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Study Design Observational study. Purpose Investigation of factors related to proximal junctional kyphosis (PJK) and device failure in patients with early-onset scoliosis. Overview of Literature The use of growth-friendly devices, such as traditional dual growing rod (TDGR) for the treatment of early-onset scoliosis (EOS), may be associated with important complications, including PJK and device failure. Methods Thirty-five patients with EOS and treated with TDGR from 2014 to 2021 with a minimum follow-up of 2 years were retrospectively evaluated. Potential risk factors, including demographic factors, disease etiology, radiological measurements, and surgical characteristics, were assessed. Results PJK was observed in 19 patients (54.3%), and seven patients (20%) had device failure. PJK was significantly associated with global final kyphosis change (p=0.012). No significant correlation was found between the rod angle contour, type of implant, connector design, and the risk of PJK or device failure. Conclusions Treatment of EOS with TDGR is associated with high rates of complications, particularly PJK and device failure. The device type may not correlate with the risk of PJK and device failure. The progression of thoracic kyphosis during multiple distractions is an important risk factor for PJK.

Study Design Retrospective case control study. Purpose In current study, we compared the incidence of facet tropism (FT) in patients with lumbar disc herniation and normal controls. Overview of Literature It has been suggested that FT can be associated with increased risk of lumbar disc herniation. Methods A total of 66 and 63 patients with L4/L5 and L5/S1 disc herniation, respectively, were evaluated in the present study. The control group comprised 61 normal subjects. Facet joint angle was measured using axial magnetic resonance images. The FT was defined as a difference of >10° between the right and left facet joints. The incidence of FT was compared between patients and controls. We also investigated the relationship between facet orientation (sagittal or coronal) and side of disc herniation. Results The incidence of FT at the L4/L5 level was significantly higher in patients with disc herniation (48.5% vs. 26.2%, p =0.01), while it was found to be the same at the L5/S1 level in patients and controls (50.8% vs. 36%, p =0.098). Among the 64 patients with FT, intervertebral disc herniation occurred significantly toward the more sagittally oriented facet joint in 41 patients (p

Study DesignProspective study.PurposeTo determine the role of routine preoperative magnetic resonance imaging (MRI) to detect the incidence and risk factors for intraspinal anomalies in patients with idiopathic scoliosis.Overview of LiteratureThe incidence and risk factors for intraspinal anomalies in patients with idiopathic scoliosis are controversial, and the indications for preoperative MRI in these patients vary among centers.MethodsInformation on patients with idiopathic scoliosis who were surgical candidates over 10 years (age at presentation, sex, magnitude and apex of major curve, intraspinal anomalies detected by MRI, and neurological examination results) were recorded, the patients were grouped according to the intraspinal anomaly, and the data were analyzed.ResultsOf the 271 patients with idiopathic scoliosis, 27 had neuroaxial abnormalities (9.9%). Of these 27 patients, 14 (52%) underwent a neurosurgical procedure. Significant differences were observed in the frequency of early disease onset and male sex (p