Treatment Of Scoliosis Research Articles

Global visualization of adolescent idiopathic scoliosis treatment: a bibliometric analysis

ObjectiveThe objective of this study is to present a comprehensive overview of current advancements, prominent areas of interest, emerging trends, and frontiers in global research concerning the treatment of adolescent idiopathic scoliosis. The aim is to offer valuable insights and guidance for future research endeavors in this field.MethodsWe conducted a literature search on the treatment of adolescent idiopathic scoliosis using the Web of Science Core Collection database spanning from 2009 to 2024. Visualization of countries, institutions, authors, and keywords was performed using CiteSpace.Results1,002 English articles were included in this study. Between 2009 and 2020, publications remained relatively low and stable. However, in 2021, interest in the treatment of adolescent idiopathic scoliosis began to surge, a noticeable increase in publications, with a peak reached in 2022. The United States emerged as the leading contributor among countries, institutions, and authors. Nanjing University and Peter O. Newton were the most prolific institutions and authors, respectively. The academic journal with the highest number of published articles was Spine. Notably, areas such as Cobb angle measurement, the efficacy of non-surgical treatments for AIS, and factors influencing the success of brace treatment garnered significant attention as hot topics in adolescent idiopathic scoliosis treatment.ConclusionThe prognosis remains consistent across patients with varying degrees of curvature in adolescent idiopathic scoliosis. Given the limited understanding of its etiology, the relationship between curvature and prognosis, as well as the exploration of its underlying causes, could emerge as new research directions in the future.

Analysis of scoliosis rod deformation after cutting with a surgical rod cutter.

Scoliosis is a complex multi-dimensional deformity of the spine that is common in children and adults. Of the various treatments for scoliosis, one is posterior spinal fusion with instrumentation. The rods typically used are composed of titanium or cobalt-chrome. Rods are cut during surgery, which causes rods to be deformed on the cut end. Inducing rod deformation raises concerns about deformed end influencing the stability of the rod-tulip-set screw interface. This study examines rod deformation from the rod cutter. This study was performed using photogrammetry, a technique allowing the creation of three-dimensional (3D) models from photographs. Rod materials included titanium (Ti) and cobalt chrome (CoCr). Three different diameters, 4.75mm, 5.5mm, and 6.0mm, were analyzed for each rod material. Five rods of each material and diameter were used for these groups, totaling 30 rods for the study. Photogrammetry was used to create a 3D rendering of the cut end of the rods. The parameters measured included local angle of deformation at each mm away from the cut, as well as roundness of the cross section. Means and standard deviations were taken for each measurement. A two-way ANOVA analysis and a Tukey post-hoc analysis were used for statistical analysis. Five rods in each rod group resulted in the analysis of 30 rods. Deformation from the rod cutter resulted in more angular deformation in the CoCr rods than the Ti rods. The CoCr rods also had lower cross-sectional roundness measurements. The 6.0-mm rods had significantly more angular deformation as well as lower roundness measurements compared to the smaller diameter rods. The 4.75-mm and 5.5-mm diameter Ti rods showed deformation up to 4mm from the cut end, while the 6.0-mm Ti rods, and all the CoCr rods, showed deformation 5mm from the cut end. The data from this study offer information about the amount of deformation present at the cut end of spinal rods. There was a difference in the angle of deformation as well as roundness along the length of the rod's cut end. Placing the deformed portion of the rods within a screw tulip theoretically increases the risk of failure of the rod-screw interface. Based on these data, to decrease the risk of construct failure, we recommend leaving at least 4mm of rod between the cut end in 4.75mm and 5.5-mm Ti rods, and 5mm in CoCr rods and 6.0-mm Ti rods.

