Spine deformity最新文献

{"title":"Normatıve sagıttal spınopelvıc profıles: A systematıc revıew of the Roussouly classıfıcatıon across dıfferent ethnıc groups ın asymptomatıc adults.","authors":"Halil Gok, Alim Can Baymurat, Aliekber Yapar, Mehmet Ali Tokgoz, Alpaslan Senkoylu","doi":"10.1007/s43390-026-01398-8","DOIUrl":"https://doi.org/10.1007/s43390-026-01398-8","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically evaluate the normative distribution of sagittal spinopelvic profiles and Roussouly classification types among asymptomatic adults across different ethnic populations, using original, updated, and pelvic incidence (PI)-based classification systems.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Web of Science, and Scopus for studies published between January 2005 and March 2025. Studies were included if they assessed asymptomatic adults, applied Roussouly (original or updated) or PI-based classifications, and reported quantitative spinopelvic data. Eight original studies (n = 2,149) from France, Canada, Turkey, India, China, Argentina, and an international multicenter cohort were included. Methodological quality was evaluated using the Joanna Briggs Institute criteria. Due to significant heterogeneity (I² > 60%), meta-analysis was not performed.</p><p><strong>Results: </strong>The most common sagittal profile was Roussouly type 3 (25. 0%-37. 8%), but substantial variation in type distribution and spinopelvic parameter values was observed between populations and classification systems. The 3AP variant, distinguishable only with updated/PI-based classification, showed high prevalence in Indian and international cohorts (16. 0%-28. 8%).</p><p><strong>Conclusion: </strong>Roussouly type distribution and spinopelvic morphology vary significantly across populations and classification systems in asymptomatic adults. Updated classification systems, together with PI-based interpretative approaches, enable a more nuanced description of sagittal morphology, particularly for the 3AP variant. These normative data support the interpretation of the Roussouly classification as a biomechanical framework for understanding sagittal balance and lumbar lordosis distribution, rather than as a system defining fixed angular surgical targets.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital twins and multimodal artificial intelligence in spine care: a scoping review of concepts, evidence, and translational barriers.","authors":"Samer G Salman, Rohan Phadke, Rahul Kumar, Nasif Zaman, Alireza Tavakkoli","doi":"10.1007/s43390-026-01397-9","DOIUrl":"https://doi.org/10.1007/s43390-026-01397-9","url":null,"abstract":"<p><strong>Purpose: </strong>This scoping review examines current evidence supporting multimodal artificial intelligence, continuous monitoring, and digital twin concepts in spine care. Our primary aims were to (1) characterize the state of digital twin development in spine care, (2) identify key technological and conceptual gaps, and (3) evaluate translational barriers to clinical implementation.</p><p><strong>Methods: </strong>A scoping review was conducted following PRISMA-ScR guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched for studies published between January 2010 and March 2025. Findings were synthesized qualitatively.</p><p><strong>Results: </strong>Twenty-six studies met inclusion criteria. Existing spine prediction models demonstrate modest discrimination and are predominantly static. Imaging-based AI shows weak associations with pain and disability. Wearable sensor monitoring is feasible but lacks consistent evidence for improved outcomes. Spine-specific digital twins remain conceptual, with no prospective validation demonstrating improved decision-making.</p><p><strong>Conclusion: </strong>Multimodal AI-enabled digital twins represent a compelling conceptual framework for personalized spine care, but current evidence does not support clinical superiority or readiness for implementation. Progress will require prospective validation, standardized data integration, and regulatory clarity.