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Article: Pedicle Dysplasia in Proximal Thoracic Adolescent Idiopathic Scoliosis Curves: What are We Missing and What are its Possible Surgical Implications? An Observational Retrospective Study on 104 Patients.

Viroli, Giovanni / Ruffilli, Alberto / Barile, Francesca / Manzetti, Marco / Traversari, Matteo / Faldini, Cesare

2024 , Page(s) 21925682241230964

Abstract: Study design: Retrospective cohort study.: Objectives: To assess if pedicle dysplasia is present in proximal thoracic (PT), both structural and nonstructural, compared to main thoracic (MT) curves; and to assess if it is predictive of radiographic ... ...

Abstract	Study design: Retrospective cohort study. Objectives: To assess if pedicle dysplasia is present in proximal thoracic (PT), both structural and nonstructural, compared to main thoracic (MT) curves; and to assess if it is predictive of radiographic outcomes at minimum 2 years of follow-up. Methods: A retrospective review of surgically-treated Adolescent Idiopathic Scoliosis (AIS) patients with Lenke 1-2-3-4 curves was performed. On preoperative CT-scan, at the apical vertebra, pedicle width on the concavity (PWc) and on the convexity (PWv) and Pedicle Dysplasia Index (PDI, defined as PWc/PWv) were measured. Preoperative and last follow-up (at least 2 years) x-rays were reviewed. Results: 104 patients meeting the inclusion criteria were divided into Structural-PT (S-PT) and Nonstructural-PT (NS-PT) groups based on Lenke criteria. PWc ( Conclusion: S-PT and NS-PT curves show significant pedicle dysplasia on the concavity. Pedicle dysplasia significantly correlated with shoulder balance at follow-up, for NS-PT patterns. Patients with a PWc <1 mm or PDI <.30 are at particular risk of postoperative shoulder imbalance.
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/21925682241230964
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Article: Ponte Osteotomies in the Surgical Treatment of Adolescent Idiopathic Scoliosis: A Systematic Review of the Literature and Meta-Analysis of Comparative Studies.

Faldini, Cesare / Viroli, Giovanni / Traversari, Matteo / Manzetti, Marco / Ialuna, Marco / Sartini, Francesco / Cargeli, Alessandro / Parisi, Stefania Claudia / Ruffilli, Alberto

Children (Basel, Switzerland)

2024 Volume 11, Issue 1

Abstract: The purpose of the present paper is to assess if Ponte osteotomies (POs) allow for a better correction in adolescent idiopathic scoliosis (AIS) surgery and to investigate their safety profile. A systematic search of electronic databases was conducted. ... ...

Abstract	The purpose of the present paper is to assess if Ponte osteotomies (POs) allow for a better correction in adolescent idiopathic scoliosis (AIS) surgery and to investigate their safety profile. A systematic search of electronic databases was conducted. Inclusion criteria: comparative studies that reported the outcomes of AIS patients who underwent surgical correction through posterior-only approach with and without POs. Clinical and radiographic outcomes were extracted and summarized. Meta-analyses were performed to estimate the differences between patients treated with and without POs.
Language	English
Publishing date	2024-01-12
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children11010092
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Article ; Online: Restoration of Spinopelvic Alignment After Reduction of High-grade Spondylolisthesis: Myth or Reality? A Systematic Review of the literature and Meta-analysis.

Viroli, Giovanni / Ruffilli, Alberto / Ialuna, Marco / Barile, Francesca / Manzetti, Marco / Traversari, Matteo / Vita, Fabio / Faldini, Cesare

Clinical spine surgery

2024

Abstract: Study design: Systematic review and meta-analysis of literature.: Objective: The aim of the presented study is to assess whether the reduction of high-grade spondylolisthesis (HGS) through the correction of lumbosacral kyphosis leads to a decrease in ...

