Behavior of the un-instrumented lumbar curve following exclusive tethering of the thoracic region.

Introduction: Anterior vertebral body tethering (AVBT) has recently been utilized as a surgical alternative to posterior spinal fusion for a subset of pediatric scoliosis patients. Indications for AVBT are evolving and, while early results have been promising, there is a paucity of literature examining the behavior of the lumbar curve after exclusive tether of the thoracic region. It was hypothesized that thoracic tether leads to a spontaneous decrease in the un-instrumented lumbar curve.

Effect of Vertebral Body Tether Tensioning on Vertebral Body Growth Modulation.

Background: The relationship between tether tension and spinal growth modulation following vertebral body tethering (VBT) has not been studied in growing children.

Aims: This study aims to explore the relationship between vertebral body growth modulation under varying tether tension.

Materials And Methods: A retrospective, multicenter pediatric registry was queried for idiopathic scoliosis patients treated with right-sided VBT, with recorded intraoperative tension (using an ordinal scale of 0-3), and 3D reconstructions from biplanar radiographs at the first erect (FE) and 2-year post-operative visits.

Complications in vertebral body tethering: what are the short term effects on patient reported outcomes?

Introduction: Vertebral body tethering (VBT) has continued to gain popularity for the treatment of idiopathic scoliosis (IS); however, complication and reoperation rates have been reported as high as 25%. There is a paucity of data on the clinical and long-term outcomes of VBT. The purpose of this study is to determine how complications from VBT effect patient quality of life (QOL) up to three years after surgery.

3-Dimensional Analysis of Disc and Vertebral Height and their Role in Kyphosis Creation in Adolescent Idiopathic Scoliosis.

Study Design: Retrospective.

Objective: Describe three-dimensional (3D) changes after Adolescent Idiopathic Scoliosis (AIS) reconstruction, with attention to anterior column (AC) shortening and middle column (MC) lengthening.

Summary Of Background Data: Relative elongation of the AC, particularly the disc, is a common feature of AIS.

Posterior spinal fusion outcomes for moderate adolescent idiopathic scoliosis in boys and girls: should we counsel them the same?

Purpose: With this study, we aim to evaluate and compare the perioperative outcomes of PSF for girls and boys. We hypothesize that female patients will have better curve correction and lower rates of complications when compared to male patients.

Methods: This study employed a retrospective review of AIS patients who underwent PSF at 23 sites between 2011 and 2021, limited to preoperative curves between 40 and 60° and stratified based on sex assigned at birth.

Efficacy of Virtual Reality vs. Tablet Games for Pain and Anxiety in Children Undergoing Bone Pins Removal: Randomised Clinical Trial.

Aims: To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures.

Design: Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game.

Methods: Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games).

My orthopedic brace inventory (MOBI): a new, reliable, and valid questionnaire to identify barriers to brace adherence in adolescent idiopathic scoliosis treatment.

Purpose: Full-time wearing of an orthopedic brace has demonstrated effectiveness in limiting curve progression in adolescents with idiopathic scoliosis. However, treatment adherence is challenging, with an average wearing time of 13 h/day. Despite this issue, barriers to brace adherence have rarely been studied.

3D Sagittal Parameters Can Guide the Indications for Anterior Release in Thoracic AIS ≥70°.

Study DesignRetrospective, multicenter.ObjectivesThis study aims to evaluate the immediate postoperative effect of, and define indications for, an anterior release (discectomy) in large AIS curves utilizing 3D deformity analysis.MethodsA multicenter registry was queried for AIS patients with main thoracic curves ≥70° treated with either anterior/posterior (AP) or posterior-only surgery and biplanar stereoradiographic pre-operative and first-erect (FE) postoperative images.

Automatic Evaluation of Bone Age Using Hand Radiographs and Pancorporal Radiographs in Adolescent Idiopathic Scoliosis.

Adolescent idiopathic scoliosis (AIS) is a complex, three-dimensional spinal deformity that requires monitoring of skeletal maturity for effective management. Accurate bone age assessment is important for evaluating developmental progress in AIS. Traditional methods rely on ossification center observations, but recent advances in deep learning (DL) might pave the way for automatic grading of bone age.

Genome-wide profiling of circulating microRNAs in adolescent idiopathic scoliosis and their relation to spinal deformity severity, and disease pathophysiology.

Adolescent Idiopathic Scoliosis (AIS) is the most common orthopedic condition requiring surgery, affecting 4% of adolescents. There is currently no proven method or prognostic test to identify symptomatic patients at risk of developing severe scoliosis who could benefit from growth-guided devices or minimally invasive non-fusion instrumentation surgeries. These innovative treatments must be performed at an early disease stage in younger patients to benefit from their growth potential.

Outcomes and complications of vertebral body tethering by patient gender.

