首页 > 最新文献

Spine deformity最新文献

英文 中文
Age and in-brace Cobb angle predict brace failure in adolescent idiopathic scoliosis. 年龄和支架内Cobb角预测青少年特发性脊柱侧凸支架失效。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-10-15 DOI: 10.1007/s43390-025-01203-y
Muhammed Enes Karatas
{"title":"Age and in-brace Cobb angle predict brace failure in adolescent idiopathic scoliosis.","authors":"Muhammed Enes Karatas","doi":"10.1007/s43390-025-01203-y","DOIUrl":"10.1007/s43390-025-01203-y","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"315-316"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293676","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
Construct-construct "rail technique" decreases screw strain during spinal deformity corrective maneuvers across a thoracic vertebral column resection: a cadaveric analysis. 构造-构造“轨道技术”在脊柱畸形矫正术中通过胸椎柱切除减少螺钉应变:一项尸体分析。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-10-07 DOI: 10.1007/s43390-025-01195-9
Alekos A Theologis, Jason DePhillips, Izabella T Lachcik, Jonathan M Mahoney, Brandon S Bucklen

Purpose: To biomechanically compare screw strains above and below a vertebral column resection (VCR) during segmental compression (SC) and cantilever bending (CB) performed via traditional methods and a novel, construct-to-construct accessory rod ("rail") technique.

Methods: Eight cadaveric torsos underwent a VCR with 250 kyphosis at T8 with pedicle screws implanted three levels above and below the VCR (T5-7; T9-11). Four screws (T6, T7, T9, T10) were instrumented with strain gauges to capture screw strains during SC and CB. Both deformity corrective maneuvers were performed over a traditional construct (central rod) and over a construct-to-construct accessory ("rail") rod. Real-time screw strains were collected and peak strains were compared between corrective techniques.

Results: Strains in screws closest to the VCR were significantly less during "rail" compression compared to traditional SC (T7: p = 0.015). Maximum screw strains were significantly lower during "rail" SC and CB compared to traditional SC (T6: p = 0.037; T7: p = 0.015) and CB (T6: p = 0.018; T9: p < 0.001). Total screw strain was more evenly distributed over all screws during "rail" compression and CB compared to traditional techniques, which concentrated strain at individual screws adjacent to the VCR.

Conclusions: Performing segmental compression and cantilever bending across a lateral accessory construct-to-construct ("rail") rod resulted in significantly lower strain on individual pedicle screws adjacent to a thoracic VCR compared to traditional SC and CB. As such, the "rail" may lessen risk of screw pull-out and screw plough during maneuvers to correct spinal deformities across a VCR.

目的:从生物力学角度比较椎体切除术(VCR)在节段压缩(SC)和悬臂弯曲(CB)期间,通过传统方法和一种新型的结构对结构附属杆(“rail”)技术进行的螺钉上下应变。方法:8具尸体在T8处行椎弓根椎弓根螺钉植入椎弓根椎弓根螺钉,椎弓根椎弓根螺钉植入椎弓根椎弓根螺钉上下三节位(T5-7; T9-11)。4个螺钉(T6, T7, T9, T10)在SC和CB过程中使用应变片测量螺钉应变。两种畸形矫正操作均在传统结构体(中心杆)和结构体对结构体附件(“轨道”)杆上进行。实时采集螺旋应变并比较两种矫正方法的峰值应变。结果:与传统SC相比,靠近VCR的螺钉在“导轨”压缩期间的应变明显减少(T7: p = 0.015)。与传统的椎弓根置换术(T6: p = 0.037; T7: p = 0.015)和椎弓根置换术(T6: p = 0.018; T9: p)相比,“轨道”置换术和椎弓根置换术的最大螺钉应变显著降低(T6: p = 0.018; T9: p)。结论:与传统的椎弓根置换术和椎弓根置换术相比,通过横向附属结构对结构(“轨道”)棒进行节段压缩和悬臂弯曲可显著降低胸椎弓根置换术相邻椎弓根螺钉的应变。因此,“导轨”可以减少螺钉拔出和螺钉犁的风险,在操作过程中纠正脊柱畸形在VCR。
{"title":"Construct-construct \"rail technique\" decreases screw strain during spinal deformity corrective maneuvers across a thoracic vertebral column resection: a cadaveric analysis.","authors":"Alekos A Theologis, Jason DePhillips, Izabella T Lachcik, Jonathan M Mahoney, Brandon S Bucklen","doi":"10.1007/s43390-025-01195-9","DOIUrl":"10.1007/s43390-025-01195-9","url":null,"abstract":"<p><strong>Purpose: </strong>To biomechanically compare screw strains above and below a vertebral column resection (VCR) during segmental compression (SC) and cantilever bending (CB) performed via traditional methods and a novel, construct-to-construct accessory rod (\"rail\") technique.</p><p><strong>Methods: </strong>Eight cadaveric torsos underwent a VCR with 25<sup>0</sup> kyphosis at T8 with pedicle screws implanted three levels above and below the VCR (T5-7; T9-11). Four screws (T6, T7, T9, T10) were instrumented with strain gauges to capture screw strains during SC and CB. Both deformity corrective maneuvers were performed over a traditional construct (central rod) and over a construct-to-construct accessory (\"rail\") rod. Real-time screw strains were collected and peak strains were compared between corrective techniques.</p><p><strong>Results: </strong>Strains in screws closest to the VCR were significantly less during \"rail\" compression compared to traditional SC (T7: p = 0.015). Maximum screw strains were significantly lower during \"rail\" SC and CB compared to traditional SC (T6: p = 0.037; T7: p = 0.015) and CB (T6: p = 0.018; T9: p < 0.001). Total screw strain was more evenly distributed over all screws during \"rail\" compression and CB compared to traditional techniques, which concentrated strain at individual screws adjacent to the VCR.</p><p><strong>Conclusions: </strong>Performing segmental compression and cantilever bending across a lateral accessory construct-to-construct (\"rail\") rod resulted in significantly lower strain on individual pedicle screws adjacent to a thoracic VCR compared to traditional SC and CB. As such, the \"rail\" may lessen risk of screw pull-out and screw plough during maneuvers to correct spinal deformities across a VCR.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"39-47"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: What can we learn from scoliosis in children with the 22q11.2 deletion syndrome? Prognostic factors at pre-adolescent age for fast progressive, mild and self-resolving forms during adolescence. 更正:从22q11.2缺失综合征儿童脊柱侧凸中我们可以学到什么?青春期前快速进展、轻度和自行消退形式的预后因素。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 DOI: 10.1007/s43390-025-01155-3
Sabrina Donzelli, Peter Lafranca, Maarten van Smeden, René Castelein, Tom Schlösser
{"title":"Correction: What can we learn from scoliosis in children with the 22q11.2 deletion syndrome? Prognostic factors at pre-adolescent age for fast progressive, mild and self-resolving forms during adolescence.","authors":"Sabrina Donzelli, Peter Lafranca, Maarten van Smeden, René Castelein, Tom Schlösser","doi":"10.1007/s43390-025-01155-3","DOIUrl":"10.1007/s43390-025-01155-3","url":null,"abstract":"","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"311"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Scolioscope: a home detection tool for measuring axial trunk rotation in scoliosis-a validation study. 脊柱侧弯镜:一种用于测量脊柱侧弯中轴向躯干旋转的家庭检测工具-验证研究。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-09-08 DOI: 10.1007/s43390-025-01174-0
Julia H E Holleman, Hanneke M van West, Thomas Q M Vu, Max Reijman, Joost P H J Rutges

