 years who underwent primary correction surgery and posterior fusion for thoracic and lumbar hyperkyphosis. Patients were categorized according to the classification of Rajasekaran et al. and divided into 2 groups: a posterior column osteotomies (PCO) group and a three-column osteotomies (3CO) group. We analyzed the angularity and flexibility of the curve, global sagittal balance, and preoperative neurological status of the patient.

Results: Forty-nine patients were included. The mean age was 12.8 years (1-18) and the mean preoperative kyphosis was 93.5° (40°-175°). In the PCO group (N = 30), the sagittal deformity angular ratio (DAR) was less than 16.5 in 26 patients (86.6%), while in the 3CO group (N = 19), sagittal DAR was greater than 16.5 in 17 patients (89.4%). In the PCO group (N = 28), the T1-Pelvic angle (TPA) was less than 17° in 19 patients (67.8%), while in the 3CO group (N = 15), TPA was greater than 17° in 10 patients (66.6%). Five patients (10.2%) had recent-onset or progressive neurological alteration, all of them (100%) required 3CO.

Conclusion: An algorithm for kyphosis was developed based on the classification by Rajasekaran et al., preoperative analysis of the angularity and flexibility of the curve, global sagittal balance and neurological status of the patient, to aid in the choice of the appropriate corrective osteotomy.

Level of evidence: IV.

目的:对于儿童胸椎和腰椎骨盆下垂症,目前还没有标准化和普遍接受的手术治疗方法。方法:对接受初次矫正手术的 18 岁以下患者进行了回顾性分析:方法:我们对因胸椎和腰椎后凸畸形而接受初次矫正手术和后路融合术的 18 岁以下患者进行了回顾性分析。根据 Rajasekaran 等人的分类方法将患者分为两组:后柱截骨术(PCO)组和三柱截骨术(3CO)组。我们分析了患者曲线的角度和柔韧性、整体矢状面平衡以及术前神经状态:结果:共纳入 49 名患者。平均年龄为 12.8 岁(1-18 岁),术前平均椎体后凸为 93.5°(40°-175°)。在 PCO 组(30 人)中,26 名患者(86.6%)的矢状位畸形角度比(DAR)小于 16.5,而在 3CO 组(19 人)中,17 名患者(89.4%)的矢状位畸形角度比大于 16.5。在 PCO 组(28 人)中,19 名患者(67.8%)的 T1 盆角(TPA)小于 17°,而在 3CO 组(15 人)中,10 名患者(66.6%)的 TPA 大于 17°。5名患者(10.2%)近期出现或进行性神经系统改变,所有患者(100%)都需要进行3CO治疗:根据Rajasekaran等人的分类、术前对患者曲线角度和柔韧性、整体矢状面平衡和神经状况的分析,制定了脊柱后凸的算法,以帮助选择合适的矫正截骨术:证据等级:IV。
{"title":"Surgical treatment algorithm for thoracic and lumbar hyperkyphosis in pediatric population.","authors":"Julián Calcagni, Carlos A Tello, Lucas Piantoni, Rodrigo Remondino, Eduardo Galaretto, Juan Pablo Arispe, Mariano Noel","doi":"10.1007/s43390-024-00986-w","DOIUrl":"https://doi.org/10.1007/s43390-024-00986-w","url":null,"abstract":"<p><strong>Purpose: </strong>There is no standardized and universally accepted surgical treatment for thoracic and lumbar hyperkyphosis in children. A surgical treatment algorithm was developed to aid in the choice of the appropriate corrective technique.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of patients younger than 18 years who underwent primary correction surgery and posterior fusion for thoracic and lumbar hyperkyphosis. Patients were categorized according to the classification of Rajasekaran et al. and divided into 2 groups: a posterior column osteotomies (PCO) group and a three-column osteotomies (3CO) group. We analyzed the angularity and flexibility of the curve, global sagittal balance, and preoperative neurological status of the patient.</p><p><strong>Results: </strong>Forty-nine patients were included. The mean age was 12.8 years (1-18) and the mean preoperative kyphosis was 93.5° (40°-175°). In the PCO group (N = 30), the sagittal deformity angular ratio (DAR) was less than 16.5 in 26 patients (86.6%), while in the 3CO group (N = 19), sagittal DAR was greater than 16.5 in 17 patients (89.4%). In the PCO group (N = 28), the T1-Pelvic angle (TPA) was less than 17° in 19 patients (67.8%), while in the 3CO group (N = 15), TPA was greater than 17° in 10 patients (66.6%). Five patients (10.2%) had recent-onset or progressive neurological alteration, all of them (100%) required 3CO.</p><p><strong>Conclusion: </strong>An algorithm for kyphosis was developed based on the classification by Rajasekaran et al., preoperative analysis of the angularity and flexibility of the curve, global sagittal balance and neurological status of the patient, to aid in the choice of the appropriate corrective osteotomy.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142474266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Apical stress redistribution during anterior vertebral body tethering for thoracic adolescent idiopathic scoliosis: a finite element analysis of a novel surgical technique. 青少年特发性脊柱侧凸胸椎椎体前部系带术中的顶端应力再分布:一种新型手术技术的有限元分析。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-18 DOI: 10.1007/s43390-024-00987-9
Jean-Marc Mac-Thiong, Bahe Hachem, Julien Clin, Franck Le Naveaux, Stefan Parent

Purpose: Apical stress redistribution (ASR) is proposed to mitigate failure risks after anterior vertebral body tethering for adolescent idiopathic scoliosis. It consists in releasing set-screws at peri-apical levels following curve tensioning to redistribute stresses within the construct. This study determines the biomechanical impact and curve correction obtained with ASR.

