{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:04:37Z","timestamp":1777658677662,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Wound complications and suboptimal pelvic correction remain significant challenges in posterior spinal fusion to the pelvis for neuromuscular scoliosis. We describe and evaluate the\n                      <jats:italic toggle=\"yes\">Rocket incision<\/jats:italic>\n                      , a novel modification of the posterior midline approach designed to redistribute closure tension and enhance access for soft tissue release.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 16 paediatric patients with neuromuscular scoliosis who underwent long posterior spinal fusion to the pelvis using the Rocket incision between 2020 and 2022. Radiographic parameters included Cobb angle and pelvic obliquity, measured pre- and postoperatively. Wound complications and readmissions were documented. Surgical exposure, instrumentation, and closure were standardised. Statistical analysis was performed using paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests (significance set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean Cobb angle improved from 81.5\u00b0 (95% CI: 72.5-90.5) to 21.0\u00b0 (95% CI: 15.0-27.1), representing a 74% mean correction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Pelvic obliquity, a primary outcome, improved from 19.8\u00b0 to 3.2\u00b0 (mean correction: 16.6\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001), with 81.3% of patients achieving &lt;5\u00b0 tilt. There were no early wound infections, wound breakdowns, or readmissions within 90 days. One patient (6.25%) developed a late superficial infection treated non-operatively. No patients experienced radiographic decompensation or loss of correction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Rocket incision appears to be a safe and effective modification to the posterior spinal approach in neuromuscular scoliosis, with promising early results in deformity correction and wound morbidity. These preliminary findings, derived from a small retrospective cohort, should be interpreted as hypothesis-generating and require further validation in comparative or prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251371561","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T08:48:14Z","timestamp":1756111694000},"page":"1067-1074","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Rocket Incision in Neuromuscular Scoliosis: A Modified Posterior Approach for Enhanced Pelvic Correction and Wound Safety (Retrospective Cohort Study)"],"prefix":"10.1177","volume":"16","author":[{"given":"Masood","family":"Shafafay","sequence":"first","affiliation":[{"name":"Nottingham University Hospitals NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4794-5522","authenticated-orcid":false,"given":"Mohamed A.","family":"Hassanin","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust"},{"name":"Assiut University Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1932-5927","authenticated-orcid":false,"given":"Naveen","family":"Pandita","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Elmeshneb","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elie","family":"Najjar","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BCO.0000000000000464"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2019.11.01"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3171\/2016.2.SPINE151377"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3171\/2017.7.FOCUS17384"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000004050"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000496693"},{"key":"e_1_3_3_8_2","first-page":"1535","article-title":"Surgical site infection following spinal instrumentation for scoliosis: a multicenter analysis of rates, risk factors, and pathogens","volume":"5","author":"Mackenzie WG","year":"2013","unstructured":"Mackenzie WG, Matsumoto H, Williams BA, et al. Surgical site infection following spinal instrumentation for scoliosis: a multicenter analysis of rates, risk factors, and pathogens. J Bone Joint Surg Am. 2013;5:1535-1586.","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13332"},{"issue":"5","key":"e_1_3_3_10_2","first-page":"1352","article-title":"Complications of scoliosis surgery in neuromuscular patients: risk factors and prevention strategies","volume":"469","author":"Tsirikos AI","year":"2011","unstructured":"Tsirikos AI, Lipton G, Chang WN. Complications of scoliosis surgery in neuromuscular patients: risk factors and prevention strategies. Clin Orthop Relat Res. 2011;469(5):1352-1362.","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00656"},{"issue":"10","key":"e_1_3_3_12_2","first-page":"1122","article-title":"Surgical treatment of scoliosis in patients with cerebral palsy using unit rod instrumentation: outcomes and complications","volume":"34","author":"Sharma S","year":"2009","unstructured":"Sharma S, Rispoli DM, Sucato DJ. Surgical treatment of scoliosis in patients with cerebral palsy using unit rod instrumentation: outcomes and complications. Spine (Phila Pa 1976). 2009;34(10):1122-1132.","journal-title":"Spine (Phila Pa 1976)"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00277"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.24293"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/clinpract14010006"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002628"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-014-0398-z"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2542-2"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-021-00346-y"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.55275\/JPOSNA-2019-8"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682251371561","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682251371561","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682251371561","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:16:32Z","timestamp":1777446992000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682251371561"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/21925682251371561"],"URL":"https:\/\/doi.org\/10.1177\/21925682251371561","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]}}}