Purpose: Screening for adolescent idiopathic scoliosis (AIS) using the Adam Forward Bending Test (AFBT) remains controversial, resulting in the discontinuation of scoliosis screening in the Netherlands. This study aims to validate the Scolioscope, a simplified version of the Scoliometer, for detecting scoliosis in a home setting.

Methods: A validation study was conducted at the orthopedic outpatient clinic of Erasmus Medical Center Sophia Children's Hospital in Rotterdam, the Netherlands. Patients aged 9-18 years with or without AIS and capable of performing the AFBT were included. The Scolioscope measurement of the parents was compared with the Scoliometer measured by an orthopedic surgeon. After unsatisfactory results with the initial Scolioscope version, a revised version was developed and tested.

Results: Among 100 patients included in the study, 79 had scoliosis. The revised version of the Scolioscope demonstrated a positive predictive value of 97%, a negative predictive value of 89%, sensitivity of 94%, and specificity of 94%. Parental measurements showed no variation, with an intra-observer reliability kappa value of 1.

Conclusion: The Scolioscope demonstrates high diagnostic accuracy and precision, making it suitable for use in at-home scoliosis screening programs.

目的:使用亚当前屈试验(AFBT)筛查青少年特发性脊柱侧凸(AIS)仍然存在争议,导致荷兰停止了脊柱侧凸筛查。本研究旨在验证脊柱侧弯镜,一种简化版的脊柱侧弯仪,用于在家庭环境中检测脊柱侧弯。方法:在荷兰鹿特丹的伊拉斯谟医学中心索菲亚儿童医院骨科门诊进行了一项验证研究。患者年龄9-18岁,有或没有AIS,并能够进行AFBT。将父母的脊柱侧弯镜测量值与骨科医生的脊柱侧弯仪测量值进行比较。在最初的脊柱侧镜版本不满意的结果后,开发了一个修订版本并进行了测试。结果:纳入研究的100例患者中,79例患有脊柱侧凸。改良版脊柱侧镜的阳性预测值为97%,阴性预测值为89%,敏感性为94%,特异性为94%。亲本测量结果没有变化,观察者内信度kappa值为1。结论:脊柱侧凸镜具有较高的诊断准确性和精密度,适合用于家庭脊柱侧凸筛查。
{"title":"The Scolioscope: a home detection tool for measuring axial trunk rotation in scoliosis-a validation study.","authors":"Julia H E Holleman, Hanneke M van West, Thomas Q M Vu, Max Reijman, Joost P H J Rutges","doi":"10.1007/s43390-025-01174-0","DOIUrl":"10.1007/s43390-025-01174-0","url":null,"abstract":"<p><strong>Purpose: </strong>Screening for adolescent idiopathic scoliosis (AIS) using the Adam Forward Bending Test (AFBT) remains controversial, resulting in the discontinuation of scoliosis screening in the Netherlands. This study aims to validate the Scolioscope, a simplified version of the Scoliometer, for detecting scoliosis in a home setting.</p><p><strong>Methods: </strong>A validation study was conducted at the orthopedic outpatient clinic of Erasmus Medical Center Sophia Children's Hospital in Rotterdam, the Netherlands. Patients aged 9-18 years with or without AIS and capable of performing the AFBT were included. The Scolioscope measurement of the parents was compared with the Scoliometer measured by an orthopedic surgeon. After unsatisfactory results with the initial Scolioscope version, a revised version was developed and tested.</p><p><strong>Results: </strong>Among 100 patients included in the study, 79 had scoliosis. The revised version of the Scolioscope demonstrated a positive predictive value of 97%, a negative predictive value of 89%, sensitivity of 94%, and specificity of 94%. Parental measurements showed no variation, with an intra-observer reliability kappa value of 1.</p><p><strong>Conclusion: </strong>The Scolioscope demonstrates high diagnostic accuracy and precision, making it suitable for use in at-home scoliosis screening programs.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"85-92"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Double claw construct with hooks for proximal fixation in adolescent idiopathic scoliosis: a randomized controlled trial. 双爪结构与钩近端固定青少年特发性脊柱侧凸:一项随机对照试验。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-08-28 DOI: 10.1007/s43390-025-01161-5
J J M Renkens, A Willems, M Reijman, P de Baat, L W L de Klerk, J P H J Rutges

Purpose: Proximal fixation in adolescent idiopathic scoliosis (AIS) surgery is a matter of discussion. All screw (AS) constructs provide better coronal correction than hybrid constructs, but high thoracic pedicle screw placement can be challenging. This study investigated whether an AS-construct provides better correction than a proximal double hook-claw (PH) construct.