Methods: Finite element models of anterior vertebral body tethering were constructed for three typical scoliotic patients with Lenke 1 curves. ASR was simulated by releasing tension on the cable at the level of the three apical set screws (i.e. untightening three consecutive periapical set screws), followed by retightening of the set screws without further tensioning. Cable tension, implant forces and spine geometry were compared before and after performing ASR.

Results: Periapical cable tension decreased post-ASR, and ASR also reduced the maximum tensions proximally and distally. Postoperative disc height was similar between conventional and ASR approaches. Apical intervertebral disc stresses were shifted from concave to convex compression intra and postoperatively, with a similar pattern between the conventional and ASR techniques. The ASR technique achieved scoliotic curve corrections of 54%, 68%, and 79%, while the conventional technique resulted in corresponding corrections (54%, 68%, and 80%) for subjects 1, 2, and 3. The periapical coronal curves exhibited similar patterns.

Conclusion: ASR demonstrated promising apical cable and implant forces re-equilibrium compared to the conventional approach. This novel technique did not impair immediate and postoperative curve correction, while maintaining similar apical intervertebral stress distribution. ASR shows potential to modulate growth while reducing maximum cable tension infra- and supra-apical.

目的:为降低青少年特发性脊柱侧凸椎体前部系带术后的失败风险,提出了椎体顶端应力再分布(ASR)。它包括在曲线拉伸后释放椎体根尖周围的固定螺钉,以重新分配结构内的应力。本研究确定了 ASR 的生物力学影响和曲线矫正效果:方法:为三名典型的 Lenke 1 型脊柱侧凸患者建立了椎体前部系带的有限元模型。模拟 ASR 的方法是在三个根尖固定螺钉处释放缆线张力(即松开三个连续的根尖周围固定螺钉),然后重新拧紧固定螺钉,不再进一步张力。对 ASR 前后的拉线张力、种植体力和脊柱几何形状进行比较:结果:ASR术后根尖周围缆线张力降低,ASR也降低了近端和远端的最大张力。传统方法和 ASR 方法的术后椎间盘高度相似。椎间盘顶端的应力在术中和术后从凹向压缩转变为凸向压缩,传统方法和ASR方法的模式相似。ASR技术对脊柱侧弯的矫正率分别为54%、68%和79%,而传统技术对受试者1、2和3的矫正率分别为54%、68%和80%。根尖冠周曲线表现出相似的模式:与传统方法相比,ASR 显示出良好的根尖拉线和种植体力再平衡效果。这种新技术不会影响术中和术后的曲线矫正,同时还能保持相似的根尖椎间应力分布。ASR显示出调节生长的潜力,同时降低了心尖下和心尖上的最大缆线张力。
{"title":"Apical stress redistribution during anterior vertebral body tethering for thoracic adolescent idiopathic scoliosis: a finite element analysis of a novel surgical technique.","authors":"Jean-Marc Mac-Thiong, Bahe Hachem, Julien Clin, Franck Le Naveaux, Stefan Parent","doi":"10.1007/s43390-024-00987-9","DOIUrl":"https://doi.org/10.1007/s43390-024-00987-9","url":null,"abstract":"<p><strong>Purpose: </strong>Apical stress redistribution (ASR) is proposed to mitigate failure risks after anterior vertebral body tethering for adolescent idiopathic scoliosis. It consists in releasing set-screws at peri-apical levels following curve tensioning to redistribute stresses within the construct. This study determines the biomechanical impact and curve correction obtained with ASR.</p><p><strong>Methods: </strong>Finite element models of anterior vertebral body tethering were constructed for three typical scoliotic patients with Lenke 1 curves. ASR was simulated by releasing tension on the cable at the level of the three apical set screws (i.e. untightening three consecutive periapical set screws), followed by retightening of the set screws without further tensioning. Cable tension, implant forces and spine geometry were compared before and after performing ASR.</p><p><strong>Results: </strong>Periapical cable tension decreased post-ASR, and ASR also reduced the maximum tensions proximally and distally. Postoperative disc height was similar between conventional and ASR approaches. Apical intervertebral disc stresses were shifted from concave to convex compression intra and postoperatively, with a similar pattern between the conventional and ASR techniques. The ASR technique achieved scoliotic curve corrections of 54%, 68%, and 79%, while the conventional technique resulted in corresponding corrections (54%, 68%, and 80%) for subjects 1, 2, and 3. The periapical coronal curves exhibited similar patterns.</p><p><strong>Conclusion: </strong>ASR demonstrated promising apical cable and implant forces re-equilibrium compared to the conventional approach. This novel technique did not impair immediate and postoperative curve correction, while maintaining similar apical intervertebral stress distribution. ASR shows potential to modulate growth while reducing maximum cable tension infra- and supra-apical.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142474252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating the long-term outcomes and efficacy of surgical intervention in patients with adolescent idiopathic scoliosis and Cobb angles ranging between 40 and 50 degrees. 调查青少年特发性脊柱侧凸和 Cobb 角介于 40 度和 50 度之间的患者手术干预的长期结果和疗效。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-17 DOI: 10.1007/s43390-024-00984-y
Adam S Friedman, Manisha Koneru, Pietro Gentile, David Clements

