Day: July 4, 2025

Failure to replace removed growth friendly implants results in deteriorating radiographic outcomes

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In a registry-based comparative cohort study (early onset scoliosis patients after implant removal) Matan S Malka et al. from the Morgan Stanley Children’s Hospital (Columbia Univ, New York). Arkansas Children’s Hospital; Shriners Philadelphia; Seattle Children’s Hosp. published in Spine Deformity Journal, to evaluate if re-implanting growth-friendly constructs within 12 months after implant removal (ROI) stabilizes deformity compared to observation-only. Early re-implantation (< 12 mo post-ROI) significantly reduces 2‑year coronal Cobb progression compared to no replacement 1).

Critical Review

– Strengths:

Multicenter registry with well-defined exposure groups.

Radiographic outcomes measured at a meaningful 2‑year follow-up.

Statistically robust with p-values: Cobb 81° vs 53° (p=0.003); progression ≥5°: 64% vs 30% (p=0.04)

– Limitations:

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Evaluation of Interstitial Fluid Volume and Diffusivity in Patients With Idiopathic Normal Pressure Hydrocephalus Using Spectral Diffusion Analysis

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In a retrospective cohort Ishida *et al.* from the University hospitals—centres in Tokyo, (e.g., Tokyo Metropolitan Geriatric Center) published in the *Journal of Magnetic Resonance Imaging* to compare interstitial fluid volume fraction (Fint) and diffusivity (Dint), derived via spectral diffusion analysis, between idiopathic normal pressure hydrocephalus (iNPH) patients and healthy controls (HCs). In iNPH patients, spectral diffusion analysis revealed increased Fint and Dint in periventricular hyperintensity (PVH) regions of the centrum semiovale (CSO) and frontal white matter (FWM), while regions outside PVH did not differ from HCs 1).

Critical Review

* Strengths:

  • Utilizes advanced spectral diffusion with non‑negative least squares to separate Interstitial Fluid Dynamics an innovative approach.
  • Well‑defined region‑based ROI analysis including CSO, FWM, lenticular nucleus (LN).
  • Robust statistical treatment via Kruskal–Wallis with Dunn’s test; Spearman’s for correlations.

* Limitations & Concerns:

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