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Study design: The Children Spine Study Group registry was queried for early onset scoliosis (EOS) patients who had final definitive spinal fusion after their scoliosis was managed with either growing rods or VEPTR. The Harms Study Group registry was queried for adolescent idiopathic scoliosis (AIS) patients who had definitive fusion Objective: The goal is to assess shoulder alignment in EOS patients after a definitive fusion and how these radiographic outcomes relate to the more familiar situation of post-definitive fusions shoulder alignment in AIS patients. Background: EOS is a challenging pathology to manage. Numerous components are important in the success of spinal surgery for this population. Shoulder balance is a one of the components that is easily seen by the patient. Recently, the importance of its relationship to patient satisfaction has received greater attention. Methods: Sample size: n= 145 (EOS (n= 34) and AIS (n= 111)). Shoulder balance parameters (SBP) of clavicular angle (CA), coracoid height difference (CHD), clavicular tilt angle difference (CTAD), and clavicle-rib cage intersection difference (CRID) measurements were measured from the reviewed radiographs and documented pre-definitive, post-definitive and 2-year follow-up measures. Shoulder balance parameters were compared between EOS and AIS cohorts at documented intervals. Results: EOS mean pre-definitive fusion SBPs (CA, CTAD, CRID, CHD) were significantly higher compared to AIS, p= 0.004, 0.003, < 0.001, < 0.001, respectively. Significant post-definitive fusion corrections were noticed for CTAD (0.01), CHD (0.01), nearly significant CA (0.07), non-significant CRID in EOS patients. In AIS patients, no significant corrections were noticed for CA, CTAD, CHD and but significant for CRID (0.02). At post-definitive and 2-year follow-up, CA, CRID, CHD were not significant between cohorts, but CTAD (< 0.01) was significantly higher in EOS cohort at final follow-up. Conclusion: Post-definitive and 2-year follow-up shoulder balance for EOS patients was not significantly different from AIS patients. Level of evidence: III.

Sagittal alignment abnormalities in Scheuermann kyphosis (SK) strongly correlate with quality of life measures. The changes in spinopelvic parameters after posterior spinal fusion have not been adequately studied. This study is to evaluate the reciprocal changes in spinopelvic parameters following surgical correction for SK.

Survey-based cross-sectional study.

Retrospective review of a prospectively collected multicenter database of patients with adolescent idiopathic scoliosis (AIS).

Retrospective analysis of radiographs for a prospective group of 196 adolescent patients with thoracic idiopathic scoliosis after anterior spinal fusion with instrumentation.

Objective: To define the current rate of postoperative surgical site infections (SSIs) in a large prospective series of surgical adolescent idiopathic scoliosis (AIS) cases. Methods: A multicenter, prospective database of patients who underwent surgical correction of AIS was reviewed. Early SSIs were defined as occurring within 90 days after the index operation, as per the Center for Disease Control’s definitions. Treatment and outcome information on all confirmed SSIs was compiled. Variables associated with the occurrence of an SSI were evaluated. Results: Of the 1,757 patients analyzed, 28 developed an SSI within the first 90 days postoperatively (1.6%). Patient weight was associated with SSI (p <.001). There was a trend in correlation with the number of levels fused (p =.07) and blood loss as a percentage of blood volume (p =.07) and the incidence of SSI. There was no correlation with any other variables. There was variation in the rate of SSI among the 9 centers, ranging from 0.6% to 4.4% (p =.27). Of the 28 infections, 26 resolved with surgery and/or antibiotics and did not need implant removal. Only 2 patients had late pain. In addition to the 28 confirmed SSIs, there were an additional 68 other wound issues (4.2%) that did not meet the Center for Disease Control criteria for an SSI. Conclusions: Early SSIs after AIS surgery occurred at a rate of 1.6%. The federal mandate to eliminate SSI and the proposed lack of reimbursement for its treatment may change clinical practice, and these data provide average SSI rates across multiple centers for future comparison. Investigations into variations in practice between centers might yield areas for potential improvement in SSI for AIS patients. Fortunately, 92% of patients were able to retain their implants and were free of pain at final follow-up.

The author would like to update the order of author names as follows