Purpose: Patients with adolescent idiopathic scoliosis (AIS) are either managed with non-operative strategies or surgery depending on the severity of lateral curvature and impact on quality of life. However, supportive evidence for the appropriate treatment approach is lacking in AIS patients with Cobb angles between 40 and 50 degrees. Therefore, we investigated differences in long-term patient-centered outcomes in AIS patients with Cobb angles between 40 and 50 degrees who received either operative or non-operative management.

Methods: A total of 919 patients aged 10-21 years old with adolescent idiopathic scoliosis and 40-50 degree Cobb angles were identified from the HARMS Study Group (HSG) registry and dichotomized based on operative or non-operative management. Baseline and 2 year follow-up SRS-22 scores from these patients were analyzed for significant differences between the total score values, domain values, and the magnitude of score change over time using multiple comparisons analyses. Multivariable regressions adjusting for age, body mass index, location of spinal deformity, and management strategy were also performed.

Results: Operative versus non-operative strategy was significantly, independently associated with differences in SRS-22 total and domain scores over time (effect likelihood ratio test, p < 0.03 for all regressions). Operatively managed patients had significantly greater improvement in SRS-22 total and domain scores over the follow-up duration compared to non-operatively managed patients (p < 0.02 for all comparisons).

Conclusions: This preliminary analysis suggests that operatively managed patients may have had better long-term outcomes than non-operatively managed patients within this AIS subpopulation. These findings support the need for further prospective investigation to determine the optimal management strategy to improve evidence-based, patient-reported outcomes for AIS patients with Cobb angles between 40 and 50 degrees.

Level of evidence: Level III.

目的:根据侧弯的严重程度和对生活质量的影响,青少年特发性脊柱侧弯症(AIS)患者要么采用非手术治疗策略,要么采用手术治疗。然而,对于 Cobb 角在 40 至 50 度之间的 AIS 患者,目前还缺乏适当治疗方法的支持性证据。因此,我们研究了 Cobb 角在 40 度和 50 度之间的 AIS 患者接受手术或非手术治疗后以患者为中心的长期疗效的差异:方法:我们从 HARMS 研究组(HSG)登记册中确定了 919 名年龄在 10-21 岁之间、Cobb 角在 40-50 度之间的青少年特发性脊柱侧凸患者,并根据手术或非手术治疗进行了二分。采用多重比较分析法,对这些患者的基线和 2 年随访 SRS-22 评分进行分析,以确定总分值、域值之间的显著差异以及评分随时间变化的幅度。此外,还对年龄、体重指数、脊柱畸形部位和治疗策略进行了多变量回归分析:结果:手术治疗与非手术治疗策略与 SRS-22 总分和域分随时间变化的差异有显著的独立相关性(效应似然比检验,P这项初步分析表明,在这一 AIS 亚群中,手术治疗患者的长期预后可能优于非手术治疗患者。这些发现支持了进一步开展前瞻性研究的必要性,以确定最佳管理策略,从而改善Cobb角在40至50度之间的AIS患者的循证患者报告结果:证据等级:三级。
{"title":"Investigating the long-term outcomes and efficacy of surgical intervention in patients with adolescent idiopathic scoliosis and Cobb angles ranging between 40 and 50 degrees.","authors":"Adam S Friedman, Manisha Koneru, Pietro Gentile, David Clements","doi":"10.1007/s43390-024-00984-y","DOIUrl":"https://doi.org/10.1007/s43390-024-00984-y","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with adolescent idiopathic scoliosis (AIS) are either managed with non-operative strategies or surgery depending on the severity of lateral curvature and impact on quality of life. However, supportive evidence for the appropriate treatment approach is lacking in AIS patients with Cobb angles between 40 and 50 degrees. Therefore, we investigated differences in long-term patient-centered outcomes in AIS patients with Cobb angles between 40 and 50 degrees who received either operative or non-operative management.</p><p><strong>Methods: </strong>A total of 919 patients aged 10-21 years old with adolescent idiopathic scoliosis and 40-50 degree Cobb angles were identified from the HARMS Study Group (HSG) registry and dichotomized based on operative or non-operative management. Baseline and 2 year follow-up SRS-22 scores from these patients were analyzed for significant differences between the total score values, domain values, and the magnitude of score change over time using multiple comparisons analyses. Multivariable regressions adjusting for age, body mass index, location of spinal deformity, and management strategy were also performed.</p><p><strong>Results: </strong>Operative versus non-operative strategy was significantly, independently associated with differences in SRS-22 total and domain scores over time (effect likelihood ratio test, p < 0.03 for all regressions). Operatively managed patients had significantly greater improvement in SRS-22 total and domain scores over the follow-up duration compared to non-operatively managed patients (p < 0.02 for all comparisons).</p><p><strong>Conclusions: </strong>This preliminary analysis suggests that operatively managed patients may have had better long-term outcomes than non-operatively managed patients within this AIS subpopulation. These findings support the need for further prospective investigation to determine the optimal management strategy to improve evidence-based, patient-reported outcomes for AIS patients with Cobb angles between 40 and 50 degrees.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142474265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetic overlap between idiopathic scoliosis and schizophrenia in the general population. 特发性脊柱侧凸与精神分裂症在普通人群中的遗传重叠。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-15 DOI: 10.1007/s43390-024-00979-9
Steven de Reuver, Worrawat Engchuan, Nickie Safarian, Mehdi Zarrei, Jacob A S Vorstman, René M Castelein, Elemi J Breetvelt