Abstract	Study design: Systematic review and meta-analysis of literature. Objective: The aim of the presented study is to assess whether the reduction of high-grade spondylolisthesis (HGS) through the correction of lumbosacral kyphosis leads to a decrease in the sagittal spinopelvic compensatory mechanisms. Summary of background data: HGS is as an anterior translation of a vertebra, >50%. It is also characterized by a kyphotic deformity of the affected level. This combination of translation and kyphosis leads to compensatory mechanisms on the sagittal plane [pelvic retroversion, increased lumbar lordosis (LL), reduction in thoracic kyphosis (TK)]. Methods: A systematic search of electronic databases was conducted. Inclusion criteria were diagnosis of HGS (Meyerding >II, Slip% >50%), partial or complete reduction surgery (with a significant decrease in Slip%), and report of spinopelvic parameters (pelvic incidence, pelvic tilt, or sacral slope). Clinical and radiographic outcomes were extracted and summarized. Meta-analyses were performed to estimate the differences between preoperative and postoperative spinopelvic alignment measures. P<0.05 was considered significant. Results: Eighteen studies were included. PT showed a statistically significant decrease of -2.1217 (95% CI: -3.4803 to -0.7630), while SS showed a significant increase of 4.8349 (95% CI: 2.7462-6.9236). Conversely, both LL and TK showed nonsignificant changes, -4.7043 (95% CI: -10.4535 to 1.0449) and 6.3881 (95% CI: -0.8344 to 13.6106), respectively. VAS significantly decreased by -3.1950 (95% CI: -4.9462 to -1.4439). Conclusions: The meta-analysis showed mild, yet statistically significant, decrease of PT and an increase in SS after HGS reduction. Conversely, nonstatically significant decrease in LL and an increase in TK occurred. The clinical significance of these results remains questionable. Level of evidence: Level IV.
Language	English
Publishing date	2024-03-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2849646-2
ISSN	2380-0194 ; 2380-0186
ISSN (online)	2380-0194
ISSN	2380-0186
DOI	10.1097/BSD.0000000000001593
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Article ; Online: Comparable rates of lumbar disc degeneration at long-term following adolescent idiopathic scoliosis spinal fusion extended to L3 or L4: systematic review and meta-analysis.

Ruffilli, Alberto / Traversari, Matteo / Manzetti, Marco / Viroli, Giovanni / Artioli, Elena / Zielli, Simone Ottavio / Mazzotti, Antonio / Faldini, Cesare

Spine deformity

2024

Abstract: Purpose: Surgical treatment of adolescent idiopathic scoliosis (AIS) requires a careful choice of fusion levels. The usual recommendation for the selection of the lowest instrumented vertebra (LIV) for double major or thoracolumbar/lumbar (TL/L) curves ... ...

Abstract	Purpose: Surgical treatment of adolescent idiopathic scoliosis (AIS) requires a careful choice of fusion levels. The usual recommendation for the selection of the lowest instrumented vertebra (LIV) for double major or thoracolumbar/lumbar (TL/L) curves falls on L3 or L4. The aim of the present study is to assess if the spinal fusion with LIV selection of L3 or L4 in AIS patients has a clinical or radiological impact in terms of degenerative disc disease (DDD) in distal unfused segments at long-term follow-up. Methods: A systematic search of electronic databases from eligible articles was conducted. Only studies regarding long-term follow-up of AIS patients treated with spinal fusion were included. Clinical and radiographic outcomes were extracted and summarized. Meta-analysis on long-term follow-up MRI studies was performed. p value < 0.05 was considered significant. Results: Fourteen studies were included, for a total of 1264 patients. Clinical assessment of included patients showed a slight tendency to have worse clinical outcomes if spinal fusion is extended to L4 rather than L3. Despite that, meta-analysis could not be performed on clinical parameters because of heterogeneity of evaluated PROMs in included studies. Magnetic resonance imaging (MRI) evaluation at long-term follow-up showed no significant difference in terms of disc degeneration rate at overall meta-analysis (p = 0.916) between patients fused to L3 and L4. Conclusion: The LIV selection of L3 rather than L4, according to current literature, does not prevent disc degeneration in distal unfused segments over the long term. Long-term studies of patients treated with contemporary spinal instrumentation are needed.
Language	English
Publishing date	2024-03-28
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2717704-X
ISSN	2212-1358 ; 2212-134X ; 2212-1358
ISSN (online)	2212-1358 ; 2212-134X
ISSN	2212-1358
DOI	10.1007/s43390-024-00849-4
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Article: Frailty Influence on Postoperative Surgical Site Infections After Surgery for Degenerative Spine Disease and Adult Spine Deformity. Can a Frailty Index be a Valuable Summary Risk Indicator? A Systematic Review and Metanalysis of the Current Literature.

