{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:16:43Z","timestamp":1760235403270,"version":"build-2065373602"},"reference-count":70,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T00:00:00Z","timestamp":1629072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>This is a retrospective radiographic review to assess post-operative sagittal plane deformities in patients with Spinal Muscular Atrophy type 2 that had been treated with posterior spinal instrumentation. Thirty-two patients with a history of either spinal fusion (N = 20) or growing rods (N = 12) were identified with an average of 7.6 (2.1\u201316.6) years post-operative follow-up. Forty percent (13\/32) of the patients were identified as having obvious \u201ctucked chin\u201d (N = 4), \u201ctipped trunk\u201d (N = 9), or both (N = 3). Sacral incidence was the only parameter that was statistically significant change between pre-operative or immediate post-operative measurements (66.9\u00b0 vs. 55.2\u00b0 p = 0.03). However, at final follow-up, the post-operative thoracic kyphosis had decreased over time in those that developed a subsequent sagittal deformity (24.2\u00b0) whereas it increased in those that did not (44.7\u00b0, p = 0.008). This decrease in thoracic kyphosis throughout the instrumented levels, resulted in a greater lordotic imbalance (30.4\u00b0 vs. 5.6\u00b0, p = 0.001) throughout the instrumented levels in the group that developed the subsequent cervical or pelvic sagittal deformities. In conclusion, sagittal plane deformities commonly develop outside the instrumented levels in children with SMA type 2 following posterior spinal instrumentation and may be the result of lordotic imbalance that occurs through continued anterior growth following posterior instrumentation.<\/jats:p>","DOI":"10.3390\/children8080703","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T21:27:45Z","timestamp":1629149265000},"page":"703","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sagittal Plane Deformities in Children with SMA2 following Posterior Spinal Instrumentation"],"prefix":"10.3390","volume":"8","author":[{"given":"Matthew A.","family":"Halanski","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rewais","family":"Hanna","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Bernatz","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Twedt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Sund","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Patterson","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth J.","family":"Noonan","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith","family":"Schultz","sequence":"additional","affiliation":[{"name":"Novartis Gene Therapies, 2275 Half Day Road, Suite 200, Bannockburn, IL 60015, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary K.","family":"Schroth","sequence":"additional","affiliation":[{"name":"Cure SMA, 925 Busse Road, Elk Grove Village, IL 60007, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Sharafinski","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian P.","family":"Hasley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/0960-8966(95)00032-1","article-title":"Spinal muscular atrophy 32nd ENMC International Workshop Naarden, The Netherlands, 10\u201312 March 1995","volume":"6","author":"Munsat","year":"1996","journal-title":"Neuromuscul. 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