ArticleJournal of spine surgery (Hong Kong)2026
Improved immediate postoperative T4-L1 hip axis with use of pre-contoured patient-specific rods versus surgeon-contoured rods in adolescent idiopathic scoliosis.
Article in Journal of spine surgery (Hong Kong), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Fewer mechanical failures in adult spine deformity patients undergoing long construct deformity correction occur when postoperative T4-L1 hip axis is optimized. To our knowledge, these parameters have not been extensively investigated in the pediatric population. In addition, despite the increased popularity of pre-contoured patient-specific rods and preoperative planning software, it is not clear if their use is associated with improved postoperative T4-L1 hip axis compared with standard surgeon-contoured rods. This study investigates the radiographic outcomes, with a focus on the T4-L1 hip axis, and mechanical failures in adolescent idiopathic scoliosis (AIS) patients who underwent posterior spinal fusion with either pre-contoured patient-specific rods or surgeon-contoured rods. Methods: This retrospective cohort study identified AIS patients treated with pre-contoured patient-specific rods or surgeon-contoured rods by a single academic pediatric spine surgeon. Demographics, Lenke classification, fused levels, osteotomies, and complications were obtained. Radiographic measurements including T4-L1 pelvic angle (T4-L1PA) were obtained pre-operatively, postoperatively, and at last follow-up. Comparison between cohorts was made based on standardized postoperative alignment goals including T4-L1PA difference within 4 degrees and deviation from ideal L1PA (=0.5 × pelvic incidence - 21). Results: There were 40 patients in the surgeon-contoured cohort and 33 patients in the pre-contoured cohort with an average follow-up of 24.1 and 16.9 months, respectively. No significant differences were identified with regards to demographics, Lenke classification, preoperative radiographic measurements, number of fused levels, and osteotomies. A T4-L1PA difference within 4 degrees in the immediate postoperative period was achieved in 81.8% of patients in the pre-contoured cohort Conclusions: Use of pre-contoured patient-specific rods was associated with improved immediate postoperative T4-L1 hip axis compared with surgeon-contoured rods in AIS patients. However, this difference was not statistically maintained at the last follow-up.
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