Purpose: Non-fusion surgical options for pediatric scoliosis management such as vertebral body tethering (VBT) offer an alternative to spinal fusion. With this study, we aim to evaluate the postoperative outcomes in boys versus girls who have undergone VBT. Our hypothesis is that girls and boys will have similar outcomes by 2-year follow-up.

Prediction of the upright articulated spine shape in the operating room using conditioned neural kernel fields.

Anterior vertebral tethering (AVT) is a non-invasive spine surgery technique, treating severe spine deformations and preserving lower back mobility. However, patient positioning and surgical strategies greatly influences postoperative results. Predicting the upright geometry from pediatric spines is needed to optimize patient positioning in the operating room (OR) and improve surgical outcomes, but remains a complex task due to immature bone properties.

Should the C7-T1 Junction Be Feared? The Effect of a T1 Upper Instrumented Vertebra on Development of Proximal Junctional Kyphosis.

Purpose: Proximal junctional kyphosis is an infrequent complication in AIS; however, equipoise remains on the effects of ending a fusion proximally at the C7-T1 junction on the future development of PJK. The purpose of this study was to determine the rate of PJK in patients with AIS who had a UIV of T1 vs those with a UIV of T2 at 5 years of follow-up.

Methods: A query was performed of a prospective, multi-center AIS database of patients who received a PSF with at least 5 years of follow-up.

Immediate Correction of Idiopathic Scoliosis With Nighttime Braces Created by a Fully Automated Generative Design Algorithm: A Randomized Controlled Crossover Trial.

Study Design: Single-center, double-blinded, prospective crossover randomized controlled trial.

Objective: To clinically validate the efficacy of nighttime braces designed automatically by a generative design algorithm to treat idiopathic scoliosis (IS). The tested hypothesis was the clinical equivalence of immediate in-brace correction for the new automatically generated brace design versus a standard Providence-type brace.

Apical stress redistribution during anterior vertebral body tethering for thoracic adolescent idiopathic scoliosis: a finite element analysis of a novel surgical technique.

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.

Associations of overweight status with spinal curve correction and complications in patients undergoing vertebral body tethering: a multicenter retrospective review.

Purpose: Our purpose was to determine associations between body mass index (BMI) category and outcomes of vertebral body tethering (VBT), a non-fusion treatment for adolescent idiopathic scoliosis (AIS) and juvenile idiopathic scoliosis (JIS).

Methods: Using a multicenter database, we identified patients with AIS or JIS who underwent VBT from 2012 to 2018 and had minimum 2-year follow-up (median, 3.0 [interquartile range 2.

A classification algorithm for prioritizing surgery in Pediatric patients with idiopathic scoliosis when Long Surgical delays are expected.

Purpose: To identify the clinical phenotypes associated with the rate of progression while waiting for surgery and propose a classification scheme for identifying subgroups of patients to prioritize for surgery when long surgical delays are expected.

Methods: We reviewed the clinical and radiographic data of a prospective cohort of patients scheduled for IS surgery from 2004 to 2020 with a minimum 1-year wait prior to surgery. Candidate predictors consisted of age, sex, Risser sign, menarchal status, angle of trunk rotation, scoliotic curve type, and main Cobb angle at baseline when scheduled for surgery.

COVID-19 significantly impacted initial consultation for idiopathic scoliosis.

Introduction: Since the outbreak of the COVID-19 pandemic, reduction of social activities and rapid adoption of telemedicine, decreasing face-to-face encounters seems to have negatively affected the timely Idiopathic Scoliosis (IS) referral with a spine specialist. We aim to document the progression of IS curves during COVID-19 pandemic reflected by the late presentation of patients at the initial visit with higher Cobb angles and to evaluate its influence on health-related quality of life scores.

Materials And Methods: All IS patients scheduled for surgery between April 2019 and September 2021 were recruited in a prospective cohort study.

Growth modulation response in vertebral body tethering depends primarily on magnitude of concave vertebral body growth.

Purpose: There is variability in clinical outcomes with vertebral body tethering (VBT) partly due to a limited understanding of the growth modulation (GM) response. We used the largest sample of patients with 3D spine reconstructions to characterize the vertebra and disc morphologic changes that accompany growth modulation during the first two years following VBT.

Methods: A multicenter registry was used to identify idiopathic scoliosis patients who underwent VBT with 2 years of follow-up.

A modified position for optimized skeletal maturity assessment of AIS patients and its impact on 3D spinal and pelvic parameters.

Purpose: A hands-on-wall (HOW) position for low-dose stereoradiography of adolescent idiopathic scoliosis (AIS) patients would allow for skeletal maturity assessment of the hand and wrist. Our aims were twofold: confirm the reliability and validity of skeletal maturity assessment using the HOW radiographs and compare the spinal and pelvic 3D parameters to those of standard hands-on-cheeks (HOC) stereoradiographs.

Methods: Seventy AIS patients underwent two successive stereoradiographs and a standard hand and wrist radiograph on the same day.