Methods: AIS patients undergoing posterior spinal fusion (PSF) were randomized to AS-construct or PH-construct from 2016 to 2020 with a two-year follow-up. Primary outcome is the main thoracic (MT) Cobb angle correction after two years. Secondary outcomes are thoracic kyphosis (TK), proximal junctional angle (PJA), proximal thoracic (PT) Cobb angle, SRS-22r, and complications after two years.

Results: 60 patients (30 AS, 30 PH) were included. No baseline differences were found. Preoperative MT Cobb angle was 62° ± 11° (AS) vs. 65° ± 12° (PH). There was no statistical difference in MT Cobb angle after two years: 25° ± 9° (AS) vs. 27° ± 7° (PH) (p = 0.247). No difference in PT Cobb angle was found: 20° ± 9° (AS) vs. 21° ± 9° (PH) and TK: 23° ± 9° (AS) vs. 22° ± 7° (PH). SRS-22r improved in both groups with no statistical difference: 3.9 ± 0.5 to 4.3 ± 0.5 (AS) vs. 3.7 ± 0.5 to 4.3 ± 0.5 (PH). There were 13 complications (ten patients) in AS group and 17 (13 patients) in PH group, including 1 major complication in each group (deep wound infection).

Conclusion: AS-construct does not provide better coronal Cobb correction after two years after surgery. A PH-construct is a reliable and safe option for proximal fixation AIS patients. TRN: NTR-NL5552 (2016).

Trial registration: Overview of medical research in the Netherlands (OMON): NL-OMON43852.

目的:近端固定在青少年特发性脊柱侧凸(AIS)手术是一个问题的讨论。所有螺钉(AS)结构比混合结构提供更好的冠状面矫正,但高位胸椎弓根螺钉放置可能具有挑战性。本研究调查了as结构是否比近端双钩爪(PH)结构提供更好的矫正。方法:2016年至2020年,接受后路脊柱融合术(PSF)的AIS患者随机分为as组或ph组,随访2年。主要结果是两年后主胸(MT) Cobb角矫正。次要结果是胸后凸(TK)、近端关节角(PJA)、近端胸角(PT) Cobb角、SRS-22r和两年后的并发症。结果:纳入60例患者(30例AS, 30例PH)。没有发现基线差异。术前MT Cobb角为62°±11°(AS) vs. 65°±12°(PH)。两年后MT Cobb角25°±9°(AS)与27°±7°(PH)无统计学差异(p = 0.247)。PT Cobb角分别为20°±9°(AS)和21°±9°(PH), TK分别为23°±9°(AS)和22°±7°(PH)。两组的SRS-22r均有改善,差异无统计学意义:AS为3.9±0.5 ~ 4.3±0.5,PH为3.7±0.5 ~ 4.3±0.5。AS组并发症13例(10例),PH组并发症17例(13例),其中两组主要并发症1例(深创面感染)。结论:as结构在术后2年后仍不能提供更好的冠状Cobb矫正。对于近端固定的AIS患者,ph结构是一种可靠和安全的选择。编号:ntr-nl5552(2016)。试验注册:荷兰医学研究概述(OMON): NL-OMON43852。
{"title":"Double claw construct with hooks for proximal fixation in adolescent idiopathic scoliosis: a randomized controlled trial.","authors":"J J M Renkens, A Willems, M Reijman, P de Baat, L W L de Klerk, J P H J Rutges","doi":"10.1007/s43390-025-01161-5","DOIUrl":"10.1007/s43390-025-01161-5","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal fixation in adolescent idiopathic scoliosis (AIS) surgery is a matter of discussion. All screw (AS) constructs provide better coronal correction than hybrid constructs, but high thoracic pedicle screw placement can be challenging. This study investigated whether an AS-construct provides better correction than a proximal double hook-claw (PH) construct.</p><p><strong>Methods: </strong>AIS patients undergoing posterior spinal fusion (PSF) were randomized to AS-construct or PH-construct from 2016 to 2020 with a two-year follow-up. Primary outcome is the main thoracic (MT) Cobb angle correction after two years. Secondary outcomes are thoracic kyphosis (TK), proximal junctional angle (PJA), proximal thoracic (PT) Cobb angle, SRS-22r, and complications after two years.</p><p><strong>Results: </strong>60 patients (30 AS, 30 PH) were included. No baseline differences were found. Preoperative MT Cobb angle was 62° ± 11° (AS) vs. 65° ± 12° (PH). There was no statistical difference in MT Cobb angle after two years: 25° ± 9° (AS) vs. 27° ± 7° (PH) (p = 0.247). No difference in PT Cobb angle was found: 20° ± 9° (AS) vs. 21° ± 9° (PH) and TK: 23° ± 9° (AS) vs. 22° ± 7° (PH). SRS-22r improved in both groups with no statistical difference: 3.9 ± 0.5 to 4.3 ± 0.5 (AS) vs. 3.7 ± 0.5 to 4.3 ± 0.5 (PH). There were 13 complications (ten patients) in AS group and 17 (13 patients) in PH group, including 1 major complication in each group (deep wound infection).</p><p><strong>Conclusion: </strong>AS-construct does not provide better coronal Cobb correction after two years after surgery. A PH-construct is a reliable and safe option for proximal fixation AIS patients. TRN: NTR-NL5552 (2016).</p><p><strong>Trial registration: </strong>Overview of medical research in the Netherlands (OMON): NL-OMON43852.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"119-128"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The growth modulating effects of tether tension on vertebral growth are biphasic: a study of posterior vertebral body tethering (pVBT) in a novel kyphotic porcine model. 拴索张力对椎体生长的调节作用是双相的:一项在新型后凸猪模型中后路椎体拴索(pVBT)的研究。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-08-20 DOI: 10.1007/s43390-025-01168-y
Matthew A Halanski, Brittney Kokinos, Ellen Leiferman, Minhao Zhou, Yousuf Abubakr, Max Twedt, Cameron Jeffers, David Bennett, Susan Hamman, Jennifer Frank, Melanie E Boeyer, Grace D O'Connell, Thomas Crenshaw

Purpose: To measure the effects of posterior vertebral tethering (pVBT) on disc pressure and the effect of tether tension on growth modulation in the hyperkyphotic swine model, and to use computational modeling to predict growth modulation in scenarios unable to be tested in the animal model.