Deep learning based decision-making and outcome prediction for adolescent idiopathic scoliosis patients with posterior surgery

With the emergence of numerous classifications, surgical treatment for adolescent idiopathic scoliosis (AIS) can be guided more effectively. However, surgical decision-making and optimal strategies still lack standardization and personalized customization. Our study aims to devise proper deep learning (DL) models that incorporate key factors influencing surgical outcomes on the coronal plane in AIS patients to facilitate surgical decision-making and predict surgical results for AIS patients. A total of 425 AIS patients who underwent posterior spinal fixation were collected. Variables such as age, gender, preoperative and final follow-up horizontal and vertical coordinate vectors, and screw positioning data were preprocessed by parameterizing image data and transforming various data types into a unified, continuous high-dimensional feature space. Four deep learning models were designed, including Multi-Layer Perceptron model, Encoder-Decoder model, CNN-LSTM Attention model and Deep FM model. For the implementation of deep learning, 70% of the data was adopted for training and 30% for evaluation. The mean square error (MSE), mean absolute error (MAE) and curve fitting between the predicted and corresponding real postoperative spinal coordinates of the test set were adopted to validate and compare the efficacy of the DL models. A total of 425 patients with an average age of 14.60 ± 2.08 years, including 77 males and 348 females, were enrolled in this study. The Lenke type 1 and 5 AIS patients accounted for the majority of the included patients. The results showed that the Multi-Layer Perceptron model achieved the best performance among the four DL models, with a mean square error of 2.77 × 10–5 and an average absolute error of 0.00350 on the validation set. Moreover, the results predicted by the Multi-Layer Perceptron model closely matched the actual coordinate positions on the original postoperative images of patients with Lenke type 1 and AIS patients. Deep learning models can provide alternative and effective decision-making support for AIS patients undergoing surgery. Regarding the learning curve and data volume, the optimal DL models should be adjusted and refined to meet future demands.

On mobility and gait in scoliosis patients: a comparison of conventional and 3D-printed braces during an instrumented timed-up and go test

ObjectiveSpinal orthoses are the most viable conservative treatment for scoliosis, and additive manufacturing techniques have shown huge perspective in producing patient-specific braces, reducing material waste, and production times. This pilot study aimed at determining whether 3D-printed braces could induce advantages or disadvantages compared to conventional braces in terms of mobility and gait, and at quantitatively evaluating the effects of braces on mobility and gait.MethodsTen participants were included in the study, eight with adolescent idiopathic scoliosis and two with osteogenesis imperfecta. Participants were asked to perform Timed-Up and Go (TUG) tests wearing a triaxial accelerometer under three conditions: unbraced, wearing a conventional (i.e., thermoformed) brace, and wearing a 3D-printed brace. After segmenting each TUG test in sub-phases, metrics quantifying gait and mobility were computed, and Friedman tests among all conditions were performed.ResultsNo significant differences in scoliotic patients mobility and gait between conventional and 3D-printed brace conditions were found, potentially suggesting that 3D-printed braces are as effective as conventional ones. Conversely, Stand flexion amplitude and Sit extension amplitude were lower in both conventional and 3D-printed brace conditions compared to the unbraced, meaning that braces limited the trunk range of motion. As for gait parameters, no significant differences in Walk Cadence and Walk Velocity among the three conditions were found, indicating that braces did not affect gait, at least during TUG tests.Trial registrationThe study was registered at Clinicaltrials.gov (Study ID NCT04282408, Date of Registration February 11th, 2020).

Evaluation and Treatment of Thoracic Insufficiency Syndrome and Early-Onset Scoliosis

Thoracic insufficiency syndrome (TIS) and early-onset scoliosis (EOS) are complex pediatric conditions involving deformities of the spine and chest wall, which can significantly impact respiratory function and overall development. Managing these conditions requires a comprehensive approach that combines precise diagnosis and innovative treatment strategies. This opinion article provides a critical discussion of the diagnosis and treatment of TIS and EOS and reflects upon the advancement of methods that are crucial for assessing these conditions and guiding treatment decisions.

The effect of Schroth Therapy combined with spinal manipulation for the treatment of adolescent idiopathic scoliosis