Introduction: Adolescent idiopathic scoliosis (AIS) and schizophrenia (SCZ) are two distinct conditions with poorly understood aetiologies that both emerge in otherwise healthy young adolescents. One rare genetic condition associated with both phenotypic outcomes is the 22q11.2 deletion (22q11DS). This microdeletion, encompassing 47 genes, occurs in approximately 1 in 2,148 live births and confers a 20-fold higher risk for both AIS and schizophrenia compared to the general population. In the general population (non-22q11DS carriers), AIS and SCZ have also been reported to be related and genetic studies suggest the involvement of genetic variants implicated in the central nervous functioning. In this study, our objective was to further investigate genetic overlaps between these conditions in the general population. Specifically, we aimed to explore the role of genes within the 22q11.2 region, not only in terms of common variants but also their potential impact on gene networks and biopathways.

Methods: We used summary statistics from three genome-wide association studies (GWAS): two focused on AIS (n = 11,210), and one on schizophrenia (n = 36,989). To explore potential overlaps between the two conditions, we conducted a comparative analysis on the significance-based ranked single nucleotide polymorphisms (SNPs) that are associated with both AIS and SCZ. Next, we employed in silico analyses to assess gene-networks enrichment for the most significant SNPs and investigate the contribution of genes within the 22q11.2 region. Post-hoc analysis was conducted to explore the biological pathways correlated with SNPs significantly associated with both AIS and SCZ.

Results: The in silico analyses revealed a significant (adjusted-p < 0.05) genetic overlap between SCZ and both AIS cohorts. The top 3% of the most significant SNPs associated with both conditions exhibited a distinct enrichment cluster which is unlikely to be a result of chance (p < 3e-04). The gene-networks analyses showed a significant overlap of 26-41% with the ones involving genes in the 22q11DS region. However, there was no overlap between SNPs in this region and the most significant SNPs identified in the GWAS.

Conclusion: This study revealed compelling evidence that beyond the shared association with 22q11DS as a rare genetic variant, AIS and SCZ exhibit common genetic risk variants and an overlap of important genes. The gene networks enriched by the most significant SNPs for both conditions also intersect with the ones involving genes in the 22q11DS region. However, SNPs within this region were not overrepresented among the most significant SNPs from GWAS for both conditions. Notably, gene networks linked to the risk for both conditions suggest an involvement of biopathways related to cellular signaling and neuronal development.

