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Advances in Diagnosis and Management of Scoliosis

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Dear Colleagues,

This Special Issue seeks to explore cutting-edge developments in understanding, diagnosing, and treating scoliosis and related spinal deformities. We invite submissions that address innovations in surgical techniques, including minimally invasive approaches and their impact on patient outcomes. Topics of interest include compensation mechanisms after deformity correction and risk stratification to improve surgical safety and efficacy. Contributions that examine long-term functional outcomes, postoperative complications, or the management of complex cases with concurrent conditions are highly encouraged. This issue aims to foster multidisciplinary research that enhances personalized care and advances therapeutic strategies for scoliosis and related spinal deformities, ultimately improving the quality of life for affected patients.

Dr. Peter G. Passias
Guest Editor

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Research

23 pages, 1288 KB

Open AccessArticle

Spinopelvic Realignment and Clinical Outcomes After Surgical Management of Adult Degenerative Lumbar Deformity: A Multicenter Retrospective Cohort Study

by Sanubar Nazarli, Teoman Bircan, Doğan Güçlühan Güçlü and Altay Sencer

J. Clin. Med. 2026, 15(13), 5280; https://doi.org/10.3390/jcm15135280 - 6 Jul 2026

Viewed by 388

Abstract

Background/Objectives: Adult degenerative lumbar deformity is a heterogeneous condition in which outcome depends on radiographic correction, patient-related risk factors, and surgical burden. This study evaluated spinopelvic realignment, clinical outcomes, complications, and predictors of unfavorable postoperative course after surgical treatment of adult degenerative lumbar deformity. Methods: This three-center retrospective cohort study included adult patients who underwent posterior decompression and instrumented fusion, with or without interbody fusion, for adult degenerative lumbar deformity between January 2021 and December 2024. Of 136 screened patients, 113 completed final follow-up and were included in the analysis. The mean follow-up duration was 31.0 ± 12.9 months. Radiographic parameters were assessed preoperatively, immediately postoperatively, and at final follow-up. Patient-reported outcome measures were analyzed using available paired data. Unfavorable postoperative course was defined as persistent or worsened pain with functional limitation, symptomatic mechanical complication, deep infection requiring surgical treatment, or revision/reoperation. Results: Surgery produced significant immediate improvement in coronal and sagittal alignment. Cobb angle improved from 29.8 ± 13.1° to 13.7 ± 6.7°, lumbar lordosis increased from 28.8 ± 15.5° to 40.3 ± 16.0°, PI–LL mismatch decreased from 21.7 ± 10.0° to 10.1 ± 11.5°, and SVA decreased from 58.8 ± 31.4 mm to 32.5 ± 36.0 mm. Partial loss of correction was observed at final follow-up, although alignment generally remained improved compared with baseline. ODI improved from 57.8 ± 12.6 to 34.7 ± 8.7 in patients with available paired data. Any postoperative complication occurred in 42.5% (n = 48) of patients, revision/reoperation in 23.9% (n = 27), and unfavorable postoperative course in 35.4% (n = 40). In multivariable analysis, osteoporosis, greater fusion length, and residual immediate postoperative PI–LL mismatch were independently associated with unfavorable postoperative course. Conclusions: In this three-center retrospective cohort, surgery for adult degenerative lumbar deformity was associated with significant radiographic correction and meaningful clinical improvement in patients with available paired outcome data. However, the substantial complication and revision/reoperation burden highlights the morbidity of adult degenerative lumbar deformity surgery. Osteoporosis, fusion length, and residual immediate postoperative PI–LL mismatch may help identify patients at higher risk for unfavorable postoperative course. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Management of Scoliosis)

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12 pages, 492 KB

Open AccessArticle

Results of Deep Surgical Site Infections Treated with the Debridement, Antibiotics, and Implant Retention (DAIR) Protocol: 25 Cases

by Ali İhsan Ökten, Saygı Uygur, Emre Bilgin, Abdullah Kılıç, Kemal Şüheda Özkavaklı, Fatih Çiçek, Erencan Kılcı, Mehmet Babaoğlan, Şahin Sancaktar, Baran Uyanık and Ali Harmanoğullarından

J. Clin. Med. 2026, 15(12), 4736; https://doi.org/10.3390/jcm15124736 - 18 Jun 2026

Cited by 1 | Viewed by 611

Abstract

Background/Objectives: There is no consensus on whether it is possible to preserve implant retention during deep surgical site infections (SSIs), and there is no widely accepted treatment protocol to date for these patients. The aim of this study is to evaluate the efficacy of the debridement, antibiotics, and implant retention (DAIR) protocol in patients who were treated for degenerative thoracolumbar spinal disorder using spinal instrumentation. Methods: This retrospective study describes the 24-month outcomes of deep SSI that developed in 25 of 720 patients (3.5%) who underwent surgery for thoracolumbar degenerative spinal disorders (disc disease, spinal stenosis, and scoliosis) and were treated according to the DAIR protocol. Results: Of these 25 patients, 18 developed early infection (<1 month), 3 developed delayed infection (1–3 months), and 4 developed late-onset deep infection (>3 months). Staphylococcus aureus was isolated in 56% of the patients. The DAIR protocol was successful in 22 (88%) of the patients, while it failed in 3 (12%). Surgical implants were removed in 25% of patients with late-onset SSI, and only 11.1% with early onset and 0% with delayed SSI. All patients who failed DAIR were smokers. A significant association was found between the Charlson Comorbidity Index and the number of surgical interventions (p = 0.022). Conclusions: In this small retrospective cohort, the DAIR protocol appeared to be a feasible treatment option for deep SSI, particularly in early infections. Implant removal may be considered when infection persists after repeat DAIR or when implant loosening is observed. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Management of Scoliosis)

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