Objective: To evaluate the effectiveness of the Schroth method combined with spinal manipulation treatment in patients with adolescent idiopathic scoliosis (AIS). Methods: This was a single-center retrospective study performed between January 2023 and February 2024, in which 150 patients with AIS were treated with Schroth method with or without spinal manipulation at Wenzhou Traditional Chinese Medicine Hospital. Patients were classified into a study group and a control group with 50 patients in each group after screening. Intervention effects, maximum Cobb angle, clavicle angle before and after the treatment, trunk rotation angle, vertebral rotation angle, and lumbar range of motion (range of motion for lumbar extension and flexion) were compared between the two groups. Results: The overall efficacy of intervention in the study group was higher than that in the control group (96.00% versus 84.00%) (P<0.05). After the treatment, the maximum Cobb angle, clavicle angle, angle of trunk rotation (ATR), and vertebral rotation angle of the two groups decreased compared to pretreatment levels and were significantly smaller in the study group compared to the control group (P<0.05). After the treatment, the degree of lumbar extension and flexion in both groups increased compared to before treatment and was markedly greater in the study group (P<0.05). Conclusions: In patients with AIS, combining the Schroth method and spinal manipulation treatment was more effective in reducing the maximum Cobb and clavicle angles, trunk rotation angle, and vertebral rotation angle and restoring the lumbar range of motion compared to the Schroth method alone. doi: https://doi.org/10.12669/pjms.41.2.11355 How to cite this: Chen H, Zhang C. The effect of Schroth Therapy combined with spinal manipulation for the treatment of adolescent idiopathic scoliosis. Pak J Med Sci. 2025;41(2):409-414. doi: https://doi.org/10.12669/pjms.41.2.11355 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The association of congenital diaphragmatic hernia with scoliosis.

To determine the prevalence of scoliosis in patients who have undergone surgical repair of CDH and attempt to assess the aetiology of scoliosis in affected cases. A prospectively collected database of patients with CDH treated in a single centre between 1997 and 2023 was reviewed. Cases with adequate records who continued to reside locally having survived beyond age 2 and > 2years following CDH repair were included. Congenital spinal abnormalities and scoliosis were diagnosed from imaging studies. In those who developed scoliosis, medical notes were reviewed to assess the aetiology of scoliosis and its treatment. 145 patients (92 male) who had undergone CDH repair were included. The median age at CDH repair was at 4days. The mean time from CDH repair to this study was 14.1years (2.0-26.2). 15 developed scoliosis (10.3%). In 8 cases, the scoliosis was considered a reflection of multisystem abnormalities including congenital vertebral anomalies in 3 cases (2%). In the 7 remaining cases the scoliosis had no obvious cause. Of those with scoliosis, to date, 3 have had surgical treatment with 1 awaiting surgery, 7 have not required scoliosis treatment and 4 have died. Scoliosis is relatively common in those who have undergone CDH repair, typically presenting before age 10years. Scoliosis when present was commonly part of a multisystem issue, with congenital vertebral anomalies rare. There appears no strong association between use of synthetic patch and scoliosis. Few children undergoing CDH repair will require treatment of a scoliosis.

Emerging Trends on the Growing Rods in Scoliosis in the Last 20 Years: A Bibliometric Analysis from 2003 to 2024.

Growing rods is a distraction-based, growth-friendly method that is commonly used in the treatment of scoliosis. Studies on growing rods in scoliosis published from 2003 to 2024 were retrieved from the Web of Science Core Collection. VOSviewer, Microsoft Excel, and CiteSpace were applied for data analysis. We identified 742 publications on growing rods in scoliosis. The annual number of publications grew steadily. The United States was the most prolific country. University of California, San Diego was the most productive institution. Behrooz A. Akbarnia ranked first among authors regarding the number of articles and citations. The Journal of Pediatric Orthopedics was the most prolific journal. The research topics can be divided into 3 clusters as follows. 1) Complications of growing rods and magnetically controlled rods in early onset scoliosis; 2) growing rods in congenital scoliosis, focusing on pulmonary function and thoracic insufficiency syndrome; and 3) scoliosis management. The frontier directions of current research included magnetically controlled growing rods and growing rods fusion. This study drew a knowledge map of growing rods in scoliosis over the past 2 decades. The changes in research hotspots and current research directions have been summarized. The high costs and limited access to growing rods methodology in less-developed regions highlight the economic and technical challenges of globalizing these advanced treatments.

New horizons for adolescent idiopathic scoliosis treatment through PosturalSpine® D'Amanti Method.

