{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:42:00Z","timestamp":1791013320992,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: This is a retrospective study. The aim of this study is to report the results of bipolar minimally invasive fusionless surgery for scoliosis in Rett syndrome with a minimum follow-up of 2 years. Conservative treatment is often not effective in Rett syndrome scoliosis. Posterior spinal fusion (PSF) has a high rate of complications; early surgery using traditional growing rods (TGRs) controls the deformity while preserving spinal and thoracic growth before arthrodesis. The need for surgical rod lengthening still has a high rate of complications and costs. Methods: We recorded the clinical and radiological outcomes of 22 consecutive patients with Rett scoliosis who underwent bipolar fusionless surgery with a mean follow-up of 56 months (24\u201399). We performed a bilateral construct with rods (with or without a self-sliding device) anchored proximally with four hook claws distally to the pelvis by ilio-sacral (IS) screws through a minimally invasive approach. Results: The Cobb angle was reduced from 74.4\u00b0 initially to 28.9\u00b0 postoperatively and to 25.7\u00b0 at the last follow-up, which corresponds to a 65% correction of the initial deformity. The gain was maintained at the last follow-up. None of the patients required spinal fusion at skeletal maturity (55% of our patients reached skeletal maturity). There was a gain in body weight (27.97 kg at preoperative time and 33.04 kg at postoperative time). The surgical complication rate was 32%. Conclusions: We recorded the stable correction of deformities and weight gain over time using the bipolar minimally invasive fusionless technique with a reduced rate of complication compared to arthrodesis. The arthrodesis was not necessary at skeletal maturity, thanks to the delayed natural ankylosis of a fixed spine.<\/jats:p>","DOI":"10.3390\/jcm14030849","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T08:57:48Z","timestamp":1738054668000},"page":"849","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Minimally Invasive Bipolar Technique for Scoliosis in Rett Syndrome\u2014Results and Complications in a Series of 22 Cases"],"prefix":"10.3390","volume":"14","author":[{"given":"Alice","family":"Del Sal","sequence":"first","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9066-6457","authenticated-orcid":false,"given":"Edouard","family":"Haumont","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"},{"name":"Faculty of Medicine, Universit\u00e9 Libre de Bruxelles, 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0683-9520","authenticated-orcid":false,"given":"Manon","family":"Pigeolet","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"},{"name":"Faculty of Medicine, Universit\u00e9 Libre de Bruxelles, 1050 Brussels, Belgium"},{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-0545","authenticated-orcid":false,"given":"Mathilde","family":"Gaume","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Riouallon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, H\u00f4pital Saint Joseph, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Bahi Buisson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Linglart","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, H\u00f4pital Universitaire Kremlin Bicetre, Paris Saclay University, 94270 Le Kremlin Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Desguerre","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5581-4699","authenticated-orcid":false,"given":"Stephanie","family":"Pannier","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotfi","family":"Miladi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, H\u00f4pital Universitaire Necker\u2014Enfants Malades, Paris Cit\u00e9 University, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"ref_1","first-page":"723","article-title":"Uber ein eigenartiges hirnatrophisches Syndrom bei Hyperammon\u00e4mie im Kindersalter [On a unusual brain atrophy syndrome in hyperammonemia in childhood]","volume":"116","author":"Rett","year":"1966","journal-title":"Wien. 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