Methods: Swine were divided into non-operative control, single-level apical pVBT, or multi-level posterior pVBT groups. Pulsed fluorochrome labeling was used to measure regional vertebral growth rates, digital radiographs to assess changes in vertebral alignment, and pressure transducers to measure intervertebral disc pressures. Finite element analysis (FEA) was performed to simulate tether-mediated disc space correction.

Results: Kyphotic swine had significantly greater angular kyphosis than control swine at 11- and 13-weeks, and deformities increased from 2 to 5 months of age. At 2-weeks post-operative, high-tension single level tethering resulted in significantly greater growth modulation than low-tension (53 ± 43% vs - 1 ± 15%, p = 0.03) or non-operative controls (p = 0.01), however, at 2-4 weeks, growth modulation was normalized between the low and high tensioned cohorts (14 ± 11% vs 10 ± 10%, p = 0.6). The FEA predicted that growth plate stress distributions worsen as the average disc height post-realignment is decreased.

Conclusion: Increased tether tension results in more effective early growth modulation in the young flexible spine without increasing disc pressure, however, these tension-related benefits are transitory as growth modulation becomes load-independent with time. Computational modeling predicted that in the less flexible spine, vertebral growth may be arrested rather than modulated.

目的:测量后椎体栓系术(pVBT)对椎间盘压力的影响以及栓系张力对过度后凸猪模型生长调节的影响,并利用计算模型预测无法在动物模型中测试的情况下的生长调节。方法:将猪分为非手术对照组、单节段根尖pVBT组和多节段后路pVBT组。脉冲荧光标记用于测量局部椎体生长速率,数字x线片用于评估椎体排列的变化,压力传感器用于测量椎间盘压力。采用有限元分析(FEA)模拟系索介导的椎间盘间隙矫正。结果:后凸猪在11周和13周时角型后凸明显大于对照猪,2 ~ 5月龄时畸形增加。在术后2周,高张力单水平系索导致的生长调节明显大于低张力组(53±43% vs - 1±15%,p = 0.03)或非手术对照组(p = 0.01),然而,在2-4周,低张力组和高张力组之间的生长调节正常化(14±11% vs 10±10%,p = 0.6)。有限元分析预测,随着调整后平均盘高的降低,生长板应力分布恶化。结论:在不增加椎间盘压力的情况下,增高的系索张力可使年轻柔韧性脊柱的早期生长调节更有效,然而,随着时间的推移,生长调节变得与负荷无关,这些与张力相关的益处是短暂的。计算模型预测,在较不灵活的脊柱中,椎体生长可能被阻止而不是被调节。
{"title":"The growth modulating effects of tether tension on vertebral growth are biphasic: a study of posterior vertebral body tethering (pVBT) in a novel kyphotic porcine model.","authors":"Matthew A Halanski, Brittney Kokinos, Ellen Leiferman, Minhao Zhou, Yousuf Abubakr, Max Twedt, Cameron Jeffers, David Bennett, Susan Hamman, Jennifer Frank, Melanie E Boeyer, Grace D O'Connell, Thomas Crenshaw","doi":"10.1007/s43390-025-01168-y","DOIUrl":"10.1007/s43390-025-01168-y","url":null,"abstract":"<p><strong>Purpose: </strong>To measure the effects of posterior vertebral tethering (pVBT) on disc pressure and the effect of tether tension on growth modulation in the hyperkyphotic swine model, and to use computational modeling to predict growth modulation in scenarios unable to be tested in the animal model.</p><p><strong>Methods: </strong>Swine were divided into non-operative control, single-level apical pVBT, or multi-level posterior pVBT groups. Pulsed fluorochrome labeling was used to measure regional vertebral growth rates, digital radiographs to assess changes in vertebral alignment, and pressure transducers to measure intervertebral disc pressures. Finite element analysis (FEA) was performed to simulate tether-mediated disc space correction.</p><p><strong>Results: </strong>Kyphotic swine had significantly greater angular kyphosis than control swine at 11- and 13-weeks, and deformities increased from 2 to 5 months of age. At 2-weeks post-operative, high-tension single level tethering resulted in significantly greater growth modulation than low-tension (53 ± 43% vs - 1 ± 15%, p = 0.03) or non-operative controls (p = 0.01), however, at 2-4 weeks, growth modulation was normalized between the low and high tensioned cohorts (14 ± 11% vs 10 ± 10%, p = 0.6). The FEA predicted that growth plate stress distributions worsen as the average disc height post-realignment is decreased.</p><p><strong>Conclusion: </strong>Increased tether tension results in more effective early growth modulation in the young flexible spine without increasing disc pressure, however, these tension-related benefits are transitory as growth modulation becomes load-independent with time. Computational modeling predicted that in the less flexible spine, vertebral growth may be arrested rather than modulated.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"19-30"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utilizing stable vertebra on push-prone traction radiographs for the determination of the lowest instrumented vertebra: a novel approach for AIS patients with Lenke type 3C and 6C. 利用推卧牵引x线片上的稳定椎体来确定最低固定椎体:Lenke 3C型和6C型AIS患者的新方法。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-09-22 DOI: 10.1007/s43390-025-01188-8
Tinnakorn Pluemvitayaporn, Suttinont Surapuchong, Nuttavut Chavalparit, Piyabuth Kittithamvongs, Warot Ratanakoosakul, Kitjapat Tiracharnvut, Chaiwat Piyasakulkaew, Sombat Kunakornsawat
<p><strong>Objective: </strong>To assess whether using stable vertebra on push-prone traction radiographs for selecting the lowest instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 3C and 6C undergoing posterior spinal surgery can preserve more lumbar motion segments while still achieving satisfactory surgical outcomes.</p><p><strong>Background: </strong>AIS patients requiring surgical treatment typically present with progressive curves exceeding 40° and are skeletally immature. This study specifically focuses on AIS patients exhibiting Lenke curve types 3C and 6C, which include structural thoracic as well as thoracolumbar and lumbar curves. The selection of the LIV remains a contentious issue due to concerns about distal adding-on and the potential for spinal imbalance postoperatively. Existing literature suggests that longer fusion constructs and positioning the LIV below L3 can lead to significant functional limitations and accelerated disc degeneration. While Lenke advocated for identifying the stable vertebra (SV) as the LIV, our recent study indicates that push-prone traction radiographs provide superior predictability for correcting postoperative spinal alignment. This study aims to evaluate the effectiveness of using the stable vertebra identified through push-prone traction radiographs as the LIV in preserving segmental motion during posterior spinal surgery for managing Lenke type 3C and 6C curves.