The aim of the study is to compare improvement outcomes in patients (aged between 8 and 18 years old) with idiopathic scoliosis treated with a traditional technique with those treated with an innovative method. The study included 17 participants allocated into two groups: experimental (n = 8) and control (n = 9) groups. The first group was treated with a new method with PosturalSpine® D'Amanti method, twice a week for 30 min per session while the second group was treated with kinesitherapy and traditional tools three times week for 45 min per session. The two groups are similar in the anthropometric characteristics, in baseline Risser index and in the Cobb angles average and no statistically significant differences were found between the two groups. After one year of motor intervention, both treatment groups showed improvements in the progression of scoliotic curves and the PosturalSpine® group showed a significantly higher improvement than the control group. Our results therefore suggest that this new specific method with PosturalSpine® D'Amanti method could play a significant role in improving adolescent idiopathic scoliosis compared to traditional exercises.

Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up.

Treatment of idiopathic scoliosis in childhood aims to prevent curve progression. It is generally accepted that curves > 50° have the highest risk of progression, but less well described is what happens with mild to moderate curves. The aim of this study was to assess long-term curve progression and health-related quality of life (HRQoL) and compare thoracic and thoracolumbar/lumbar (TL/L) curves. We identified 177 patients diagnosed with a pediatric spinal deformity and treated at our institution from 1972 through 1983. 91 of 129 eligible patients with idiopathic scoliosis completed follow-up (71%). Patient files from treatment/observation in childhood were reviewed including detailed descriptions of radiographs. At follow-up we assessed long standing full-spine radiographs and HRQoL with the Scoliosis Research Society 22 revised questionnaire. Mean follow-up was 41 years (standard deviation [SD] 2.5 years). 21 patients underwent surgery in adolescence or early adulthood leaving 70 patients for analysis of curve progression, of whom 61 had complete radiographs. For patients with a main curve < 25° at the end of treatment in adolescence (n = 19) mean curve progression was 7° (SD 9); for 25-40° curves (n = 26) 16° (SD 13); for 40-50° curves (n =10) 22° (SD 8); and for curves > 50° (n = 6) 17° (SD 6). There was a linear association between main curve size at follow-up and SRS-22r subtotal score (P = 0.003). We found substantial curve progression for patients with main curves > 25° at end of treatment, but with a considerable variation between patients. Curve progression was not associated with curve size at the end of treatment and did not differ significantly between thoracic and TL/L curves. Larger main curve size at follow-up was associated with lower HRQoL.

2D and 3D Classification Systems for Adolescent Idiopathic Scoliosis: Clinical Implications and Technological Advances.

Classification systems for Adolescent Idiopathic Scoliosis (AIS) play an important role in guiding both surgical planning and conservative treatments. Traditional 2D classification systems, such as the Lenke, King and Lehnert-Schroth classifications, have been widely used for the clinical diagnosis and treatment of scoliosis. However, with the growing understanding of the three-dimensional nature of scoliosis and advancements in 3D reconstruction technologies, 3D classification systems are gaining increasing attention. This paper reviews the current applications, advantages, and limitations of different 2D and 3D classification systems, focusing on their clinical significance in treatment planning. While 3D classification systems offer clear advantages in capturing the complexity of spinal deformities, their clinical implementation faces challenges such as high costs and technical complexity. Additionally, studies show that computer-assisted technologies, artificial intelligence can significantly improve the accuracy and consistency of classification systems, reducing human errors. The paper also explores the future directions of classification system development, emphasizing the potential of combining 2D and 3D technologies and the impact of these advancements on personalized scoliosis treatment.

Machine learning analysis of cervical balance in early-onset scoliosis post-growing rod surgery: a case-control study