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in pain following posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective cohort study.","authors":"Devika A Shenoy, Ian Halliday, Katelyn E Parsons, Chun Xu, Cynthia L Green, Elizabeth Chan, Elizabeth Sachs, Mason Dermott, Robert K Lark, Anthony A Catanzano","doi":"10.1007/s43390-026-01404-z","DOIUrl":"https://doi.org/10.1007/s43390-026-01404-z","url":null,"abstract":"<p><strong>Purpose: </strong>While opioids are commonly prescribed for postoperative pain management, their use is recommended with caution in pediatric populations. In adult populations, patient sex has been identified as a predictor for increased opioid use, and understanding sex-related differences in postoperative pain is important for optimizing analgesia safety in adolescents undergoing posterior spinal fusion for idiopathic scoliosis.</p><p><strong>Methods: </strong>A single-institution retrospective cohort study was conducted on patients < 18 years who underwent corrective surgery for adolescent idiopathic scoliosis (AIS). Variables included patient demographics and socioeconomic factors. Primary outcomes were patient-reported pain scores on a 0-10 scale during the index hospitalization. Secondary outcomes included total inpatient opioid consumption (converted to morphine milligram equivalents), discharge opioid prescriptions, and rates of opioid refills.</p><p><strong>Results: </strong>In total, 266 patients were analyzed, including 188 (71%) females and 78 (29%) males. Female patients reported higher pain across multiple inpatient pain outcomes, including postoperative day 1 (least-squares [LS]-mean difference 0.97, 95% CI 0.41-1.50, p < 0.001), highest inpatient score (LS-mean difference 0.54, 95% CI 0.07-1.00, p = 0.025), and discharge pain score (LS-mean difference 1.10, 95% CI 0.38-1.90, p = 0.003). Descriptively, mean total opioid consumption was higher among males (37.8 ± 20.3 mg vs. 35.4 ± 17.7 mg in females); however, sex was not significantly associated with total opioid use in adjusted models.</p><p><strong>Conclusions: </strong>In our cohort of AIS patients undergoing posterior spinal fusion, female patients reported higher levels of pain during the early postoperative period. Clinicians should be aware of these differences to set appropriate expectations, provide guidance, and develop more personalized pain management strategies to ensure analgesia for all patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal energy balance can predict post-operative spine alignment in Lenke 1 Adolescent Idiopathic Scoliosis.","authors":"Tristan Langlais, Jérôme Sales de Gauzy, Joe Rassi, Mathilde Bony, Baptiste Brun-Cottan, Amandine Eon, Franck Accadbled, Pascal Swider, Pauline Assemat","doi":"10.1007/s43390-026-01353-7","DOIUrl":"https://doi.org/10.1007/s43390-026-01353-7","url":null,"abstract":"<p><strong>Purpose: </strong>The preoperative planning of adolescent idiopathic scoliosis (AIS) remains largely debated. We hypothesized that adopting a biomechanical energetic framework could provide valuable insights for exploring the impact of spinal arthrodesis. Using this approach, we conducted a comparative analysis to quantify discrepancies between in silico simulations derived from preoperative radiographs and the actual three-dimensional spinal alignment obtained from post-operative imaging.</p><p><strong>Methods: </strong>Fifty-two consecutive patients with Lenke Type 1 AIS (mean age: 16 years; mean thoracic Cobb angle: 52°) who underwent posterior spinal fusion were included in the analysis. All patients had complete biplanar radiographs at three time points: preoperatively, post-operatively and at two-year follow-up. Discrepancies between in silico simulated surgery, calculated using preoperative radiographs and a biomechanical model, and actual clinical outcomes were quantified using two metrics: maximum coronal/sagittal deviations (MaxC/MaxS) from T1 to L5, and a comprehensive predictability factor ( <math><msub><mtext>a</mtext> <mtext>c</mtext></msub> </math> and <math><msub><mtext>a</mtext> <mtext>s</mtext></msub> </math> ) measuring cumulative 3D position discrepancies across 17 vertebral levels, normalized by total spinal length.</p><p><strong>Results: </strong>Mean MaxC was 4.7 mm (SD=4.9) and MaxS was 5.7 mm (SD=3.8). Mean values of <math><msub><mi>a</mi> <mtext>c</mtext></msub> </math> were 3.4% (SD=3.8) and <math><msub><mi>a</mi> <mtext>s</mtext></msub> </math> were 4.1% (SD=2.6). Of the cohort, 44 patients (90%) showed very good or good agreement in the coronal in silico simulation and 43 patients (88%) in the sagittal in silico simulation. When the coronal and sagittal results were combined, 38 patients (78%) showed very good or good agreement.