Search Our Scientific Publications & Authors

World J Orthop 2022 Apr 18;13(4):365-372. Epub 2022 Apr 18.

Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, Al 35294, United States.

Background: Neuromuscular scoliosis is commonly associated with a large pelvic obliquity. Scoliosis in children with cerebral palsy is most commonly managed with posterior spinal instrumentation and fusion. While consensus is reached regarding the proximal starting point of fusion, controversy exists as to whether the distal level of spinal fusion should include the pelvis to correct the pelvic obliquity. Read More

J Pediatr Orthop 2022 May 5. Epub 2022 May 5.

Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD.

Introduction: Patients with neuromuscular disease are at high risk for developing hip dysplasia and scoliosis. The purpose of this study was to investigate the technical challenges and outcomes of pelvic osteotomy in patients with prior sacral-alar-iliac (SAI) fixation.

Methods: We reviewed clinical and radiographic records of patients aged 18 years and below who underwent pelvic osteotomy after SAI fixation. Read More

Clin Spine Surg 2022 May 3. Epub 2022 May 3.

Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD.

Study Design: This was a retrospective study.

Objective: The purpose of this study was to investigate the technical challenges and outcomes of sacral-alar-iliac (SAI) fixation for scoliosis in patients who had previously undergone a pelvic osteotomy for hip dysplasia.

Summary Of Background Data: Patients with neuromuscular disease are at high risk for developing hip dislocation and scoliosis. Read More

Neuromuscul Disord 2022 May 27;32(5):445-449. Epub 2022 Mar 27.

Harry Perkins Institute, Centre for Medical Research, University of Western Australia, Nedlands, WA, Australia. Electronic address:

Arthrogryposis is a consequence of reduced fetal movements and arises due to environmental factors or underlying genetic defects, with extensive genetic heterogeneity. In many instances, the genes responsible are involved in neuromuscular function. Missense variants in the gene encoding embryonic myosin heavy chain (MYH3) usually cause distal arthrogryposis. Read More

Adv Ther 2022 Apr 23. Epub 2022 Apr 23.

Parent Project Muscular Dystrophy, Hackensack, NJ, USA.

Introduction: This study aims to identify stages of Duchenne muscular dystrophy (DMD) and assess the disease burden by progression stage using real-world administrative claims supplemented by relevant electronic medical record (EMR) data.

Methods: Claims and EMR data from the Decision Resources Group's Real World Data Repository (2011-2020) were used to identify patients with DMD by diagnosis code and to stratify them into four disease stages by diagnosis and procedure markers reflective of DMD progression. Clinical and medical history data from the Cooperative International Neuromuscular Research Group (CINRG) were used to validate the developed claims-based staging algorithm. Read More

Int J Environ Res Public Health 2022 04 12;19(8). Epub 2022 Apr 12.

Sports & Musculoskeletal System Research Group (RAQUIS), University of Murcia, 30100 Murcia, Spain.

The Cobb angle value is a critical parameter for evaluating adolescent idiopathic scoliosis (AIS) patients. This study aimed to evaluate a software's validity and absolute reliability to determine the Cobb angle in AIS digital X-rays, with two different degrees of experienced observers. Four experts and four novice evaluators measured 35 scoliotic curves with the software on three separate occasions, one month apart. Read More

Acta Ortop Mex 2021 Sep-Oct;35(5):399-404

Ortopedia y Traumatología. Hospital Italiano de Buenos Aires, Argentina.

Objective: The aim of the study was to evaluate the outcomes and complications in patients with myelomeningocele who have undergone spinal fusion for neuromuscular scoliosis.

Material And Methods: Retrospective study of 40 consecutive patients with myelomeningocele with neuromuscular scoliosis who underwent spinal arthrodesis, treated at our center between July 1991 and July 2028.

Results: Mean follow up was 10 years. Read More

Eur Spine J 2022 Apr 17. Epub 2022 Apr 17.

Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China.