</p><p><strong>Methods: </strong>AIS patients with Lenke type 3C and 6C who underwent posterior spinal surgery between 2021 and 2024 were enrolled in the study. Preoperative 36-inch whole spine radiographs, including push-prone traction view, were obtained for curve flexibility assessment. The lowest instrumented vertebra (LIV) was determined by identifying the stable vertebra (SV) on push-prone traction radiographs. Demographic data, including sex, age, BMI, Lenke's curve type, and pre- and postoperative major coronal Cobb angle, thoracic kyphosis, lumbar lordosis, and C7 to central sacral vertical line (C7-CSVL), were collected. Statistical analysis was conducted to assess the differences in curve magnitudes between pre- and postoperative measurements.</p><p><strong>Results: </strong>Thirty-six AIS patients (33 female and 3 male) with a mean age of 13.9 ± 2.2 years were included in this study, with a mean follow-up period of 28.4 months. Preoperatively, the cohort presented with Lenke type 3C (24 out of 36) and Lenke type 6C (12 out of 36). The preoperative thoracic curve was corrected to an average of 5.7°, demonstrating an average correction rate of 89%. Similarly, the preoperative lumbar curve was corrected to an average of 5° with a correction rate of 90%.</p><p><strong>Conclusion: </strong>Push-prone traction radiographs may serve as an alternative method for determining the optimal LIV level in patients with Lenke type 3C and 6C. Identifying stable vertebra on push-prone traction radiographs
目的:探讨在Lenke 3C型和6C型青少年特发性脊柱侧凸(AIS)后路手术患者中,采用稳定椎体在俯卧牵引x线片上选择最低固定椎体(LIV)是否能保留更多的腰椎运动节段,同时仍能获得满意的手术效果。背景:需要手术治疗的AIS患者通常表现为进行性弯曲超过40°,骨骼不成熟。本研究特别关注具有Lenke曲线3C和6C型的AIS患者,包括结构性胸椎、胸腰椎和腰椎弯曲。LIV的选择仍然是一个有争议的问题,因为担心远端增加和术后脊柱不平衡的可能性。现有文献表明,较长的融合结构和位于L3以下的LIV可导致严重的功能限制和加速椎间盘退变。虽然Lenke主张将稳定椎体(SV)确定为LIV,但我们最近的研究表明,俯卧推牵引x线片为纠正术后脊柱对齐提供了更好的可预测性。本研究旨在评估通过俯卧推牵引x线片确定的稳定椎体作为LIV在后路脊柱手术中保持节段性运动的有效性,以治疗Lenke型3C和6C型弯曲。方法:纳入2021 - 2024年间行后路脊柱手术的Lenke 3C型和6C型AIS患者。术前36英寸全脊柱x线片,包括俯卧推位牵引视图,用于评估脊柱弯曲柔韧性。通过在俯卧推牵引x线片上识别稳定椎体(SV)来确定最低固定椎体(LIV)。收集人口统计学资料,包括性别、年龄、BMI、Lenke曲线类型、术前和术后Cobb主冠状角、胸后凸、腰椎前凸、C7至骶中央垂直线(C7- csvl)。统计分析评估术前和术后测量曲线幅度的差异。结果:纳入AIS患者36例(女性33例,男性3例),平均年龄13.9±2.2岁,平均随访时间28.4个月。术前,患者为Lenke 3C型(36例中有24例)和Lenke 6C型(36例中有12例)。术前胸椎弯曲平均矫正为5.7°,平均矫正率为89%。同样,术前腰椎弯曲平均矫正为5°,矫正率为90%。结论:俯卧推位牵引x线片可作为确定Lenke 3C型和6C型患者最佳LIV水平的替代方法。在俯卧推牵引x线片上确定稳定椎体为LIV可以在获得良好手术结果的同时保留更多的腰椎运动节段。
{"title":"Utilizing stable vertebra on push-prone traction radiographs for the determination of the lowest instrumented vertebra: a novel approach for AIS patients with Lenke type 3C and 6C.","authors":"Tinnakorn Pluemvitayaporn, Suttinont Surapuchong, Nuttavut Chavalparit, Piyabuth Kittithamvongs, Warot Ratanakoosakul, Kitjapat Tiracharnvut, Chaiwat Piyasakulkaew, Sombat Kunakornsawat","doi":"10.1007/s43390-025-01188-8","DOIUrl":"10.1007/s43390-025-01188-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess whether using stable vertebra on push-prone traction radiographs for selecting the lowest instrumented vertebra (LIV) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 3C and 6C undergoing posterior spinal surgery can preserve more lumbar motion segments while still achieving satisfactory surgical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;AIS patients requiring surgical treatment typically present with progressive curves exceeding 40° and are skeletally immature. This study specifically focuses on AIS patients exhibiting Lenke curve types 3C and 6C, which include structural thoracic as well as thoracolumbar and lumbar curves. The selection of the LIV remains a contentious issue due to concerns about distal adding-on and the potential for spinal imbalance postoperatively. Existing literature suggests that longer fusion constructs and positioning the LIV below L3 can lead to significant functional limitations and accelerated disc degeneration. While Lenke advocated for identifying the stable vertebra (SV) as the LIV, our recent study indicates that push-prone traction radiographs provide superior predictability for correcting postoperative spinal alignment. This study aims to evaluate the effectiveness of using the stable vertebra identified through push-prone traction radiographs as the LIV in preserving segmental motion during posterior spinal surgery for managing Lenke type 3C and 6C curves.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;AIS patients with Lenke type 3C and 6C who underwent posterior spinal surgery between 2021 and 2024 were enrolled in the study. Preoperative 36-inch whole spine radiographs, including push-prone traction view, were obtained for curve flexibility assessment. The lowest instrumented vertebra (LIV) was determined by identifying the stable vertebra (SV) on push-prone traction radiographs. Demographic data, including sex, age, BMI, Lenke's curve type, and pre- and postoperative major coronal Cobb angle, thoracic kyphosis, lumbar lordosis, and C7 to central sacral vertical line (C7-CSVL), were collected. Statistical analysis was conducted to assess the differences in curve magnitudes between pre- and postoperative measurements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-six AIS patients (33 female and 3 male) with a mean age of 13.9 ± 2.2 years were included in this study, with a mean follow-up period of 28.4 months. Preoperatively, the cohort presented with Lenke type 3C (24 out of 36) and Lenke type 6C (12 out of 36). The preoperative thoracic curve was corrected to an average of 5.7°, demonstrating an average correction rate of 89%. Similarly, the preoperative lumbar curve was corrected to an average of 5° with a correction rate of 90%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Push-prone traction radiographs may serve as an alternative method for determining the optimal LIV level in patients with Lenke type 3C and 6C. Identifying stable vertebra on push-prone traction radiographs","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"103-110"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114199","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
Spinopelvic alignment and sagittal gait kinematics of adult patients with cerebral palsy. 成年脑瘫患者的脊柱骨盆对准和矢状位步态运动学。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-09-20 DOI: 10.1007/s43390-025-01190-0
Patrick P Nian, Vishnu Deep Chandran, Colson Zucker, Peter Cirrincione, Zhenkun Gu, Silvia Zanini, Jennifer Jezequel, Bridget Assip, Sherry Backus, Dara Jones, David Scher, Paulo Selber