Manzetti, Marco / Ruffilli, Alberto / Viroli, Giovanni / Traversari, Matteo / Ialuna, Marco / Salamanna, Francesca / Neri, Simona / Faldini, Cesare

Global spine journal

2024 , Page(s) 21925682241235605

Abstract: Study design: Metanalysis.: Objective: Surgical site infections (SSI) is one of the commonest postoperative adverse events after spine surgery. Frailty has been described as a valuable summary risk indicator for SSI in spine surgery. The aim of this ... ...

Abstract	Study design: Metanalysis. Objective: Surgical site infections (SSI) is one of the commonest postoperative adverse events after spine surgery. Frailty has been described as a valuable summary risk indicator for SSI in spine surgery. The aim of this metanalysis is to evaluate the influence of frailty on postoperative SSI in this cohort and provide hints on which index can predict the risk of SSI. Methods: Papers describing the postoperative SSI rate in adult degenerative spine disease or adult spine deformity patients with varying degrees of frailty were included in the analysis. The SSI rate in different grades of frailty was considered for outcome measure. Meta-analysis was performed on studies in whom data regarding patients with different levels of frailty and occurrence of postoperative SSI could be pooled. Results: 16 studies were included. The frailty prevalence measured using mFI-11 ranged from 3% to 17.9%, these values were inferior to those measured with mFI-5. Significant difference was found between frail and non-frail patients in postoperative SSI rate at metanalysis (z = 5.9547, Conclusion: This is the first meta-analysis to specifically investigate the impact of frailty, on occurrence of SSI. We found a relevant statistical difference between frail and non-frail patients in SSI occurrence rate. This is a relevant finding, as the ageing of population increases alongside with spine surgery procedures, a better understanding of risk factors may advance our ability to treat patients while minimizing the occurrence of SSI.
Language	English
Publishing date	2024-02-21
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/21925682241235605
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Article ; Online: Transient L5 Nerve Root Palsy Caused by Subfascial Drain After Lumbar Surgery: Case Report and Literature Review.

Barile, Francesca / Ruffilli, Alberto / Viroli, Giovanni / Manzetti, Marco / Traversari, Matteo / Faldini, Cesare

JBJS case connector

2022 Volume 12, Issue 2

Abstract: Case: We describe the case of a 45-year-old woman who developed a transient L5 deficit after a posterior L4-L5 interbody fusion. A perfusion computed tomography scan ruled out all described causes of postoperative deficit and showed compression of the ... ...

Abstract	Case: We describe the case of a 45-year-old woman who developed a transient L5 deficit after a posterior L4-L5 interbody fusion. A perfusion computed tomography scan ruled out all described causes of postoperative deficit and showed compression of the right L5 root by the subfascial drain. The deficit spontaneously resolved. Conclusion: New neurological deficit after spine surgery is a complication that requires a quick diagnostic and therapeutic approach. This particular case is of interest not only because it describes a rarely reported complication (transient neurological motor deficit after posterior fusion) but also because the hypothesized cause has never been described before.
MeSH term(s)	Female ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Lumbosacral Region ; Middle Aged ; Paralysis ; Spinal Fusion/adverse effects ; Spinal Fusion/methods ; Tomography, X-Ray Computed
Language	English
Publishing date	2022-05-18
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	e22.00006
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Article: Surgical treatment of severe adolescent idiopathic scoliosis through one-stage posterior-only approach: A systematic review and meta-analysis.

Traversari, Matteo / Ruffilli, Alberto / Barile, Francesca / Viroli, Giovanni / Manzetti, Marco / Vita, Fabio / Faldini, Cesare

Journal of craniovertebral junction & spine

2022 Volume 13, Issue 4, Page(s) 390–400

Abstract: The aim of this meta-analysis was to analyze the results of one-stage all-posterior spinal fusion for severe adolescent idiopathic scoliosis (AIS). A systematic search of articles about one-stage posterior spinal fusion for severe AIS was conducted ... ...

Abstract	The aim of this meta-analysis was to analyze the results of one-stage all-posterior spinal fusion for severe adolescent idiopathic scoliosis (AIS). A systematic search of articles about one-stage posterior spinal fusion for severe AIS was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data about population, pre-and postoperative radiographical data, surgical procedure details, and complications were extracted. Meta-analyses were performed when possible. Fourteen studies (640 patients) were included. The mean Cobb angle of the major curve varied from 80.0 ± 7.3 to 110.8 ± 12.1. The meta analysis showed a comprehensive coronal correction rate of the major curve of 58.6%, a comprehensive operative time of 274.5 min, and a comprehensive estimated intraoperative blood loss of 866.5 mL (95% confidence interval: 659.3-1073.6,
Language	English
Publishing date	2022-12-07
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2573344-8
ISSN	0976-9285 ; 0974-8237
ISSN (online)	0976-9285
ISSN	0974-8237
DOI	10.4103/jcvjs.jcvjs_80_22
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Article: Is Sarcopenia a Risk Factor for Postoperative Surgical Site Infection After Posterior Lumbar Spinal Fusion?

