Evidence map›Paper›PMID 38514530›Full record

ArticleSpine deformity2024

Lowest instrumented vertebrae in early onset scoliosis: is there a role for a more selective approach?

Michael J Heffernan, Claudia Leonardi, Lindsay M Andras, Bailli Fontenot, Luke Drake, Joshua M Pahys, John T Smith, Peter F Sturm, George H Thompson, Michael P Glotzbecker and 4 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 94% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 0 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 10 institutions in 1 country.

Michael J HeffernanJackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #69, Los Angeles, CA, 90027, USA. mheffernan@chla.usc.edu.ORCID 0000-0002-0632-3367
Claudia LeonardiSchool of Public Health, LSU Health Sciences Center, New Orleans, LA, USA.
Lindsay M AndrasJackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #69, Los Angeles, CA, 90027, USA.
Bailli FontenotLSU Health Sciences Center, Children's Hospital New Orleans, New Orleans, LA, USA.
Luke DrakeJackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #69, Los Angeles, CA, 90027, USA.
Joshua M PahysDepartment of Orthopedics, Shriners Hospital for Children, Philadelphia, PA, USA.
John T SmithDepartment of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
Peter F SturmCincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
George H ThompsonRainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
Michael P GlotzbeckerRainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
Tyler A TetreaultJackie and Gene Autry Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Mailstop #69, Los Angeles, CA, 90027, USA.
Benjamin D RoyeDepartment of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA.
Pediatric Spine Study Group
Ying LiDepartment of Orthopaedic Surgery, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.
Orthopaedic Center · USC. S. Mott Children's Hospital · USRainbow Babies & Children's Hospital · USChildren's Hospital of Los Angeles · USChildren's Hospital of New Orleans · USCincinnati Children's Hospital Medical Center · USLouisiana State University Health Sciences Center New Orleans · USMorgan Stanley Children's Hospital · USShriners Hospitals for Children - Philadelphia · USUniversity of Utah · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis purpose of this study was to assess the impact of patient and implant characteristics on LIV selection in ambulatory children with EOS and to assess the relationship between the touched vertebrae (TV), the last substantially touched vertebrae (LSTV), the stable vertebrae (SV), the sagittal stable vertebrae (SSV), and the LIV.

methodsA multicenter pediatric spine database was queried for patients ages 2-10 years treated by growth friendly instrumentation with at least 2-year follow up. The relationship between the LIV and preoperative spinal height, curve magnitude, and implant type were assessed. The relationships between the TV, LSTV, SV, SSV, and the LIV were also evaluated.

resultsOverall, 281 patients met inclusion criteria. The LIV was at L3 or below in most patients with a lumbar LIV: L1 (9.2%), L2 (20.2%), L3 (40.9%), L4 (29.5%). Smaller T1 - T12 length was associated with more caudal LIV selection (p = 0.001). Larger curve magnitudes were similarly associated with more caudal LIV selection (p = < 0.0001). Implant type was not associated with LIV selection (p = 0.32) including MCGR actuator length (p = 0.829). The LIV was caudal to the TV in 78% of patients with a TV at L2 or above compared to only 17% of patients with a TV at L3 or below (p < 0.0001).

conclusionsMost EOS patients have an LIV of L3 or below and display TV-LIV and LSTV-LIV incongruence. These findings suggest that at the end of treatment, EOS patients rarely have the potential for selective thoracic fusion. Further work is necessary to assess the potential for a more selective approach to LIV selection in EOS. LEVEL OF EVIDENCE: III.

Indexed as

ScoliosisAge of OnsetChildChild, PreschoolFemaleHumansLumbar VertebraeMaleRetrospective StudiesSpinal FusionThoracic VertebraeEarly-onset scoliosisGrowth-friendly instrumentationLIV selectionLowest instrumented vertebrae

Identifiers

PMID38514530
PMCPMC11217120
OpenAlexW4393031593

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.