Purpose: Sagittal spinopelvic alignment (SPA) is originally calculated by the algebraic expression pelvic incidence-lumbar lordosis (PI-LL), heralded numerous clinically relevant radiographic measures of spine alignment, e.g., T4-L1-pelvic angle. SPA malalignment compromises spine fusion outcomes and quality of life of typically aging persons. This study investigated gait and SPA of patients with cerebral palsy (CP) using multiple sagittal radiographic measures.

Methods: Twenty-three patients, mean age 35 years with CP at GMFCS I-II were included. Radiographic measures included C2PA, T4PA, L1PA. PI-LL and T4-L1PA mismatch were defined as > 10°/ < - 10° and > 4°/ < - 4°, respectively. Trunk, pelvis, hips, and knees kinematics were obtained. Statistical parameter mapping (SPM) assessed kinematic differences throughout the gait cycle. Multivariable linear regression assessed the relationship between gait and radiographic parameters.

Results: Fourteen and eleven patients (60.9% and 47.8%) presented with PI-LL and T4-L1PA mismatch, respectively. PI-LL mismatched patients demonstrated significantly lower knee flexion during gait. T4-L1PA mismatched patients demonstrated increased anterior pelvic tilt, hip flexion, and decreased knee flexion during gait, which was consistent with SPM analysis. Multivariable linear regression showed T4-L1PA, C2PA, and anterior pelvic tilt were associated with knee flexion.

Conclusion: This is the first study to evaluate SPA parameters and gait kinematics in patients with CP. This observational and preliminary data suggested that SPA and knee flexion in gait may be associated. Whether the variations in gait patterns are coping mechanisms or the cause for SPA malalignment requires clarification. The implications of SPA malalignment on the quality of life of this population warrant further investigations.

目的:矢状椎盂对准(SPA)最初是通过骨盆发生率-腰椎前凸(PI-LL)的代数表达式来计算的,预示着许多临床相关的脊柱对准的影像学测量,例如t4 - l1 -骨盆角。SPA错位损害脊柱融合结果和典型老年人的生活质量。本研究采用多种矢状位射线测量方法研究脑瘫(CP)患者的步态和SPA。方法:纳入23例平均年龄35岁的GMFCS I-II期CP患者。x线测量包括C2PA、T4PA、L1PA。PI-LL和T4-L1PA错配定义为> 10°/ 4°。结果:PI-LL和T4-L1PA错配分别为14例和11例(60.9%和47.8%)。PI-LL不匹配的患者在步态中表现出明显的下膝关节屈曲。T4-L1PA不匹配的患者在步态中表现出骨盆前倾增加、髋关节屈曲和膝关节屈曲减少,这与SPM分析一致。多变量线性回归显示T4-L1PA、C2PA和骨盆前倾与膝关节屈曲有关。结论:这是第一个评估CP患者SPA参数和步态运动学的研究。这一观察和初步数据表明SPA和步态中的膝关节屈曲可能相关。步态模式的变化是应对机制还是导致SPA错位的原因需要澄清。SPA失调对这一人群生活质量的影响值得进一步调查。
{"title":"Spinopelvic alignment and sagittal gait kinematics of adult patients with cerebral palsy.","authors":"Patrick P Nian, Vishnu Deep Chandran, Colson Zucker, Peter Cirrincione, Zhenkun Gu, Silvia Zanini, Jennifer Jezequel, Bridget Assip, Sherry Backus, Dara Jones, David Scher, Paulo Selber","doi":"10.1007/s43390-025-01190-0","DOIUrl":"10.1007/s43390-025-01190-0","url":null,"abstract":"<p><strong>Purpose: </strong>Sagittal spinopelvic alignment (SPA) is originally calculated by the algebraic expression pelvic incidence-lumbar lordosis (PI-LL), heralded numerous clinically relevant radiographic measures of spine alignment, e.g., T4-L1-pelvic angle. SPA malalignment compromises spine fusion outcomes and quality of life of typically aging persons. This study investigated gait and SPA of patients with cerebral palsy (CP) using multiple sagittal radiographic measures.</p><p><strong>Methods: </strong>Twenty-three patients, mean age 35 years with CP at GMFCS I-II were included. Radiographic measures included C2PA, T4PA, L1PA. PI-LL and T4-L1PA mismatch were defined as > 10°/ < - 10° and > 4°/ < - 4°, respectively. Trunk, pelvis, hips, and knees kinematics were obtained. Statistical parameter mapping (SPM) assessed kinematic differences throughout the gait cycle. Multivariable linear regression assessed the relationship between gait and radiographic parameters.</p><p><strong>Results: </strong>Fourteen and eleven patients (60.9% and 47.8%) presented with PI-LL and T4-L1PA mismatch, respectively. PI-LL mismatched patients demonstrated significantly lower knee flexion during gait. T4-L1PA mismatched patients demonstrated increased anterior pelvic tilt, hip flexion, and decreased knee flexion during gait, which was consistent with SPM analysis. Multivariable linear regression showed T4-L1PA, C2PA, and anterior pelvic tilt were associated with knee flexion.</p><p><strong>Conclusion: </strong>This is the first study to evaluate SPA parameters and gait kinematics in patients with CP. This observational and preliminary data suggested that SPA and knee flexion in gait may be associated. Whether the variations in gait patterns are coping mechanisms or the cause for SPA malalignment requires clarification. The implications of SPA malalignment on the quality of life of this population warrant further investigations.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"215-226"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102998","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
Curve stabilization at 2 years despite declining brace adherence in adolescent idiopathic scoliosis: a single-center cohort with sociodemographic analysis. 青少年特发性脊柱侧凸患者,尽管支架依从性下降,但2年曲线稳定:单中心队列社会人口统计学分析
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-10-15 DOI: 10.1007/s43390-025-01196-8
Daniel C Gabriel, Nicole D Agaronnik, Danielle Cook, Daniel Hedequist, Craig M Birch, M Timothy Hresko, Grant D Hogue