导言:青少年特发性脊柱侧弯症(AIS)和精神分裂症(SCZ)是两种不同的疾病,其病因尚不清楚,但都出现在原本健康的青少年身上。22q11.2缺失(22q11DS)是与这两种表型结果相关的一种罕见遗传病。这种微缺失包括 47 个基因,大约每 2,148 个活产婴儿中就有 1 个会出现这种情况,与普通人群相比,AIS 和精神分裂症的患病风险高出 20 倍。据报道,在普通人群(非 22q11DS 携带者)中,AIS 和 SCZ 也是相关的,遗传研究表明,与中枢神经功能有关的基因变异也参与其中。在本研究中,我们的目标是进一步调查普通人群中这两种疾病之间的遗传重叠。具体而言,我们旨在探索 22q11.2 区域内基因的作用,这不仅体现在常见变异上,还体现在它们对基因网络和生物通路的潜在影响上:我们使用了三项全基因组关联研究(GWAS)的汇总统计数据:两项研究以 AIS(n = 11,210 个)为重点,一项研究以精神分裂症(n = 36,989 个)为重点。为了探索这两种疾病之间可能存在的重叠,我们对与 AIS 和 SCZ 相关的单核苷酸多态性(SNPs)进行了基于显著性排序的比较分析。接下来,我们采用硅分析评估了最重要 SNP 的基因网络富集情况,并调查了 22q11.2 区域内基因的贡献。我们还进行了事后分析,以探索与AIS和SCZ显著相关的SNP相关的生物通路:硅学分析表明,22q11.2 区域的 SNPs 与 AIS 和 SCZ 有显著的相关性(调整后-p):这项研究揭示了令人信服的证据,即除了与 22q11DS 这一罕见遗传变异有共同关联外,AIS 和 SCZ 还表现出共同的遗传风险变异和重要基因的重叠。这两种疾病最重要的 SNPs 所富集的基因网络也与涉及 22q11DS 区域基因的网络相交。然而,在这两种疾病的全球基因组研究中,该区域内的 SNPs 在最重要的 SNPs 中并没有过高的代表性。值得注意的是,与这两种疾病风险相关的基因网络表明,与细胞信号传导和神经元发育相关的生物通路也参与其中。
{"title":"Genetic overlap between idiopathic scoliosis and schizophrenia in the general population.","authors":"Steven de Reuver, Worrawat Engchuan, Nickie Safarian, Mehdi Zarrei, Jacob A S Vorstman, René M Castelein, Elemi J Breetvelt","doi":"10.1007/s43390-024-00979-9","DOIUrl":"https://doi.org/10.1007/s43390-024-00979-9","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent idiopathic scoliosis (AIS) and schizophrenia (SCZ) are two distinct conditions with poorly understood aetiologies that both emerge in otherwise healthy young adolescents. One rare genetic condition associated with both phenotypic outcomes is the 22q11.2 deletion (22q11DS). This microdeletion, encompassing 47 genes, occurs in approximately 1 in 2,148 live births and confers a 20-fold higher risk for both AIS and schizophrenia compared to the general population. In the general population (non-22q11DS carriers), AIS and SCZ have also been reported to be related and genetic studies suggest the involvement of genetic variants implicated in the central nervous functioning. In this study, our objective was to further investigate genetic overlaps between these conditions in the general population. Specifically, we aimed to explore the role of genes within the 22q11.2 region, not only in terms of common variants but also their potential impact on gene networks and biopathways.</p><p><strong>Methods: </strong>We used summary statistics from three genome-wide association studies (GWAS): two focused on AIS (n = 11,210), and one on schizophrenia (n = 36,989). To explore potential overlaps between the two conditions, we conducted a comparative analysis on the significance-based ranked single nucleotide polymorphisms (SNPs) that are associated with both AIS and SCZ. Next, we employed in silico analyses to assess gene-networks enrichment for the most significant SNPs and investigate the contribution of genes within the 22q11.2 region. Post-hoc analysis was conducted to explore the biological pathways correlated with SNPs significantly associated with both AIS and SCZ.</p><p><strong>Results: </strong>The in silico analyses revealed a significant (adjusted-p < 0.05) genetic overlap between SCZ and both AIS cohorts. The top 3% of the most significant SNPs associated with both conditions exhibited a distinct enrichment cluster which is unlikely to be a result of chance (p < 3e-04). The gene-networks analyses showed a significant overlap of 26-41% with the ones involving genes in the 22q11DS region. However, there was no overlap between SNPs in this region and the most significant SNPs identified in the GWAS.</p><p><strong>Conclusion: </strong>This study revealed compelling evidence that beyond the shared association with 22q11DS as a rare genetic variant, AIS and SCZ exhibit common genetic risk variants and an overlap of important genes. The gene networks enriched by the most significant SNPs for both conditions also intersect with the ones involving genes in the 22q11DS region. However, SNPs within this region were not overrepresented among the most significant SNPs from GWAS for both conditions. Notably, gene networks linked to the risk for both conditions suggest an involvement of biopathways related to cellular signaling and neuronal development.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142474264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with rod fracture following surgery for adult spinal deformity: a single-center retrospective study. 成人脊柱畸形手术后杆骨折的相关因素:一项单中心回顾性研究。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-14 DOI: 10.1007/s43390-024-00985-x
Hiroki Konuma, Junya Katayanagi, Takahiro Iida, Shingo Morishita, Tomoyuki Tanaka, Tsukasa Yanase, Tetsuya Jinno, Hiroyuki Inose

Purpose: Adult spinal deformity (ASD) has a significant impact on trunk balance and quality of life in the elderly. Postoperative rod fractures pose significant challenges, but the mechanisms of their occurrence are underexplored compared to other complications such as proximal junctional kyphosis. This study investigated factors associated with rod fracture in patients with ASD.

Methods: A retrospective single-center study analyzed 110 adult patients who underwent spinal deformity correction between 2012 and 2020. Comparative analysis and univariate and multivariate Cox regression analyses were employed to identify factors associated with rod fracture.

Results: In this study, rod fracture occurred in 14.5% of patients. The rod fracture group exhibited a larger change in lumbar lordosis (LL), a higher proportion of patients with pre-operatively existing (pre-existing) vertebral fractures, and a greater percentage of patients with a rod diameter of 6 mm or less compared to the non-rod fracture group. Univariate Cox regression analysis revealed that rod fracture was associated with pre-existing vertebral fracture, LL change, preoperative sagittal vertical axis, and preoperative pelvic tilt. Multivariate Cox regression analysis identified pre-existing vertebral fractures and the amount of LL change as independent factors associated with rod fractures.

