{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:19:20Z","timestamp":1761823160279},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,7]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The authors sought to analyze prospectively the outcome of surgery for complex spinal deformity in the pediatric and young adult populations.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The authors evaluate all pediatric and adolescent patients undergoing operative correction of complex spinal deformity from December 1997 through July 1999. No patient was lost to follow-up review (average 21.1 months). There were 27 consecutive pediatric and adolescent patients (3\u201320 years of age) who underwent 32 operations. Diagnoses included scoliosis (18 idiopathic, five nonidiopathic) and four severe kyphoscoliosis. Operative correction and arthrodesis were achieved via 21 posterior approaches (Cotrel-Dubousset-Horizon), seven anterior approaches (Isola or Kaneda Scoliosis System), and two combined approaches. Operative time averaged 358 minutes (range 115\u2013620 minutes). Blood loss averaged 807 ml (range 100\u20132000 ml). Levels treated averaged 9.1 (range three\u201316 levels). There was a 54% average Cobb angle correction (range 6\u201382%). No case was complicated by the patient's neurological deterioration, loss of somatosensory evoked potential monitoring, cardiopulmonary disease, donor-site complication, or wound breakdown. There was one case of hook failure and one progression of deformity beyond the site of surgical instrumentation that required reoperation. There were 10 minor complications that did not significantly affect patient outcome. No patient received undirected banked blood products. There was a significant improvement in cosmesis, and no patient experienced continued pain postoperatively. All patients have been able to return to their preoperative activities.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Compared with other major neurosurgical operations, segmental instrumentation for pediatric and adolescent spinal deformity is a safe procedure with minimal morbidity and there is a low risk of needing to use allogeneic blood products.<\/jats:p>","DOI":"10.3171\/spi.2001.95.1.0017","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:53:32Z","timestamp":1241711612000},"page":"17-24","source":"Crossref","is-referenced-by-count":2,"title":["Management of complex pediatric and adolescent spinal deformity"],"prefix":"10.3171","volume":"95","author":[{"given":"Gregory C.","family":"Wiggins","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Rauzzino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry M.","family":"Bartkowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russ P.","family":"Nockels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Ann Intern Med","first-page":"403","article-title":"Practice strategies for elective red blood cell transfusion.","volume":"116","year":"1992"},{"key":"b2","series-title":"Spine","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1097\/00007632-198610000-00007","article-title":"Natural history of untreated idiopathic scoliosis after skeletal maturity.","volume":"11","author":"Ascani","year":"1986"},{"key":"b3","series-title":"Inst Course Lect","first-page":"551","article-title":"The treatment of neuromuscular scoliosis.","volume":"48","author":"Banta","year":"1999"},{"key":"b4","series-title":"Spine","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/00007632-199902010-00007","article-title":"Comparison of anterior and posterior instrumentation for correction of adolescent thoracic idiopathic scoliosis.","volume":"24","author":"Betz","year":"1999"},{"key":"b5","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2607","DOI":"10.1097\/00007632-199912150-00008","article-title":"Surgical treatment of idiopathic adolescent scoliosis.","volume":"24","author":"Bridwell","year":"1999"},{"key":"b6","series-title":"Spine","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1097\/00007632-199802010-00008","article-title":"Major intraoperative neurologic deficits in pediatric and adult spinal deformity patients. 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