</p><p><strong>Conclusion: </strong>The distribution of biomechanical energy obtained from preoperative radiographs is reliable to simulate spine alignment after arthrodesis in a Lenke 1 AIS cohort.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age matters: increased perioperative morbidity in young adults compared to adolescents undergoing posterior spinal fusion for idiopathic scoliosis.","authors":"Vivien Chan, Prudhvi Kodali, Jacqueline Borissov, Luke Maclean, Michael G Vitale, Justin L Reyes, Mehdi Elfilali, Zeeshan M Sardar, David L Skaggs","doi":"10.1007/s43390-026-01396-w","DOIUrl":"https://doi.org/10.1007/s43390-026-01396-w","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare perioperative outcomes between adolescents and young adults undergoing posterior spinal fusion for idiopathic scoliosis using a large clinical registry.</p><p><strong>Methods: </strong>This was a retrospective cohort study using data from the NSQIP and NSQIP-Pediatric databases from 2016 to 2024. Patients aged 10-40 years who underwent posterior spinal fusion for idiopathic scoliosis were included. Two study cohorts were defined: (1) adolescent idiopathic scoliosis (AIS) (10-17 years) and (2) young adult idiopathic scoliosis (YADIS) (18-40 years). Outcomes included operative time, length of stay (LOS), allogeneic transfusion, any adverse event, 30-day readmission, 30-day reoperation, and non-home discharge. Groups were compared using chi-square test and Student's t-test. Multivariable regression analyses were performed controlling for sex, ASA, and number of fusion levels.</p><p><strong>Results: </strong>There were 31,120 AIS patients (mean age 14.5 years) and 439 YADIS patients (mean age 21.9 years). Compared with the AIS cohort, YADIS had significantly longer operative times (AIS: 276.4 min vs YADIS: 353.7 min; p < 0.001) and longer LOS (AIS: 3.4 days vs YADIS: 5.1 days; p < 0.001). The YADIS cohort had higher rates of allogeneic transfusion (AIS: 10.9% vs YADIS: 33.3%; p < 0.001), any adverse event (AIS: 1.6% vs YADIS: 3.0%; p = 0.03), reoperation (AIS: 1.3% vs YADIS: 2.5%; p = 0.03), and non-home discharge (AIS: 0.4% vs YADIS: 2.7%; p < 0.001). There was no significant difference in readmission (AIS: 1.7% vs YADIS: 2.7%; p = 0.10). In multivariable logistic regression analyses, the YADIS cohort had higher odds of allogeneic transfusion (OR 4.8, p < 0.001), reoperation (OR 1.9, p = 0.04), any adverse event (OR 1.8, p = 0.04), and non-home discharge (OR 7.19, p < 0.001). In multivariable linear regression analyses, YADIS was associated with longer operative time (+ 78.9 min, p < 0.001) and length of stay (+ 1.7 days, p < 0.001).</p><p><strong>Conclusion: </strong>Compared with adolescents, young adults undergoing posterior spinal fusion for idiopathic scoliosis experience greater perioperative morbidity and resource utilization. These findings highlight important age-related differences that should be considered during surgical decision-making.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curve progression in female adolescent idiopathic scoliosis with risser grade ≥ 3: incidence, magnitude, and risk factors in a cohort of 915 unbraced female patients.","authors":"Yusuke Setojima, Toshiaki Kotani, Tomoyuki Asada, Shun Okuwaki, Yosuke Ogata, Shuhei Ohyama, Yasushi Iijima, Tsuyoshi Sakuma, Shohei Minami, Seiji Ohtori","doi":"10.1007/s43390-026-01375-1","DOIUrl":"https://doi.org/10.1007/s43390-026-01375-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the magnitude and incidence of curve progression and identify clinical factors independently associated with late-stage progression in untreated female adolescent idiopathic scoliosis (AIS) patients with Risser grade ≥ 3.</p><p><strong>Methods: </strong>This retrospective cohort study included 915 female AIS patients with Risser grade ≥ 3 and a major Cobb angle ≥ 10° without prior treatment. The primary outcome was change in the major Cobb angle (ΔCobb). Patients were additionally divided into the progressive (ΔCobb ≥ 6°) and the non-progressive groups. Multivariable regression analyses were performed to evaluate independent factors associated with curve progression. Covariates included age, months since menarche, body mass index (BMI), residual height growth, and main curve location.