Conclusion: Pre-existing vertebral fractures and the magnitude of lumbar lordosis correction are independent risk factors for rod fracture following ASD surgery. Surgeons should consider these factors during preoperative planning to reduce the risk of postoperative rod fracture.

Level of evidence: IV.

目的:成人脊柱畸形(ASD)对老年人的躯干平衡和生活质量有重大影响。术后连杆骨折是一项重大挑战,但与近端交界性脊柱后凸等其他并发症相比,人们对其发生机制的探索还很不够。本研究调查了与ASD患者杆骨折相关的因素:一项回顾性单中心研究分析了2012年至2020年间接受脊柱畸形矫正的110名成年患者。采用比较分析、单变量和多变量Cox回归分析来确定与杆骨折相关的因素:结果:在这项研究中,14.5%的患者发生了杆骨折。与非连杆骨折组相比,连杆骨折组的腰椎前凸(LL)变化较大,术前已有(已存在)椎体骨折的患者比例较高,连杆直径为 6 毫米或以下的患者比例较高。单变量 Cox 回归分析显示,杆状骨折与术前存在的椎体骨折、LL 变化、术前矢状纵轴和术前骨盆倾斜有关。多变量 Cox 回归分析发现,术前存在的椎体骨折和 LL 变化量是与杆状骨折相关的独立因素:结论:先前存在的脊椎骨折和腰椎前凸矫正的程度是ASD手术后发生骨棒骨折的独立风险因素。外科医生在术前计划时应考虑这些因素,以降低术后杆骨折的风险:证据等级:IV。
{"title":"Factors associated with rod fracture following surgery for adult spinal deformity: a single-center retrospective study.","authors":"Hiroki Konuma, Junya Katayanagi, Takahiro Iida, Shingo Morishita, Tomoyuki Tanaka, Tsukasa Yanase, Tetsuya Jinno, Hiroyuki Inose","doi":"10.1007/s43390-024-00985-x","DOIUrl":"https://doi.org/10.1007/s43390-024-00985-x","url":null,"abstract":"<p><strong>Purpose: </strong>Adult spinal deformity (ASD) has a significant impact on trunk balance and quality of life in the elderly. Postoperative rod fractures pose significant challenges, but the mechanisms of their occurrence are underexplored compared to other complications such as proximal junctional kyphosis. This study investigated factors associated with rod fracture in patients with ASD.</p><p><strong>Methods: </strong>A retrospective single-center study analyzed 110 adult patients who underwent spinal deformity correction between 2012 and 2020. Comparative analysis and univariate and multivariate Cox regression analyses were employed to identify factors associated with rod fracture.</p><p><strong>Results: </strong>In this study, rod fracture occurred in 14.5% of patients. The rod fracture group exhibited a larger change in lumbar lordosis (LL), a higher proportion of patients with pre-operatively existing (pre-existing) vertebral fractures, and a greater percentage of patients with a rod diameter of 6 mm or less compared to the non-rod fracture group. Univariate Cox regression analysis revealed that rod fracture was associated with pre-existing vertebral fracture, LL change, preoperative sagittal vertical axis, and preoperative pelvic tilt. Multivariate Cox regression analysis identified pre-existing vertebral fractures and the amount of LL change as independent factors associated with rod fractures.</p><p><strong>Conclusion: </strong>Pre-existing vertebral fractures and the magnitude of lumbar lordosis correction are independent risk factors for rod fracture following ASD surgery. Surgeons should consider these factors during preoperative planning to reduce the risk of postoperative rod fracture.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142474253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arthur David Steffee, Jr., MD. 小阿瑟-戴维-斯蒂菲,医学博士。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-12 DOI: 10.1007/s43390-024-00981-1
{"title":"Arthur David Steffee, Jr., MD.","authors":"","doi":"10.1007/s43390-024-00981-1","DOIUrl":"https://doi.org/10.1007/s43390-024-00981-1","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patients with achondroplasia have increased risk of 90-day adverse events following laminectomy: A matched comparison using a national database. 软骨发育不全患者在椎板切除术后发生 90 天不良事件的风险更高:使用国家数据库进行匹配比较。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-09 DOI: 10.1007/s43390-024-00977-x
Anusha Patil, Peter Y Joo, Jay Moran, Lancelot Benn, Addisu Mesfin

Purpose: Performing laminectomies in patients with achondroplasia-a common skeletal dysplasia-can present unique challenges. There are a limited number of studies that have reported on the adverse effects of laminectomies in patients with achondroplasia. To compare the 90-day postoperative adverse events following laminectomy in patients with and without achondroplasia.

Methods: Retrospective cohort study using the 2010-2020 PearlDiver Mariner 91 administrative database was used to identify patients who underwent thoracic, thoracolumbar, or lumbar laminectomy. Patients with achondroplasia were matched 1:4 to patients without achondroplasia based on age, sex, insurance, and ECI. Univariate and multivariate logistic regression analyses assessed and compared 90-day adverse events. Odds ratios (OR), 95% confidence intervals (CI), and p-values were reported with significance set at p < 0.05.