Purpose: To investigate whether socioeconomic factors may predict brace adherence and curve magnitude in adolescent idiopathic scoliosis (AIS).

Methods: Patients with adolescent idiopathic scoliosis (AIS) who received a Boston Brace 3D (BB3D) thoracic-lumbar-sacral orthosis (TLSO) from January 2014 to October 2019 at a single center were reviewed. Brace adherence was objectively measured using temperature sensors embedded in orthotics. Brace wear was reported at 4 to 6 weeks (weaning period), 6 months, 12 months, 18 months, and 24 months since the first brace fitting. We abstracted demographic and socioeconomic variables including age, sex, race, ethnicity, median household income, insurance status, and pre-existing mental health conditions. Linear mixed-effect modeling was used to determine changes in adherence and curve magnitude at each visit.

Results: Among 62 patients (84% female, 63% White, 11% publicly insured), average adherence peaked at 6 months (79%) and declined to 64% by 24 months. Our findings suggest that males, on average, had 16% lower adherence to bracing compared to females (p = 0.035). Age at the pre-brace visit was found to be a statistically significant predictor of curve change at the 24-month follow-up, with each 1-year age difference associated with a three-degree increase in curve magnitude (p = 0.006). Other sociodemographic variables were not significantly associated with adherence or curve change.

Conclusion: Despite declining adherence over time, curve magnitude remained stable in most patients, aligning with bracing success criteria. Gender may predict brace adherence, while age may predict curve progression. Analysis of sociodemographic factors in this limited cohort suggests potential disparities in non-operative management that warrant further investigation in more diverse populations. Such insights may inform targeted counseling strategies to optimize long-term outcomes.

目的:探讨社会经济因素是否可以预测青少年特发性脊柱侧凸(AIS)的支架依从性和弯曲幅度。方法:回顾性分析2014年1月至2019年10月在单中心接受Boston Brace 3D (BB3D)胸-腰-骶矫形术(TLSO)治疗的青少年特发性脊柱侧凸(AIS)患者。使用嵌入矫形器的温度传感器客观地测量支具粘附性。首次安装支具后,分别在4 ~ 6周(断奶期)、6个月、12个月、18个月和24个月佩戴支具。我们抽象了人口统计学和社会经济变量,包括年龄、性别、种族、民族、家庭收入中位数、保险状况和先前存在的精神健康状况。使用线性混合效应模型来确定每次就诊时依从性和曲线大小的变化。结果:在62例患者(84%女性,63%白人,11%公共保险)中,平均依从性在6个月时达到峰值(79%),到24个月时下降到64%。我们的研究结果表明,与女性相比,男性对支具的依从性平均低16% (p = 0.035)。在24个月的随访中,发现使用支具前的年龄是曲线变化的一个有统计学意义的预测因子,每1年的年龄差异与曲线幅度增加3度相关(p = 0.006)。其他社会人口学变量与依从性或曲线变化没有显著关联。结论:尽管依从性随着时间的推移而下降,但大多数患者的弯曲幅度保持稳定,符合支具成功标准。性别可能预测支架的依从性,而年龄可能预测弯曲的进展。在这个有限的队列中,社会人口因素分析表明非手术治疗的潜在差异,值得在更多样化的人群中进一步调查。这些见解可以为有针对性的咨询策略提供信息,以优化长期结果。
{"title":"Curve stabilization at 2 years despite declining brace adherence in adolescent idiopathic scoliosis: a single-center cohort with sociodemographic analysis.","authors":"Daniel C Gabriel, Nicole D Agaronnik, Danielle Cook, Daniel Hedequist, Craig M Birch, M Timothy Hresko, Grant D Hogue","doi":"10.1007/s43390-025-01196-8","DOIUrl":"10.1007/s43390-025-01196-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether socioeconomic factors may predict brace adherence and curve magnitude in adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>Patients with adolescent idiopathic scoliosis (AIS) who received a Boston Brace 3D (BB3D) thoracic-lumbar-sacral orthosis (TLSO) from January 2014 to October 2019 at a single center were reviewed. Brace adherence was objectively measured using temperature sensors embedded in orthotics. Brace wear was reported at 4 to 6 weeks (weaning period), 6 months, 12 months, 18 months, and 24 months since the first brace fitting. We abstracted demographic and socioeconomic variables including age, sex, race, ethnicity, median household income, insurance status, and pre-existing mental health conditions. Linear mixed-effect modeling was used to determine changes in adherence and curve magnitude at each visit.</p><p><strong>Results: </strong>Among 62 patients (84% female, 63% White, 11% publicly insured), average adherence peaked at 6 months (79%) and declined to 64% by 24 months. Our findings suggest that males, on average, had 16% lower adherence to bracing compared to females (p = 0.035). Age at the pre-brace visit was found to be a statistically significant predictor of curve change at the 24-month follow-up, with each 1-year age difference associated with a three-degree increase in curve magnitude (p = 0.006). Other sociodemographic variables were not significantly associated with adherence or curve change.</p><p><strong>Conclusion: </strong>Despite declining adherence over time, curve magnitude remained stable in most patients, aligning with bracing success criteria. Gender may predict brace adherence, while age may predict curve progression. Analysis of sociodemographic factors in this limited cohort suggests potential disparities in non-operative management that warrant further investigation in more diverse populations. Such insights may inform targeted counseling strategies to optimize long-term outcomes.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"59-65"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303299","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
Disparities in spinal deformity surgery care for children with cerebral palsy and neuromuscular scoliosis. 小儿脑瘫和神经肌肉性脊柱侧凸脊柱畸形手术护理的差异。
IF 1.8 Q3 CLINICAL NEUROLOGY Pub Date : 2026-01-01 Epub Date: 2025-10-17 DOI: 10.1007/s43390-025-01198-6
Luis Torres-Gonzalez, Sara J Morgan, Christopher D Seaver, Rhonda G Cady, Zelphia C Brown, Maykala J Williams, Daniel J Miller

