Eduardo Muscogliati

A recent trend in healthcare education has been the increasing emphasis on the development of humanism and empathy in students. Within anatomy education, some institutions have implemented curricular innovations such as donor non‐anonymization to facilitate this development. This systematic review aims to evaluate the existing literature on donor non‐anonymization, with a particular focus on its potential humanistic and educational impacts on students. A comprehensive search was conducted across eight databases on the 27th of June 2024, yielding 3516 studies after duplicate removal. Following a two‐stage screening process and independent review, 11 studies met inclusion criteria. These were assessed for quality using the Medical Education Research Study Quality Instrument and the Critical Appraisal Skills Programme Qualitative Checklist. Given the qualitative nature of the data, a thematic analysis was conducted, identifying three overarching themes: students' emotional responses, reciprocity to the community and empathy, and the impact of non‐anonymization on learning. Of the included studies, nine were deemed high quality, one medium, and one low quality and were weighed accordingly during analysis. Overall, non‐anonymization was associated with positive outcomes, including greater emotional engagement, enhanced empathy, and deeper motivation to learn. Optional participation in non‐anonymization anatomy programs appeared beneficial for accommodating varied emotional responses among students. However, due to limitations of included studies and potential cultural variability, findings should be interpreted with caution. Further longitudinal research is needed to better understand the long‐term educational and professional impacts of donor non‐anonymization in anatomy education.

Objectives To determine how often adult spinal deformity (ASD) surgery meets preoperative sagittal alignment goals and whether these corrections are durable over time, including the impact of planning frameworks and enabling technologies. Methods We performed a PRISMA-guided search of MEDLINE, EMBASE, Web of Science, Cochrane Library, and Scopus through June 2025. Eligible studies enrolled adults undergoing ASD surgery where preoperative alignment targets were defined by numeric thresholds (e.g., SVA, PI–LL, PT), algorithmic frameworks (e.g., Roussouly, GAP), or technology-assisted modalities (e.g., virtual surgical planning/patient-specific rods/robotics/custom implants). Outcomes included plan-to-achieved alignment fidelity, longitudinal maintenance of targets, mechanical complications, and PROMs. Risk of bias was assessed with ROBINS-I. When data were sufficiently homogeneous, random-effects meta-analyses were performed for commonly reported targets (SVA < 5 cm, PI–LL ≤ 10°, PT ≤ 20°). Results Fifteen unique studies (Fig. 1) from 2006–2025 encompassing ~ 1,980 patients reported outcomes for achieving preoperative alignment goals in ASD. Cohort sizes ranged from 15 to 608; among cohorts reporting demographics, mean age was 65 years (range means 58–72) with 68% female (57–80%). Mean follow-up was 20 months (immediate postoperative to 5 years). Across studies, most patients achieved early postoperative targets for SVA, PI–LL and/or PT, though durability attenuated on longer follow-up in several cohorts. Algorithm-driven planning—particularly restoration to a Roussouly-consistent profile—was associated with lower mechanical complication rates, while technology-assisted approaches (virtual planning/patient-specific rods/custom implants/robotics) generally improved plan-to-achieved fidelity; translation to superior PROMs was inconsistent. Overall study quality varied: several small, single-center series were at higher risk of bias, whereas multicenter prospective cohorts showed lower risk but remained heterogeneous in definitions, targets, and follow-up windows. Prisma chart [17] Conclusions Adult spinal deformity surgery reliably achieves planned sagittal alignment early postoperatively, but long-term durability is variable. Pelvic tilt is the most difficult parameter to correct and maintain, with loss of correction by one to two years. Alignment strategies emphasizing restoration of physiologic sagittal profile, particularly Roussouly-based frameworks, show superior long-term maintenance and fewer mechanical failures than isolated numeric targets. Although patient-reported outcomes improve consistently, enabling technologies enhance alignment fidelity without consistent incremental PROM benefit. Future studies should prioritize profile-driven, patient-specific planning and assess durability and patient-centered outcomes beyond two years in prospective multicenter cohorts.

Background While the primary goal of treating Adolescent Idiopathic Scoliosis (AIS) is curve correction, long-term psychological and sexual outcomes are rarely examined. This systematic review evaluates whether bracing or surgical treatment affects sexual health, body image, and psychological well-being compared to healthy controls. Methods A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and CENTRAL were searched up to November 2024 for studies assessing sexual and psychological outcomes in AIS patients treated with bracing or surgery. Inclusion criteria encompassed observational and interventional studies with validated outcome tools. Risk of bias was assessed using the ROBINS-I tool. Results Nine studies involving 3231 participants were included. Among 1085 AIS patients (average age at treatment 15.6 years; female-to-male ratio 18:1), 498 underwent bracing and 587 underwent surgery. Meta-analyses demonstrated that AIS patients had significantly lower sexual function (FSFI: SMD = 0.54, 95% CI: 0.29–0.80), higher sexual distress (FSDS: SMD = 0.76, 95% CI: 0.21–1.32), and reduced sexual satisfaction (GSSI: SMD = 0.39, 95% CI: 0.10–0.74) compared to controls, with low heterogeneity across outcomes (I² = 0%). Narrative synthesis further revealed higher rates of body image dissatisfaction and reduced self-esteem among AIS patients. Surgically treated individuals showed marginally better sexual satisfaction than braced patients, though differences in psychological and intimacy outcomes were inconsistent. Physical limitations and pain-related sexual dysfunction were noted across both treatment groups. Conclusion AIS treatment may influence long-term sexual and psychological health, particularly among brace-treated patients. While surgical intervention may offer modest benefits, evidence remains limited. These outcomes should be incorporated into AIS follow-up and future research, emphasizing patient-centred care.