Results: A multivariate analysis revealed that when laminectomy was performed, patients with achondroplasia were 2.82 times more likely to have 90-day AE compared to those without achondroplasia (p < 0.001). When comparing individual subtypes of adverse events, patients with achondroplasia were found to have significantly greater odds of a transfusion (OR 6.40, p < 0.001), UTI (OR 3.79, p < 0.001), disruption of wound (OR 3.71, p < 0.001), and hematoma (OR 2.94, p = 0.032). Pneumonia, cardiac arrest, AKI, other perioperative events, durotomy, and VTE were not significantly different between the two cohorts.

Conclusion: This study uses one of the largest cohorts to compare patients with and without achondroplasia undergoing laminectomy. Patients with achondroplasia were found to have a significantly greater risk of 90-day adverse events following laminectomy compared to their matched cohort of patients without achondroplasia.

目的:对软骨发育不全(一种常见的骨骼发育不良)患者实施椎板切除术可能会带来独特的挑战。有关软骨发育不全患者椎板切除术不良反应的研究报告数量有限。目的:比较软骨发育不良患者和非软骨发育不良患者椎板切除术后 90 天的不良反应:使用 2010-2020 年 PearlDiver Mariner 91 管理数据库进行回顾性队列研究,以确定接受胸椎、胸腰椎或腰椎椎板切除术的患者。根据年龄、性别、保险和 ECI,软骨发育不全患者与非软骨发育不全患者按 1:4 配对。单变量和多变量逻辑回归分析评估并比较了90天不良事件。报告了概率比 (OR)、95% 置信区间 (CI) 和 p 值,显著性设置为 p 结果:多变量分析显示,与无软骨发育不全的患者相比,实施椎板切除术的软骨发育不全患者发生 90 天不良事件的几率是后者的 2.82 倍(p 结论:该研究采用了最大规模的队列研究,对软骨发育不全患者的 90 天不良事件进行了比较:本研究使用了一个最大的队列来比较接受椎板切除术的软骨发育不全患者和非软骨发育不全患者。研究发现,软骨发育不全患者在接受椎板切除术后发生 90 天不良事件的风险明显高于无软骨发育不全的匹配队列患者。
{"title":"Patients with achondroplasia have increased risk of 90-day adverse events following laminectomy: A matched comparison using a national database.","authors":"Anusha Patil, Peter Y Joo, Jay Moran, Lancelot Benn, Addisu Mesfin","doi":"10.1007/s43390-024-00977-x","DOIUrl":"https://doi.org/10.1007/s43390-024-00977-x","url":null,"abstract":"<p><strong>Purpose: </strong>Performing laminectomies in patients with achondroplasia-a common skeletal dysplasia-can present unique challenges. There are a limited number of studies that have reported on the adverse effects of laminectomies in patients with achondroplasia. To compare the 90-day postoperative adverse events following laminectomy in patients with and without achondroplasia.</p><p><strong>Methods: </strong>Retrospective cohort study using the 2010-2020 PearlDiver Mariner 91 administrative database was used to identify patients who underwent thoracic, thoracolumbar, or lumbar laminectomy. Patients with achondroplasia were matched 1:4 to patients without achondroplasia based on age, sex, insurance, and ECI. Univariate and multivariate logistic regression analyses assessed and compared 90-day adverse events. Odds ratios (OR), 95% confidence intervals (CI), and p-values were reported with significance set at p < 0.05.</p><p><strong>Results: </strong>A multivariate analysis revealed that when laminectomy was performed, patients with achondroplasia were 2.82 times more likely to have 90-day AE compared to those without achondroplasia (p < 0.001). When comparing individual subtypes of adverse events, patients with achondroplasia were found to have significantly greater odds of a transfusion (OR 6.40, p < 0.001), UTI (OR 3.79, p < 0.001), disruption of wound (OR 3.71, p < 0.001), and hematoma (OR 2.94, p = 0.032). Pneumonia, cardiac arrest, AKI, other perioperative events, durotomy, and VTE were not significantly different between the two cohorts.</p><p><strong>Conclusion: </strong>This study uses one of the largest cohorts to compare patients with and without achondroplasia undergoing laminectomy. Patients with achondroplasia were found to have a significantly greater risk of 90-day adverse events following laminectomy compared to their matched cohort of patients without achondroplasia.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Matched comparison of non-fusion surgeries for adolescent idiopathic scoliosis: posterior dynamic distraction device and vertebral body tethering. 青少年特发性脊柱侧凸非融合手术的匹配比较:后方动态牵引装置和椎体系绳术。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-08 DOI: 10.1007/s43390-024-00982-0
Julia Todderud, A Noelle Larson, Geoffrey Haft, Ron El-Hawary, Nigel Price, John T Anderson, Ryan Fitzgerald, Gilbert Chan, Baron Lonner, Michael Albert, Daniel Hoernschemeyer, Todd A Milbrandt

Purpose: Two non-fusion devices for adolescent idiopathic scoliosis (AIS) received HDE approval for clinical use in 2019: posterior dynamic distraction device (PDDD) and vertebral body tethering system (VBT). Although indications are similar, there is no comparative study of these devices. We hypothesize that curve correction will be comparable, but PDDD will have better perioperative metrics.