Purpose: Genetic diagnosis is a promising approach because several single-nucleotide polymorphisms (SNPs) associated with adolescent idiopathic scoliosis (AIS) progression have been reported. We review the predictive value of SNPs in curve progression of adolescent idiopathic scoliosis.

Methods: We reviewed DNA-based prognostic testing to predict curve progression. Read More

Spine J 2022 Apr 3. Epub 2022 Apr 3.

Department of Orthopaedic Surgery, Graduate School of Medicine, Hirosaki University, Hirosaki, Aomori, Japan.

Background Context: Despite the many advances in understanding and treating early-onset scoliosis, the incidence and prevalence of this disease in the population remains unknown. Such knowledge is important for guiding clinical practice, directing research and raising awareness.

Purpose: To identify the incidence and prevalence of early-onset scoliosis, including all categories, within the population. Read More

Cureus 2022 Feb 28;14(2):e22719. Epub 2022 Feb 28.

Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, USA.

Sublaminar band fixation is a reliable way to anchor spinal rods to the vertebral column. This technique is especially useful when the anatomy precludes safe pedicle screw placement. Sublaminar bands allow for deformity correction and stabilization of the spine. Read More

Quant Imaging Med Surg 2022 Mar;12(3):1706-1715

Sports & Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain.

Background: Axial vertebral rotation and Cobb's angle are essential parameters for analysing adolescent idiopathic scoliosis. This study's scope evaluates the validity and absolute reliability of application software based on a new mathematical equation to determine the axial vertebral rotation in digital X-rays according to Raimondi's method in evaluators with different degrees of experience.

Methods: Twelve independent evaluators with different experience levels measured 33 scoliotic curves in 21 X-rays with the software on three separate occasions, separated one month. Read More

Pediatr Pulmonol 2022 Jun 24;57(6):1497-1504. Epub 2022 Mar 24.

Department of Respiratory Medicine, Sydney Children's Hospital, Randwick, New South Wales, Australia.

Objectives: To examine objective daytime predictors of nocturnal hypercapnic hypoventilation (NHH) and identify a forced vital capacity (FVC) z-score cut off that predicts NHH using the 2012 Global Lung Function Initiative (GLI) reference equations in pediatric neuromuscular patients.

Design: Single-centre retrospective medical record review.

Setting: Tertiary pediatric hospital in Australia. Read More

Am J Transl Res 2022 15;14(2):1100-1106. Epub 2022 Feb 15.

Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University Katra, Jammu and Kashmir, India.

AIS is a heterogeneous 3D spinal deformity with Cobb angle ≥10°. It affects children in the age group of 10-16 years globally with 2-3% prevalence and significant female predominance. The exact etiology of AIS is not known however, it is supposed to be associated with factors such as anthropometric, metabolic, neuromuscular abnormalities and genetics. Read More

Int J Spine Surg 2022 Feb 10;16(1):4-10. Epub 2022 Mar 10.

Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn, NY, USA

Background: Disseminated intravascular coagulation (DIC) is a rare but serious complication of pediatric scoliosis surgery; sparse current evidence warrants more information on causality and prevention. This systematic review sought to identify incidence of DIC in pediatric patients during or shortly after corrective scoliosis surgery and identify any predictive factors for DIC.

Methods: Medline/PubMed, EMBASE, and Ovid databases were systematically reviewed through July 2017 to identify pediatric patients with DIC in the setting of scoliosis surgery. Read More

J Electromyogr Kinesiol 2022 Apr 7;63:102640. Epub 2022 Feb 7.

The University of Queensland, Laboratory for Motor Control and Pain Research, School of Biomedical Sciences, St Lucia, 4072 QLD, Australia. Electronic address:

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity occurring between ages of 10-18 years. We aimed to present a reasoned synthesis of the published evidence for and against asymmetrical paraspinal muscle activation in AIS. PubMed and Embase databases were searched using terms: adolescent idiopathic scoliosis AND electromyogra* (EMG). Read More

Neuromuscul Disord 2022 03 11;32(3):206-212. Epub 2021 Dec 11.