We aimed to analyze the cervical sagittal alignment change following the growing rod treatment in early-onset scoliosis (EOS) and identify the risk factors of sagittal cervical imbalance after growing-rod surgery of machine learning. EOS patients from our centre between 2007 and 2019 were retrospectively reviewed. Radiographic parameters include the cervical lordosis (CL), T1 slope, C2-C7 sagittal vertical axis (C2-7 SVA), primary curve Cobb angle, thoracic kyphosis (TK), C7-S1 sagittal vertical axis (C7-S1 SVA) and proximal junctional angle (PJA) were evaluated preoperatively, postoperatively and at the final follow-up. The parameters were analyzed using a t-test and χ2 test. The machine learning methodology of a sparse additive machine (SAM) was applied to identify the risk factors that caused the cervical imbalance. 138 patients were enrolled in this study (96 male and 42 female). The mean thoracic curve Cobb angle was 67.00 ± 22.74°. The mean age at the first operation was 8.5 ± 2.6yrs. The mean follow-up was 38.48 ± 10.87 months. CL, T1 slope, and C2-7 SVA increased significantly in the final follow-up compared with the pre-operative data. (P < 0.05). The CL and T1 slope increased more significantly in the group of patients who had proximal junctional kyphosis (PJK) compared with the patients without PJK (P < 0.05). The location of the upper instrumented vertebrae (UIV) and single/dual growing rod had no significant influence on the sagittal cervical parameters (P > 0.05). According to the SAM analysis of machine learning algorithms, Postoperative PJK, more improvement of kyphosis, and T1 slope angle were identified as the risk factors of cervical sagittal imbalance during the treatment of growing rod surgery. The growing rod surgery in EOS significantly affected the cervical sagittal alignment. Postoperative PJK and more improvement of kyphosis and T1 slope angle would lead to a higher incidence of cervical sagittal imbalance.

Supine Traction vs Fulcrum Bending Radiographs in Preoperative Imaging of Scoliosis Patients Treated With Magnetically Controlled Growing Rods (MCGR) - which Technique is Better to Predict Surgical Correction of the Main Curve?

Retrospective Cohort Study. Flexibility radiographs such as traction or bending radiographs are essential in preoperative imaging to assess for curve flexibility and to estimate the amount of operative correction in order to determine the type and length of instrumentation in growth-accompanying scoliosis treatment. Both traction and bending radiographs are controversially discussed in the literature. The predictability of flexibility radiographs of postoperative main curve correction specifically in patients treated with magnetically controlled growing rods (MCGR) has not yet been studied. Juvenile patients with idiopathic or neuromuscular scoliosis that were surgically treated with a primary MCGR implant with pedicle screw fixation between 2018-2022 were retrospectively registered. Patients that underwent prior spine surgery, with supine lying-down radiograph and patients with missing traction or bending radiographs available were excluded. Image analysis was conducted using Surgimap® software. For statistical analysis, t test and ANOVA analysis were used to compare the means between groups with a significance level set at P < 0.05. A total of 50 patients, 34 diagnosed with idiopathic scoliosis (IS) and 16 diagnosed with neuromuscular scoliosis (NMS), were included. Globally, main curve Cobb angles were significantly higher in supine traction compared to fulcrum bending images (44.8° vs 39.6°; P < 0.001) and in the IS subgroup (42.4° vs 37.3°; P < 0.001). Compared to postoperative images, significant differences of supine traction but not fulcrum bending radiographs were detected in total (P < 0.001; P = 0.20) as well as IS (P < 0.001; P = 0.32) and NMS (P < 0.001; P = 0.44) subgroups. Fulcrum bending images displayed significantly higher flexibility rates (FR) and flexibility index (FI) compared to traction images in total (FR: 42.9 vs 35.2, P < 0.001; FI: 1.08 vs 1.58, P = 0.024) and the IS subgroup (FR: 44.2 vs 35.8, P < 0.001; FI: 1.19 vs 1.43, P = 0.033). Fulcrum bending radiographs showed better flexibility and prediction of operative main curve correction compared to supine traction radiographs in total and IS subgroup. Fulcrum bending might be more precise for predicting the postoperative main curve correction potential of primary MCGR surgery in IS patients.

Halo Gravity Traction Utilized in the Treatment of Early-onset Scoliosis for Patients With Prader-Willi Syndrome: A Case Report

Halo Gravity Traction Utilized in the Treatment of Early-onset Scoliosis for Patients With Prader-Willi Syndrome: A Case Report

Surgical approach to idiopathic scoliosis: a systematic review with meta-analysis

Objectives: to analyze surgical approaches for the treatment of idiopathic scoliosis and the prognosis achieved. Methodology: A systematic review with meta-analysis was carried out using the electronic databases PubMed/MEDLINE and Cochrane Library. Results: The sample consisted of 217 patients with a mean age of 15 years diagnosed with idiopathic scoliosis. In all the studies included, the pathological curvature was reduced by more than 49%. Conclusion: The pathological curvature was reduced in all surgical interventions, and the short- and long-term post-operative results were satisfactory.

