2026-04-17T19:26:51Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/133502025-10-24T10:36:52Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
cerpa, meghan
author
Zuckerman, Scott L.
author
Carreon, Leah
author
Cheung, Kenneth
author
Lenke, Lawrence
author
Kelly, Michael
author
Pellise, Ferran
2025-10-24T10:36:52Z
2025-10-24T10:36:52Z
2025-07-04T06:37:15Z2025-07-04T06:37:15Z2025-05
http://hdl.handle.net/11351/13350
Non-neurologic complications; Postoperative complications; Spinal deformity surgeryComplicaciones no neurológicas; Complicaciones postoperatorias; Cirugía de deformidad espinalComplicacions no neurològiques; Complicacions postoperatòries; Cirurgia de deformitat espinalPurpose
The purpose of this study is to evaluate if AR offers improved 3D kyphosis restoration during PSF for hypokyphosis in moderate AIS (< 70° coronal cobb), where the decision for AR is likely driven by sagittal concerns.
Methods
A multicenter pediatric spine registry was queried for hypokyphotic (< 10°) Lenke 1–4 AIS patients aged < 20 years with > 2-year surgical follow-up. Coronal curves were limited to < 70°. A linear mixed model was created to predict 2-year 3D kyphosis by treatment and pre-op 3D kyphosis, while controlling for age, sex, thoracic coronal deformity and flexibility, osteotomy use, implant characteristics, surgery recency, and surgeon.
Results
1384 patients were included with 53 (3.8%) undergoing PSF + AR. Mean preop 3D kyphosis was similar between PSF and PSF + AR groups (− 3.7° vs. − 0.5°; p = 0.08). PSF-AR had similar 2-year 3D kyphosis (23.0° [95% CI 20.5–25.4°] vs. 23.3° [22.9–23.6°]) and correction (26.7° [23.3–29.9°] vs. 23.7° [23.3–24.2°]) compared to PSF. When controlling for covariates, the models demonstrated no difference between approach (p = 0.058) or interaction of approach and preop 3D kyphosis (p = 0.31). Post-hoc power analysis showed an adequate sample size to detect a difference of 5° between approaches. PSF + AR had longer surgical times (324 vs. 266 min, p < 0.001) though no significant increase in overall complications (17% vs. 12.4%) compared to PSF alone.
Conclusion
In AIS patients with coronal curve < 70° and 3D hypokyphosis of 10 to − 40°, treatment with PSF + AR did not improve 2-year sagittal correction more than PSF alone. Surgeon identity and surgery recency influenced post-operative kyphosis more than any other patient or surgical factor.This study was funded by AO Spine through the AO Spine Knowledge Forum Deformity, the Scoliosis Research Society (SRS), and Norton Healthcare.
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
Sistema nerviós - Malalties
Escoliosi - Cirurgia - Complicacions
Adults
DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications
DISEASES::Musculoskeletal Diseases::Bone Diseases::Spinal Diseases::Spinal Curvatures::Scoliosis
Other subheadings::Other subheadings::Other subheadings::/surgery
DISEASES::Nervous System Diseases
NAMED GROUPS::Persons::Age Groups::Adult
ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias
ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades de la columna vertebral::desviaciones de la columna vertebral::escoliosis
Otros calificadores::Otros calificadores::Otros calificadores::/cirugía
ENFERMEDADES::enfermedades del sistema nervioso
DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::adulto
Long-term follow-up of non‑neurologic and neurologic complications after complex adult spinal deformity surgery: results from the Scoli-RISK-1 study
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion