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Clinical New Insights into Management of Scoliosis
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Clinical New Insights into Management of Scoliosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 30 July 2025 | Viewed by 322

Special Issue Editors

Dr. Piotr Janusz

E-Mail Website
Guest Editor
Spine Disorders Unit, Department of Spine Disorders and Pediatric Orthopedics, Poznan University of Medical Sciences, 61-545 Poznan, Poland
Interests: scoliosis; idiopathic scoliosis; congenital scoliosis; neuromuscular scoliosis
Prof. Dr. Marcin Tyrakowski

E-Mail Website
Guest Editor
Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Professor Adam Gruca Orthopedic and Trauma Teaching Hospital, Konarskiego 13, 05-400 Otwock, Poland
Interests: knee instability; degenerative disease; knee osteoarthritis; arthroplasty; periprosthetic joint infection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Spine deformations, especially scoliosis, reflect a wide range of complex conditions with different backgrounds and diverse treatment approaches. Despite advancements in understanding their etiology and treatment options, significant gaps persist in optimizing outcomes for patients.

This Special Issue aims to gather the latest clinical and scientific research on scoliosis management, including innovative surgical and non-surgical treatments, rehabilitation techniques, and long-term care strategies. Key areas include understanding the underlying causes, risk factors, and progression patterns of scoliosis, as well as exploring advanced imaging, diagnostic tools, and treatment efficacy. Contributions addressing challenges in patient-specific care and interdisciplinary approaches to improving the quality of life of scoliosis patients and treatment results are particularly welcome.

Additionally, the scope extends to exploring the etiology, background, and underlying basic science of scoliosis.

Researchers and clinicians are invited to contribute studies that push the boundaries of current treatment practices, ensuring a more comprehensive understanding of scoliosis and its management.

This Special Issue aims to provide fresh insights into optimizing patient care and improving treatment outcomes.

Dr. Piotr Janusz
Prof. Dr. Marcin Tyrakowski
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • scoliosis
  • idiopathic scoliosis
  • congenital scoliosis
  • neuromuscular scoliosis
  • degenerative scoliosis
  • kyphosis
  • spine deformation
  • scoliosis etiology
  • surgical treatment
  • non-surgical treatment

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Published Papers (1 paper)

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Research

14 pages, 802 KiB  
Article
Risk Factor Analysis for Proximal Junctional Kyphosis in Neuromuscular Scoliosis: A Single-Center Study
by Tobias Lange, Kathrin Boeckenfoerde, Georg Gosheger, Sebastian Bockholt and Albert Schulze Bövingloh
J. Clin. Med. 2025, 14(11), 3646; https://doi.org/10.3390/jcm14113646 - 22 May 2025
Viewed by 83
Abstract
Background/Objectives: Proximal junctional kyphosis (PJK) is one of the most frequently discussed complications following corrective surgery in patients with neuromuscular scoliosis (NMS). Despite its clinical relevance, the etiology of PJK remains incompletely understood and appears to be multifactorial. Biomechanical and limited clinical studies [...] Read more.
Background/Objectives: Proximal junctional kyphosis (PJK) is one of the most frequently discussed complications following corrective surgery in patients with neuromuscular scoliosis (NMS). Despite its clinical relevance, the etiology of PJK remains incompletely understood and appears to be multifactorial. Biomechanical and limited clinical studies suggest that preoperative hyperkyphosis, resection of the spinous processes with consequent disruption of posterior ligamentous structures, and rod contouring parameters may contribute as risk factors. Methods: To validate these findings, we retrospectively analyzed 99 NMS patients who underwent posterior spinal fusion using a standardized screw-rod system between 2009 and 2017. Radiographic assessments were conducted at three time points: preoperatively (preOP), postoperatively (postOP), and at a mean follow-up (FU) of 29 months. Clinical variables collected included patient age, weight, height, sex, and Risser sign. Radiographic evaluations encompassed Cobb angles, thoracic kyphosis (TK), lumbar lordosis, the levels of the upper (UIV) and lower (LIV) instrumented vertebrae, the total number of fused segments, parameters of sagittal alignment, the rod contour angle (RCA), and the postoperative mismatch between RCA and the proximal junctional angle (PJA). Based on the development of proximal junctional kyphosis, patients were categorized into PJK and non-PJK groups. Results: The overall incidence of PJK was 23.2%. In line with previous biomechanical findings, spinous process resection was significantly associated with PJK development. Furthermore, the PJK group demonstrated significantly higher preoperative TK (59.3° ± 29.04° vs. 34.5° ± 26.76°, p < 0.001), greater RCA (10.2° ± 4.01° vs. 7.7° ± 4.34°, p = 0.021), and a larger postoperative mismatch between PJA and RCA (PJA−RCA: 3.8° ± 6.76° vs. −1.8° ± 6.55°, p < 0.001) compared to the non-PJK group. Conclusions: Spinous process resection, a pronounced mismatch between postoperative PJA and RCA (odds ratio [OR] = 1.19, p = 0.002), excessive rod bending (i.e., high RCA), and severe preoperative thoracic hyperkyphosis with an expected increase in the risk of PJK of approximately 6.5% per degree of increase in preoperative TK are significant risk factors for PJK. These variables should be carefully considered during the surgical planning and execution of deformity correction in NMS patients. Full article
(This article belongs to the Special Issue Clinical New Insights into Management of Scoliosis)
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