Letter to the editor: re-evaluating approaches: current issues in the treatment of adolescent idiopathic scoliosis.

Letter to the editor: re-evaluating approaches: current issues in the treatment of adolescent idiopathic scoliosis.

Achieving the Needed Correction in Vertebral Body Tethering: The Relationship Between Preoperative Flexibility, Intraoperative Correction, and First Erect Imaging.

Vertebral body tethering (VBT) is a nonfusion surgical treatment for scoliosis. Recent data have shown that intraoperative correction is critical for successful curve correction over time. This study aims to evaluate the relationship between preoperative, intraoperative, and postoperative correction. We hypothesize that preoperative flexibility will match first erect imaging, intraoperative correction will overestimate postoperative correction, and correction has improved over time with increased surgeon experience. This study is a retrospective review of patients who underwent VBT at a single center between 2015 and 2023. Patient radiographs were reviewed preoperatively (standing and fulcrum bending), intraoperatively, and postoperatively first erect. Our study included 157 patients: 127 females (81%) with a mean age of 13.2 years (range: 9 to 17) at surgery and a mean of 7.9 vertebrae instrumented (range: 5 to 12 vertebrae). Twenty-three had 2 curves instrumented (85% single curve). One hundred eight patients had thoracic curves (69%), 33 thoracolumbar (21%), and 16 lumbar (10%). Preoperative curve magnitude averaged 51 degrees (range: 36 to 72). The mean bending radiograph curve measurement was 24 degrees (53% correction). The mean intraoperative curve magnitude was 15 degrees (72% correction). Intraoperative curve magnitude and correction were significantly different between curve types, with increased correction in lumbar curves (7 degrees, 86% correction) and less correction in thoracic curves (16 degrees, 68% correction). On first erect postoperative imaging (mean 8d post-op, range: 1 to 44), the curve magnitude was 26 degrees (49% correction). The R2 correlation of the first erect radiograph was 0.209 for preoperative bending and 0.554 for intraoperative measurements. The mean difference in first erect curve magnitude was +2 degrees from preoperative flexibility radiographs and +11 degrees from intraoperative radiographs. Pre-2020, the intraoperative curve averaged 18 degrees, and >2020 averaged 13 degrees (P=0.001). Pre-2020, the first erect averaged 30 degrees, and >2020 improved to 24 degrees (P<0.001), despite equivalent preoperative metrics (both 51 degrees curves, P=0.98, with 54 vs. 52% flexibility, P=0.31). Our study indicates that preoperative bending films can provide a practical approximation of the correction on first erect imaging. Intraoperative correction has the strongest relationship and averages 11 degrees less than the postoperative standing curve magnitude. Further, our site's intraoperative and postoperative correction has improved over time with increased surgeon experience. Level III-retrospective cohort.

Outcomes of Growth-Friendly Surgical Treatment of Early Onset Scoliosis in Children With Prune Belly Syndrome: A Preliminary Report.

Prune belly syndrome (PBS) is a rare condition characterized by absence of abdominal musculature, cryptorchidism, and obstructive uropathy. The most common orthopaedic problem is scoliosis, yet no reports on growth-friendly surgical treatment of early-onset scoliosis (EOS) exist. Our purpose was to evaluate outcomes of distraction-based implants in children with PBS. This was a multicenter retrospective review. Children with PBS treated with TGR, MCGR, or VEPTR with a minimum 2-year follow-up were identified. Demographics, radiographic/surgical data, complications, and unplanned returns to the operating room (UPROR) were collected. Quality of life was measured using EOSQ-24. Seven patients (100% male) were identified. The mean age at index surgery was 5.6 years. The mean length of follow-up was 4 years (range: 2 to 11y). Implant types included MCGR (4 patients), TGR (2 patients), and VEPTR (1 patient). Two patients had pelvic fixation. The mean major curve magnitude was 87 degrees preindex, 47 degrees postindex, and 53 degrees at the last follow-up. Mean kyphosis was 55 degrees preindex, 25 degrees postindex, and 42 degrees at the most recent follow-up. Mean T1-T12 and T1-S1 lengths increased 4.4 and 4.8cm, respectively, between preindex and last follow-up.Complications occurred in 3 patients. One patient had 3 TGR breakages resulting in 3 UPRORs to revise the rods and 1 superficial wound infection treated with antibiotics. Another patient was readmitted for respiratory failure after TGR lengthening and a third patient had a superficial infection manifested by incisional swelling after MCGR insertion that resolved with antibiotics. Two patients have undergone definitive fusion and 1 patient has retained his TGR definitively. The other patients are still undergoing rod lengthening. Children with PBS can develop severe scoliosis at a young age. Distraction-based implants can successfully control scoliosis while allowing spinal growth. The complication rate is comparable to patients with idiopathic EOS treated with growth-friendly implants. Therapeutic level IV.