Methods: AIS PDDD patients were prospectively enrolled in this matched multicenter study. Inclusion criteria were Lenke 1 or 5 curves, preoperative curves 35°-60°, correction to ≤30° on bending radiographs, and kyphosis <55°. Patients were matched by age, sex, Risser, curve type and curve magnitude to a single-center cohort of VBT patients. Results were compared at 2 years.

Results: 20 PDDD patients were matched to 20 VBT patients. Blood loss was higher in the VBT cohort (88 vs. 36 ml, p < 0.001). Operative time and postoperative length of stay were longer in the VBT cohort, 177 vs. 115 min (p < 0.001) (2.9 vs. 1.2 days, p < 0.001). Postoperative curve measurement and correction at 6 months were better in the PDDD cohort (15° vs. 24°, p < 0.001; 68% vs. 50%, p < 0.001). At 1-year, PDDD patients had improved Cobb angles (14° vs. 21°, p = 0.001). At 2 years, a correction was improved in the PDDD cohort, with a curve measurement of 17° for PDDD and 22° for VBT (p = 0.043). At the latest follow-up, 3 PDDD patients and 1 VBT patient underwent revision surgery.

Conclusion: Early results show PDDD demonstrates better index correction, reduced operative time, less blood loss, and shorter length of stay but higher rates of revision compared to a matched cohort of VBT patients at two-year follow-up.

Level of evidence: Level II, prospective cohort matched comparative study.

目的:2019 年,两种用于青少年特发性脊柱侧凸(AIS)的非融合器械获得了 HDE 批准,可用于临床:后路动态牵引器械(PDDD)和椎体系带系统(VBT)。虽然适应症相似,但目前还没有对这些装置进行比较研究。我们假设曲线矫正效果相当,但 PDDD 的围手术期指标更好:方法:在这项匹配的多中心研究中,前瞻性地纳入了 AIS PDDD 患者。纳入标准为 Lenke 1 或 5 型曲线,术前曲线 35°-60°,弯曲位片矫正≤30°,脊柱后凸 结果:20 名 PDDD 患者与 20 名 VBT 患者进行了配对。VBT 患者的失血量更高(88 毫升对 36 毫升,P 结论:PDDD 患者的失血量更高,VBT 患者的失血量更少:早期结果显示,与匹配的 VBT 患者队列相比,PDDD 的指数矫正效果更好、手术时间更短、失血量更少、住院时间更短,但两年随访后的翻修率更高:二级,前瞻性队列匹配比较研究。
{"title":"Matched comparison of non-fusion surgeries for adolescent idiopathic scoliosis: posterior dynamic distraction device and vertebral body tethering.","authors":"Julia Todderud, A Noelle Larson, Geoffrey Haft, Ron El-Hawary, Nigel Price, John T Anderson, Ryan Fitzgerald, Gilbert Chan, Baron Lonner, Michael Albert, Daniel Hoernschemeyer, Todd A Milbrandt","doi":"10.1007/s43390-024-00982-0","DOIUrl":"https://doi.org/10.1007/s43390-024-00982-0","url":null,"abstract":"<p><strong>Purpose: </strong>Two non-fusion devices for adolescent idiopathic scoliosis (AIS) received HDE approval for clinical use in 2019: posterior dynamic distraction device (PDDD) and vertebral body tethering system (VBT). Although indications are similar, there is no comparative study of these devices. We hypothesize that curve correction will be comparable, but PDDD will have better perioperative metrics.</p><p><strong>Methods: </strong>AIS PDDD patients were prospectively enrolled in this matched multicenter study. Inclusion criteria were Lenke 1 or 5 curves, preoperative curves 35°-60°, correction to ≤30° on bending radiographs, and kyphosis <55°. Patients were matched by age, sex, Risser, curve type and curve magnitude to a single-center cohort of VBT patients. Results were compared at 2 years.</p><p><strong>Results: </strong>20 PDDD patients were matched to 20 VBT patients. Blood loss was higher in the VBT cohort (88 vs. 36 ml, p < 0.001). Operative time and postoperative length of stay were longer in the VBT cohort, 177 vs. 115 min (p < 0.001) (2.9 vs. 1.2 days, p < 0.001). Postoperative curve measurement and correction at 6 months were better in the PDDD cohort (15° vs. 24°, p < 0.001; 68% vs. 50%, p < 0.001). At 1-year, PDDD patients had improved Cobb angles (14° vs. 21°, p = 0.001). At 2 years, a correction was improved in the PDDD cohort, with a curve measurement of 17° for PDDD and 22° for VBT (p = 0.043). At the latest follow-up, 3 PDDD patients and 1 VBT patient underwent revision surgery.</p><p><strong>Conclusion: </strong>Early results show PDDD demonstrates better index correction, reduced operative time, less blood loss, and shorter length of stay but higher rates of revision compared to a matched cohort of VBT patients at two-year follow-up.</p><p><strong>Level of evidence: </strong>Level II, prospective cohort matched comparative study.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Spine deformity
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1