Purpose: To assess potential disparities in care for non-ambulatory children with cerebral palsy (CP) and associated neuromuscular scoliosis treated at a quaternary pediatric hospital.

Methods: This retrospective cohort study included non-ambulatory children CP who received spinal deformity surgery between 01/2012 and 12/2022. Demographic, clinical, and radiographic data were collected. Relationships between demographic factors and clinical/radiographic data were assessed using Fisher's Exact Test, Wilcoxon Rank-Sum test, Kruskal-Wallis one-way ANOVA, and linear regression models.

Results: Of 502 children identified, 328 met eligibility criteria. The mean age of the sample was 9.8 ± 4.0 years, 59% were male. On presentation, the average major coronal curve magnitude was 46 ± 23˚. Most (70%) were White, 13% were Black, 6% were Hispanic or Latino, and the remaining participants were Asian, Pacific Islander, Native American, Alaska Native, or declined to answer. Most spoke English (89%). Just under half (45%) had both government and commercial insurance and 24% had only government insurance. Black compared to White race (p = .03), government compared to commercial insurance (p = .02), and farther distance from hospital (p < .001) were associated with larger curve magnitudes at presentation, after adjustment for covariates. Non-English language (p = .002) was associated with longer time from surgical recommendation to surgery, after adjustment for covariates.

Conclusions: Health disparities were identified related to ethnicity, race, preferred language, and geographical distance from the hospital for children with CP and neuromuscular scoliosis. These findings highlight the need for development of standardized criteria for surveillance, imaging, and referral to reduce health disparities for this specific population.

目的:评估在第四儿科医院治疗脑瘫(CP)和相关神经肌肉性脊柱侧凸的非门诊儿童的潜在护理差异。方法:本回顾性队列研究纳入2012年1月至2022年12月期间接受脊柱畸形手术的非门诊儿童CP。收集了人口统计学、临床和放射学数据。使用Fisher精确检验、Wilcoxon秩和检验、Kruskal-Wallis单因素方差分析和线性回归模型评估人口统计学因素与临床/放射学数据之间的关系。结果:在确定的502名儿童中,328名符合资格标准。样本的平均年龄为9.8±4.0岁,男性占59%。呈现时,平均主冠状曲线大小为46±23˚。大多数(70%)是白人,13%是黑人,6%是西班牙裔或拉丁裔,其余的参与者是亚洲人、太平洋岛民、美洲原住民、阿拉斯加原住民,或者拒绝回答。大多数人说英语(89%)。只有不到一半(45%)的人同时拥有政府和商业保险,24%的人只拥有政府保险。黑人与白人的比较(p =。03),政府保险与商业保险相比(p =。结论:CP和神经肌肉性脊柱侧凸患儿的健康差异与民族、种族、首选语言和离医院的地理距离有关。这些发现强调需要制定标准化的监测、成像和转诊标准,以减少这一特定人群的健康差距。
{"title":"Disparities in spinal deformity surgery care for children with cerebral palsy and neuromuscular scoliosis.","authors":"Luis Torres-Gonzalez, Sara J Morgan, Christopher D Seaver, Rhonda G Cady, Zelphia C Brown, Maykala J Williams, Daniel J Miller","doi":"10.1007/s43390-025-01198-6","DOIUrl":"10.1007/s43390-025-01198-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess potential disparities in care for non-ambulatory children with cerebral palsy (CP) and associated neuromuscular scoliosis treated at a quaternary pediatric hospital.</p><p><strong>Methods: </strong>This retrospective cohort study included non-ambulatory children CP who received spinal deformity surgery between 01/2012 and 12/2022. Demographic, clinical, and radiographic data were collected. Relationships between demographic factors and clinical/radiographic data were assessed using Fisher's Exact Test, Wilcoxon Rank-Sum test, Kruskal-Wallis one-way ANOVA, and linear regression models.</p><p><strong>Results: </strong>Of 502 children identified, 328 met eligibility criteria. The mean age of the sample was 9.8 ± 4.0 years, 59% were male. On presentation, the average major coronal curve magnitude was 46 ± 23˚. Most (70%) were White, 13% were Black, 6% were Hispanic or Latino, and the remaining participants were Asian, Pacific Islander, Native American, Alaska Native, or declined to answer. Most spoke English (89%). Just under half (45%) had both government and commercial insurance and 24% had only government insurance. Black compared to White race (p = .03), government compared to commercial insurance (p = .02), and farther distance from hospital (p < .001) were associated with larger curve magnitudes at presentation, after adjustment for covariates. Non-English language (p = .002) was associated with longer time from surgical recommendation to surgery, after adjustment for covariates.</p><p><strong>Conclusions: </strong>Health disparities were identified related to ethnicity, race, preferred language, and geographical distance from the hospital for children with CP and neuromuscular scoliosis. These findings highlight the need for development of standardized criteria for surveillance, imaging, and referral to reduce health disparities for this specific population.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":"205-214"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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:604180095
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