University Health Network, Division of Neurology, Toronto General Hospital, University Health Network, Division of Neurology, Toronto, Ontario, Canada. Electronic address:

Transition in paediatric health care refers to the planned process of shifting to an adult model of care and is highly individualised, patient focussed and requires a coordinated effort from different health care professionals. Through this retrospective study, we describe the spectrum of neuromuscular diseases evaluated through a paediatric to adult neuromuscular transition program in a tertiary academic centre in Canada, and also the speciality supports needed for these patients. 126 patients were transitioned during the study period. Read More

J Clin Med 2022 Feb 11;11(4). Epub 2022 Feb 11.

Department of Pediatrics and Neurology, Penn State Health Children's Hospital, Penn State College of Medicine, Hershey, PA 17033, USA.

Since the emergence of SARS-CoV-2, several studies have been published describing neuromuscular manifestations of the disease, as well as management of pre-existing pediatric neuromuscular disorders during the COVID-19 pandemic. These disorders include muscular dystrophies, myasthenic syndromes, peripheral nerve disorders, and spinal muscular atrophy. Such patients are a vulnerable population due to frequent complications such as scoliosis, cardiomyopathy, and restrictive lung disease that put them at risk of severe complications of COVID-19. Read More

Plast Reconstr Surg 2022 Mar;149(3):485e-495e

From the Divisions of Plastic and Reconstructive Surgery and Orthopaedics, Children's Hospital of Philadelphia.

Background: Vertical expandable prosthetic titanium rib (VEPTR) devices were designed to treat childhood scoliosis and thoracic insufficiency syndrome. Although they have drastically reduced patient mortality, they present a profound subcutaneous hardware burden. The authors examined the surgical and nonsurgical factors associated with salvage of VEPTR hardware exposures. Read More

Pediatr Pulmonol 2022 05 24;57(5):1303-1309. Epub 2022 Feb 24.

Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.

Introduction: Understanding the impact of scoliosis surgery on lung function is important for counseling patients about risks and benefits of surgery. We prospectively compared the trends in lung function test (LFT) results before and after scoliosis surgery in children with neuromuscular diseases or dysmorphic syndromes. We hypothesized a stabilization. Read More

Hosp Pediatr 2022 Feb 17. Epub 2022 Feb 17.

Pediatric Orthopaedic Surgery.

Background: Surgical correction remains the most effective treatment of patients with severe neuromuscular scoliosis (NMS). However, postoperative inpatient clinical care after spinal surgery for NMS patients is highly complex and variable, depending on the provider and/or institution. Our project used a quality improvement methodology to implement a standardized clinical care pathway for NMS patients during their primary spinal surgery, with the global aim of decreasing postoperative hospitalized length of stay (LOS). Read More

Infect Dis Clin North Am 2022 03;36(1):101-123

Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA.

Implant-associated spinal infection affects up to 10% of all pediatric instrumented spinal fixation surgeries and is associated with patient morbidity and significant impact on the health care system. Children with neuromuscular scoliosis are at increased risk compared with those with idiopathic scoliosis. Early infections (≤90 days from index surgery) are caused by virulent pathogens such as Staphylococcus aureus; more indolent pathogens cause late infections. Read More

J Pediatr Orthop 2022 May-Jun 01;42(5):280-284

Division of Pediatric Orthopaedics, Rainbow Babies and Children's Hospitals/University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.

Purpose: Surgical site infection (SSI) rates in pediatric spinal deformity surgery for cerebral palsy (CP) patients are higher than that in idiopathic scoliosis. The use of vancomycin powder is associated with decreased risk of SSI in neuromuscular patients. Prior studies in adult and pediatric early-onset scoliosis patients have shown that vancomycin powder alters microbacterial profile in patients that develop SSI. Read More

Spine Deform 2022 Feb 11. Epub 2022 Feb 11.

Division of Orthopaedic Surgery, Department of Surgery, IWK Health Center, 5850 University Avenue, PO Box 9700, Halifax, NS, B3K-6R8, Canada.

