{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:09:28Z","timestamp":1777658968314,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Multi-center, prospective, observational cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare myelopathic vs. non-myelopathic ambulatory patients in short- and long-term neurologic function, operative treatment, and patient-reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Pediatric deformity patients from 16 centers were enrolled with the following inclusion criteria: aged 10-21 years-old, a Cobb angle \u2265100\u00b0 in either the coronal or sagittal plane or any sized deformity with a planned 3-column osteotomy, and community ambulators. Patients were dichotomized into 2 groups: myelopathic (abnormal preoperative neurologic exam with signs\/symptoms of myelopathy) and non-myelopathic (no clinical signs\/symptoms of myelopathy).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 311 patients with an average age of 14.7 \u00b1 2.8 years, 29 (9.3%) were myelopathic and 282 (90.7%) were non-myelopathic. There was no difference in age ( P = 0.18), gender ( P = 0.09), and Risser Stage ( P = 0.06), while more patients in the non-myelopathic group had previous surgery (16.1% vs. 3.9%; P = 0.03). Mean lower extremity motor score (LEMS) in myelopathic patients increased significantly compared to baseline at every postoperative visit: Baseline: 40.7 \u00b1 9.9; Immediate postop: 46.0 \u00b1 7.1, P = 0.02; 1-year: 48.2 \u00b1 3.7, P &lt; 0.001; 2-year: 48.2 \u00b1 7.7, P &lt; 0.001). The non-myelopathic group had significantly higher LEMS immediately postoperative ( P = 0.0007), but by 1-year postoperative, there was no difference in LEMS between groups (non-myelopathic: 49.3 \u00b1 3.6, myelopathic: 48.2 \u00b1 3.7, P = 0.10) and was maintained at 2-years postoperative (non-myelopathic: 49.2 \u00b1 3.3, myelopathic: 48.2 \u00b1 5.7, P = 0.09). Both groups improved significantly in all SRS domains compared to preoperative, with no difference in scores in the domains for pain ( P = 0.12), self-image ( P = 0.08), and satisfaction ( P = 0.83) at latest follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In severe spinal deformity pediatric patients presenting with preoperative myelopathy undergoing spinal reconstructive surgery, myelopathic patients can expect significant improvement in neurologic function postoperatively. At 1-year and 2-year postoperative, neurologic function was no different between groups. While non-myelopathic patients had significantly higher postoperative outcomes in SRS mental-health, function, and total-score, both groups had significantly improved outcomes in every SRS domain compared to preoperative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682211034837","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T05:23:50Z","timestamp":1629350630000},"page":"1384-1393","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Myelopathic Patients Undergoing Severe Pediatric Spinal Deformity Surgery Can Improve Neurologic Function to That of Non-Myelopathic Patients by 1-Year Postoperative"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5931-7067","authenticated-orcid":false,"given":"Meghan","family":"Cerpa","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-7406","authenticated-orcid":false,"given":"Michael P.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Washington University, St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burt","family":"Yaszay","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Newton","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Sponseller","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Erickson","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado Aurora, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumeet","family":"Garg","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado Aurora, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Pahys","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amer","family":"Samdani","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Cahill","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Bumpass","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Sucato","sequence":"additional","affiliation":[{"name":"Texas Scottish Rite Hospital for Children Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oheneba","family":"Boachie-Adjei","sequence":"additional","affiliation":[{"name":"FOCOS Orthopedic Hospital, Accra, Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suken","family":"Shah","sequence":"additional","affiliation":[{"name":"Nemours\/Alfred I. duPont Hospital for Children, Wilmington, DE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-4377","authenticated-orcid":false,"given":"Munish","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Washington University, St. Louis, MO, 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