Developmental Dysplasia of the Hip (DDH) includes a broad spectrum of hip abnormalities. DDH requires early diagnosis and treatment; however, no international consensus on screening protocol and treatment is provided in the literature. Epidemiological studies are helpful to understand the national variation of a specific surgical procedure and compare it with that of other countries. Data provided by different countries could allow researchers to provide international guidelines for DDH screening and treatment. Limited data are reported regarding trends of hospitalization for DDH, and no public database is available. The purpose of this study was to estimate annual admissions for DDH in Italian patients from 2001 to 2016, based on the hospitalization reports. Data of this study were collected from the National Hospital Discharge Reports (SDO) reported at the Italian Ministry of Health. Descriptive statistical analyses were performed. From 2001 to 2016, 3103 hospitalizations for DDH were recorded in Italy, with a mean incidence of 2.33 (per 100,000 young inhabitants). Females of the 0–4 years old group represented the majority of patients hospitalized for DDH.

Background: The relationship between physical activity and low back pain (LBP) in adolescents is complex, with conflicting evidence on whether activity is protective or a risk factor. The COVID-19 pandemic has introduced new challenges, increasing sedentary behaviors among adolescents. This systematic review updates the evidence on the association between physical activity and LBP in this population, focusing on the impact of the pandemic. Methods: A systematic search of PubMed, Cochrane Library, Web of Science, Medline, and SCOPUS identified observational studies published between January 2011 and December 2023. This review focused on adolescents aged 10 to 19 years, examining the effects of various physical activity levels and types on LBP incidence. Quality assessment was conducted using the ROBINS-I tool. Results: Twelve studies were included, with a total of 78,850 adolescents. The findings suggest a U-shaped relationship between physical activity and LBP, where low and high activity levels increase LBP risk, while moderate activity appears protective. The pandemic exacerbated LBP prevalence, likely due to increased sedentary behavior. Gender differences were noted, with females more likely to report LBP, particularly related to sports participation. Conclusions: Moderate physical activity may protect against LBP in adolescents, whereas both inactivity and excessive activity heighten risk. The pandemic’s impact highlights the need for balanced physical activity to prevent LBP. Further research should explore the long-term effects of these changes.

Background and Objectives: Surgical site infections (SSIs) significantly impact pediatric spinal deformity surgery. Considering the increased risk of Gram-negative infections in neuromuscular scoliosis (NMS), broader antibiotic coverage could be advantageous. Some studies suggest extending this approach to all scoliosis etiologies to reduce SSI rates. This study evaluates whether a dual antibiotic prophylaxis with cephalosporin and aminoglycoside reduces SSI incidence within 90 days postsurgery in adolescent idiopathic scoliosis (AIS), NMS, and syndromic scoliosis (SS) patients. Materials and Methods: This study included pediatric patients with AIS, NMS, or SS curves, treated with posterior spinal fusion between January 2019 and December 2022, with a minimum two-year follow-up. The primary outcome was early SSI incidence and its correlation with dual antibiotic prophylaxis in pediatric scoliosis surgery. Secondary outcomes included operative data, blood loss, hemoglobin levels, hospital stay, complications, pelvic fixation, and radiographic correction and how these factors could be identified as potential risk factors for SSIs. Descriptive and inferential statistics were used to analyze antibiotic regimen, SSI risk, and perioperative variables using chi-square, Mann–Whitney U, ANOVA, and Cox regression. Significance was set at p < 0.05. Results: The study included 296 patients: 222 with AIS, 46 with NMS, and 28 with SS. Ninety days postsurgery, SSI rates were 1.2% in AIS (0.8% deep, 0.4% superficial), 6.5% in NMS (all superficial), and 3.5% in SS (all superficial). Deep SSIs in AIS were associated with methicillin-resistant Staphylococcus aureus (MRSA). None of the cases required implant removal. Univariate Cox regression did not reveal any statistically significant predictors for SSIs. However, older age at surgery showed a protective trend, while higher preoperative ASA scores seemed to be a negative prognostic factor (respectively p = 0.051 and p = 0.08). Conclusions: Dual antibiotic prophylaxis with cefazolin and amikacin was associated with a lower SSI rate after posterior spinal fusion for scoliosis, with no adverse events. Further studies are needed to refine dosage, timing, and duration.

Background/Objectives: Early-onset scoliosis (EOS) frequently requires growth-friendly interventions, such as magnetically controlled growing rods (MCGRs), followed by definitive spinal fusion upon skeletal maturity. The optimal implant density (ID) for final posterior spinal fusion in these patients remains controversial. This study aimed to compare the radiographic, surgical, and economic outcomes associated with high-density (HD) versus low-density (LD) screw constructs in EOS patients previously treated with MCGRs undergoing definitive fusion. Methods: This retrospective study included 27 EOS patients who underwent definitive posterior spinal fusion between January 2017 and September 2022. Participants were categorized into two groups: HD (n = 13) and LD (n = 14). Primary outcomes included coronal and sagittal radiographic parameters assessed at early postoperative and final follow-up visits (minimum of 2 years). The secondary outcomes analyzed were major postoperative complications (grade ≥ IIIB according to Clavien–Dindo–Sink Classification [CDSC]), operative time, blood loss, hospital stay length, and total implant costs. Results: Baseline characteristics between the HD and LD groups were comparable. Early postoperative radiographic assessment demonstrated significantly greater thoracic kyphosis (16.3 ± 7.6° vs. 10.9 ± 14.4°, p = 0.021) and T1-S1 spinal height (43.3 ± 6.7 mm vs. 39.1 ± 4.3 mm, p = 0.039) in the HD group. At final follow-up, only T1-S1 spinal height remained significantly higher in the HD group (45.4 ± 7 mm vs. 39.7 ± 5.1 mm, p = 0.021). Implant costs were significantly higher in the HD group (EUR 6046.5 ± 1146.9 vs. EUR 4376.4 ± 999.4, p < 0.001), while operative time, blood loss, and hospital stay length showed no significant differences. HD constructs had three major complications requiring surgical revision, whereas LD constructs reported no perioperative complications but experienced three late-onset complications also necessitating revision surgery. Conclusions: LD constructs provided comparable long-term radiographic and clinical outcomes to HD constructs, with significantly lower implant-related costs. Despite initial superior kyphosis correction in HD constructs, this benefit diminished by the final follow-up. These findings support a selective, lower-density screw placement strategy to minimize costs and surgical complexity without compromising patient outcomes in EOS undergoing definitive spinal fusion.