Purpose: The purpose of this study was to determine the relationship between pre-operative scoliosis flexibility and post-operative outcomes, including curve correction and complications, for patients who have been treated with growth friendly surgery (GFS) for early onset scoliosis (EOS).

Methods: The study was conducted as a retrospective review of prospectively collected data from an international, multicenter, EOS database. EOS patients with pre-operative flexibility radiographs (traction or bending) were identified. Read More

Top Spinal Cord Inj Rehabil 2022 23;28(1):34-41. Epub 2021 Aug 23.

Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Background: Acute flaccid myelitis (AFM) is an anterior horn disorder that manifests as rapid onset muscle weakness or paralysis. Development of scoliosis in pediatric AFM patients has been anecdotally reported, but associated risk factors or incidence have yet to be determined.

Methods: Pediatric AFM patients treated over a 10-year period at a tertiary care center were identified. Read More

Orthop Traumatol Surg Res 2022 02 7:103234. Epub 2022 Feb 7.

Service de chirurgie infantile à orientation orthopédique, Hôpital Universitaire Robert Debré, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 48 Bd Sérurier, 75019 Paris, France.

Background: Correcting pelvic obliquity is among the main goals of surgery for neuromuscular scoliosis. Spino-pelvic fixation must be stable and capable of withstanding the considerable mechanical forces applied at the lumbo-sacral junction. Selection of the best anchoring option is therefore crucial. Read More

J Pediatr Orthop 2022 Apr;42(4):e390-e396

Division of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Columbia University Irving Medical Center.

Background: While largely of concern in nonambulatory patients, pelvic obliquity (PO) can be found in many patients with early onset scoliosis (EOS) and may remain following surgery. However, its association with health-related quality of life (HRQoL) in children and their caregivers at the end of treatment is not well understood. The purpose of this study was to investigate the association between residual PO and HRQoL in children and their caregivers at the end of surgical treatment in ambulatory patients with EOS. Read More

Arch Orthop Trauma Surg 2022 Feb 9. Epub 2022 Feb 9.

Pediatric Orthopedic Surgery Department, Paris Descartes University, Assistance Publique Hôpitaux de Paris (AP-HP),Necker Hospital, 149 rue de Sevres, 75015, Paris, France.

J Pediatr Orthop 2022 Mar;42(3):131-137

Children's Hospital of Philadelphia, Philadelphia, PA.

Introduction: Early-onset scoliosis (EOS) is a spinal deformity that occurs in patients 9 years of age or younger. Severe deformity may result in thoracic insufficiency, respiratory failure, and premature death. The purpose of this study is to describe the modern-day natural history of mortality in patients with EOS. Read More

Neurospine 2022 Mar 29;19(1):177-187. Epub 2022 Jan 29.

Division of Pediatric Orthopedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.

Surgical treatment for neuromuscular scoliosis has evolved with pedicle screw instrumentation and the improvement of perioperative management. We aimed to review recent papers related to posterior surgical correction with a pedicle screw system for neuromuscular scoliosis, particularly cerebral palsy and muscular dystrophy, in terms of indication, correction method, and outcomes. The most remarkable change was the posterior-only operation with all-pedicle screw fixations. Read More

Surg Infect (Larchmt) 2022 Apr 28;23(3):226-231. Epub 2022 Jan 28.

Division of Pediatric Surgery, Duke University Medical Center, Durham, North Carolina, USA.

Prior studies have demonstrated that children with neuromuscular scoliosis have a higher incidence of infection after spine surgery. The purpose of the study is to determine whether children with neuromuscular disorders (NMDs) have higher rate of superficial surgical site infection (SSI) or increased hospital length of stay (LOS) compared with children without NMDs following laparoscopic gastrostomy creation, a common pediatric general surgery operation. We performed a retrospective propensity-matched analysis of laparoscopic gastrostomy creation in children from National Surgical Quality Improvement Program Pediatrics database (NSQIP-P) 2018-2019. Read More