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Dr. Noelle Larson from Mayo Clinic joins the show to discuss her recent research.  We discuss pearls and pitfalls of RCTs in orthopedics when discussing her famed Minimize Implants Maximize Outcomes study. We discuss new ways for eliciting patient and family surgery preferences with regards to VBT vs. PSF choices. We also touch on the evolving role of AI in pediatric orthopedics and enabling technologies such as navigation-assisted surgery. Highlights from the lightning round include long-term Dega osteotomy outcomes and some impressive results from Halo-Pelvic traction for severe spine deformities. Your hosts are Craig Louer from Vanderbilt, Carter Clement from Children’s Hospital of New Orleans, and Josh Holt from University of Iowa. Music by A. A. Alto.

Nov 2023 Show Notes – Noelle Larson

Main Event

The Effect of Implant Density on Adolescent Idiopathic Scoliosis Fusion: Results of the Minimize Implants Maximize Outcomes Randomized Clinical Trial. The Journal of Bone and Joint Surgery ():10.2106/JBJS.23.00178, November 16, 2023. | Larson, A. Noelle MD1,a,*; Polly, David W. MD2,*; Sponseller, Paul D. MD3; Kelly, Michael P. MD, MSc4; Richards, B. Stephens MD5; Garg, Sumeet MD6; Parent, Stefan MD, PhD7; Shah, Suken A. MD8; Weinstein, Stuart L. MD9; Crawford, Charles H. MD10; Sanders, James O. MD11; Blakemore, Laurel C. MD12; Oetgen, Matthew E. MD13; Fletcher, Nicholas D. MD14; Kremers, Walter K. PhD15; Marks, Michelle C. PT, MA16; Brearley, Ann M. PhD17; Aubin, Carl-Eric PhD18; Sucato, Daniel J. MD, MS5; Labelle, Hubert MD7; Erickson, Mark A. MD6;  the Minimize Implants Maximize Outcomes Study Group†

Non-Fusion Versus Fusion Surgery in Pediatric Idiopathic Scoliosis: What Trade-Offs in Outcomes Are Acceptable for the Patient and Family?

A Noelle Larson, Michelle Claire Marks, Juan Marcos Gonzalez Sepulveda, Peter O Newton, Vincent J Devlin, Raquel Peat, Michelle E Tarver, Olufemi Babalola, Allen L Chen, David Gebben, Patrick Cahill, Suken Shah, Amer Samdani, Keith Bachmann, Baron Lonner

Journal of Bone and Joint Surgery. American Volume 2023 November 10

Radiation exposure in navigated techniques for AIS: is there a difference between pre-operative CT and intraoperative CT?

Mikaela H Sullivan, Lifeng Yu, Beth A Schueler, Ahmad Nassr, Julie Guerin, Todd A Milbrandt, A Noelle Larson

Spine Deformity 2023 October 24

• Settings on the intraoperative scanner typically were 80 kV, 20 mA, and 20 mAs, but occasionally 70 kV, 16 mA, and 64 mAs for patients < 60 kgs.

Automated Measurements of Interscrew Angles in Vertebral Body Tethering Patients with Deep Learning.

Kellen L Mulford, Christina Regan, Charles P Nolte, Zachariah W Pinter, Todd A Milbrandt, A Noelle Larson

Spine Journal : Official Journal of the North American Spine Society 2023 September 28

Lightning Round

Twelve to Twenty-year Follow-up of Dega Acetabuloplasty in Patients With Developmental Dysplasia of the Hip: Is it as Effective as Expected?

Murat Danişman, Gökay Dursun, İsmail Aykut Koçyiğit, Caglar Yilgor, Mehmet Cemalettin Aksoy

Journal of Pediatric Orthopedics 2023 November 2

Evaluation of Pulmonary Function After Halo-Pelvic Traction for Severe and Rigid Kyphoscoliosis Utilizing CT with 3D Reconstruction.

Lijin Zhou, Hanwen Zhang, Honghao Yang, Zhangfu Li, Chaofan Han, Yiqi Zhang, Yong Hai

Journal of Bone and Joint Surgery. American Volume 2023 September 22