Rates of School Absences in Pediatric Scoliosis Patients and Work Absences in Their Parents/Caregivers: A Retrospective Analysis.

Background/Objectives: The burden of scoliosis care extends beyond treatment costs and includes missed school for patients and lost income for parents. Chronic absenteeism, defined as more than 18 days of missed school, can have a significant impact on a child's educational progression, but missed school and work due to scoliosis treatment are not well quantified in the literature. This study investigates absenteeism among scoliosis patients and their caregivers. Methods: We conducted a retrospective comparative study of survey results based on surgery timing and surgery type. Patients and caregivers presenting for clinic visits for scoliosis treatment at a single large tertiary care center from 2014 to 2022 were queried. Results: We collected 2772 surveys from 1104 unique patients. Of these, 223 surveys from 132 patients were within one year of surgery: 140 post-fusion surveys, 71 post-nonfusion surveys, and 11 post-halo/multistage surgery surveys. A total of 2280 surveys were from 1022 nonoperatively treated patients. School absenteeism was significantly higher for surgeries during the school year compared to summer in both the fusion and nonfusion groups, though work absenteeism showed no significant differences. Halo/multistage surgery patients had the highest rates of absenteeism. Conclusions: This study highlights the impacts of scoliosis surgery timing and type on absenteeism among patients and their caregivers. Surgery during summer breaks reduces school absenteeism and academic disruption. Halo/multistage surgery patients face the greatest risk of chronic absenteeism from school, indicating a need for targeted interventions. Optimized surgical timing and planning can help families navigate the educational and financial challenges of scoliosis treatment.

Anterior Vertebral Body Tethering (AVBT) in the Treatment of Adolescent Idiopathic Scoliosis: A Retrospective Study.

Background/Objectives: Anterior Vertebral Body Tethering (AVBT) is a relatively novel minimally invasive surgical technique for the treatment of adolescent idiopathic scoliosis (AIS) that enables deformity correction of the spine diminishing vertebral motion reduction caused by the standard posterior spinal fusion approach. This paper reports the introduction of a new technical variant of AVBT, with the aim of evaluating its effectiveness on the correction of both axial and coronal spinal deformity. Methods: A single-centre single-surgeon retrospective cohort study was conducted. AVBTs were performed between 2020 and 2024. Radiographical values, surgical details, and complications of 67 patients affected by AIS were compared before surgery, immediately after surgery, and at the most recent follow-up. Results: Postoperative results have revealed a statistically significant coronal curve correction of 29.85% in the main thoracic (MT) curves (from mean preoperative width of 54.81 ± 11.86° to 38.45 ± 10.19°) and of 26.93% in the thoracolumbar (TL/L) curves (from 35.15 ± 11.83° to 25.69 ± 10.50°) in line with that obtained by the standard technique. Coronal correction at the most recent follow-up was maintained. Postoperative axial rotation reduction was found to be statistically significant in the main thoracic (MT) curves (from mean Nash-Moe value of 1.84 ± 0.71 to 1.36 ± 0.73), with a further decrease at the most recent follow-up compared with preoperative values. Improvement in other radiographical measures did not reach statistical significance and the complication rate was comparable to the standard technique. Conclusions: The extent of coronal correction in patients treated with the proposed modified AVBT technique is satisfactory and in line with results from studies testing the standard AVBT technique. The findings of this study seem to suggest that this technical variant of AVBT is effective in the correction of both axial and coronal deformity, with a surgical complication rate comparable to the standard technique.