Barile, Francesca / Ruffilli, Alberto / Fiore, Michele / Manzetti, Marco / Geraci, Giuseppe / Viroli, Giovanni / Faldini, Cesare

International journal of spine surgery

2022

Language	English
Publishing date	2022-07-14
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4599
ISSN	2211-4599
DOI	10.14444/8302
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Article ; Online: Sacroiliac Joint Degeneration and Pain After Spinal Arthrodesis: A Systematic Review.

Manzetti, Marco / Ruffilli, Alberto / Barile, Francesca / Fiore, Michele / Viroli, Giovanni / Cappello, Lorenzo / Faldini, Cesare

Clinical spine surgery

2022 Volume 36, Issue 4, Page(s) 169–182

Abstract: Study design: This was a systematic review.: Objective: The present study aims to review the available literature concerning sacroiliac joint (SIJ) pain and degeneration after lumbosacral fixation to identify the prevalence and potential risk factors. ...

Abstract	Study design: This was a systematic review. Objective: The present study aims to review the available literature concerning sacroiliac joint (SIJ) pain and degeneration after lumbosacral fixation to identify the prevalence and potential risk factors. Summary of background data: Although numerous factors can predispose patients to SIJ degeneration and pain various clinical studies indicate lumbosacral arthrodesis as a major cause. Materials and methods: The PubMed-MEDLINE, Cochrane Central Registry of Controlled Trials, and Embase Biomedical database were searched. Peer-reviewed comparative studies, cohort studies, case series studies and case control studies, conducted either in a retrospective or prospective design, that registered data about SIJ pain and degeneration after lumbosacral fixation were included. Results: Twenty-one studies including 2678 patients met the inclusion criteria. The percentage of SIJ pain after lumbosacral fixation diagnosed with injections and physical examination varied widely, from 3% to 90%. Among patients who underwent spinal fusion, SIJ pain prevalence was higher when arthrodesis was fixed compared with floating fusions (59% vs. 10%, P -value >0.05). The prevalence of SIJ degenerative changes at computed tomography scan was more frequent in patients who underwent spinal arthrodesis than in those who did not (75% vs. 38.2%, P -value ≤0.05). Conclusion: According to current evidence, patients who received lumbosacral fixation are at risk of SIJ pain. Number of fused levels, involvement of pelvis or sacrum in the arthrodesis area, inadequate lumbosacral sagittal alignment, and site of bone graft harvesting could be possible risk factor leading to sacroiliac degeneration and pain after lumbar spine fixation that should be investigated by physicians. However, there is a lack of homogeneity of the studies that address the problem, therefore, further prospective comparative studies, with a homogeneous architecture and cohorts are needed. Level of evidence: Level III.
MeSH term(s)	Humans ; Spinal Fusion/adverse effects ; Spinal Fusion/methods ; Sacroiliac Joint/diagnostic imaging ; Sacroiliac Joint/surgery ; Retrospective Studies ; Cohort Studies ; Arthralgia
Language	English
Publishing date	2022-05-10
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2849646-2
ISSN	2380-0194 ; 2380-0186
ISSN (online)	2380-0194
ISSN	2380-0186
DOI	10.1097/BSD.0000000000001341
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Article ; Online: Correction: Multilevel non-contiguous thoracic pedicle subtraction osteotomy for fixed rounded hyperkyphotic deformity of the thoraco-lumbar junction with anterior bony fusion: technical note.

Faldini, Cesare / Barile, Francesca / Viroli, Giovanni / Manzetti, Marco / Geraci, Giuseppe / Ruffilli, Alberto

Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology

2022 Volume 23, Issue 1, Page(s) 58

Language	English
Publishing date	2022-12-22
Publishing country	Italy
Document type	Published Erratum
ZDB-ID	2043336-0
ISSN	1590-9999 ; 1590-9921
ISSN (online)	1590-9999
ISSN	1590-9921
DOI	10.1186/s10195-022-00679-y
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