Machine learning analysis of cervical balance in early-onset scoliosis post-growing rod surgery: a case-control study

Scientific Reports, 2025 · DOI: https://doi.org/10.1038/s41598-025-86330-2 · Published: January 9, 2025

Orthopedics Spinal Disorders Bioinformatics

Simple Explanation

This study investigates how growing rod surgery for early-onset scoliosis (EOS) affects the alignment of the neck (cervical spine). The researchers used machine learning to identify risk factors for cervical imbalance after this surgery. They found that a complication called proximal junctional kyphosis (PJK) and improvements in kyphosis and T1 slope angle were key risk factors.

Study Duration

2007 to 2019

Participants

138 EOS patients (96 male, 42 female)

Evidence Level

Level 3, Retrospective Case-Control Study

Key Findings

1
Growing rod surgery significantly affects cervical sagittal alignment in EOS patients.
2
Postoperative PJK is a risk factor for cervical sagittal imbalance.
3
Greater improvement of kyphosis and T1 slope angle increases the risk of cervical sagittal imbalance.

Research Summary

The study aimed to analyze cervical sagittal alignment changes following growing rod treatment in early-onset scoliosis (EOS) and identify risk factors for cervical imbalance using machine learning. The machine learning analysis identified postoperative PJK, improvement of kyphosis, and T1 slope angle as risk factors for cervical sagittal imbalance. The study concludes that growing rod surgery significantly affects cervical sagittal alignment, and postoperative PJK and greater improvement of kyphosis and T1 slope angle lead to a higher incidence of cervical sagittal imbalance.

Practical Implications

Surgical Planning

Careful selection of UIV and LIV during the preoperative plan can minimize PJK incidence.

Intraoperative Technique

Protecting the posterior ligamentous complex (PLC) of the junctional area intraoperatively to decrease the incidence of PJK as much as possible.

Postoperative Monitoring

Close monitoring and follow-up are crucial to observe long-term cervical instability in patients with excessive T1 slope increase.

Study Limitations

1
Retrospective study design
2
Small sample size from a single institution
3
Difficulties in assessing quality of life and correlating cervical spine sequence changes with clinical efficacy

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