</p><p><strong>Results: </strong>Overall, 111 patients (12.1%) experienced clinically significant progression. Multivariable linear regression analysis revealed that lower BMI, lower Risser grade, greater residual height growth, and smaller baseline Cobb angle were independently associated with a greater magnitude of curve progression.　Curve location was a significant predictor, with thoracolumbar curve showing significantly less progression magnitude compared to proximal thoracic curve. Multivariable logistic regression identified lower BMI, lower Risser grade, and greater residual height growth as independent factors associated with clinically significant progression.</p><p><strong>Conclusion: </strong>Despite late-stage skeletal maturity, a clinically significant risk of curve progression persists in female AIS patients with a Risser grade ≥ 3. The Risser sign is insufficient; lower BMI, residual height growth, and specific curve patterns are independent factors of late-stage progression. They should be integrated with skeletal maturity indicators to improve risk stratification and guide management decisions for traditionally low-risk patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The closing triradiate cartilage stage identifies accelerated curve progression in idiopathic scoliosis.","authors":"Hong Zhang, Judy-Mae Lima, Chanhee Jo, Daniel J Sucato","doi":"10.1007/s43390-026-01394-y","DOIUrl":"https://doi.org/10.1007/s43390-026-01394-y","url":null,"abstract":"<p><strong>Purpose: </strong>Triradiate cartilage (TRC) status is commonly used to assess skeletal maturity and progression risk in scoliosis; however, its traditional binary classification as open or closed may inadequately capture critical transitional growth periods. This study aimed to re-evaluate TRC maturation by subdividing it into four stages and to investigate scoliosis progression and growth patterns during the transitional phases.</p><p><strong>Methods: </strong>A retrospective longitudinal study was conducted of 179 patients with idiopathic scoliosis (126 girls, 53 boys) who were followed from childhood through early adolescence. Inclusion criteria were age > 6 years with an open TRC at baseline, initial major Cobb angle < 45° (mean 27.8° ± 10° in girls and 30.3° ± 9.5° in boys), and documented curve progression to ≥ 50° requiring surgical treatment during adolescence. TRC status was classified as open, closing, initial closed, or fully closed based on radiographic appearance and the Risser sign. Cobb progression rate, spine height increase rate, and standing height increase rate were measured and calculated for the open-, closing-, and initial-closed-TRC stages.</p><p><strong>Results: </strong>In both sexes, Cobb progression peaked during the closing-TRC stage, increasing approximately fivefold in girls and more than 30-fold in boys compared with the open-TRC stage (p < 0.0001). Elevated Cobb progression rate persisted into the initial closed-TRC stage. Spine height increase rate did not peak during the closing-TRC and showed a significant inverse correlation with Cobb progression in girls, whereas standing height remained relatively stable and did not correlate with Cobb progression in either sex.</p><p><strong>Conclusion: </strong>The closing-TRC stage represents a critical transitional period associated with accelerated scoliosis progression, independent of overall somatic growth. A four-stage TRC framework may improve early risk stratification and clinical decision-making in skeletally immature patients with idiopathic scoliosis.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of bracing on pulmonary function in adolescent idiopathic scoliosis: a systematic review with meta-analysis.","authors":"Zeinab Rezaeian, Hanieh Khaliliyan, Gillian Yeowell, Ebrahim Sadeghi-Demneh","doi":"10.1007/s43390-026-01389-9","DOIUrl":"https://doi.org/10.1007/s43390-026-01389-9","url":null,"abstract":"<p><strong>Background: </strong>The impact of bracing on pulmonary function in adolescent idiopathic scoliosis (AIS) remains unclear, with prior studies reporting variable findings. Some report short-term reductions during brace wear, whereas long-term impairment has not been consistently demonstrated. To clarify these effects, we conducted a systematic review and meta-analysis of controlled clinical trials.</p><p><strong>Methods: </strong>PubMed, Web of Science, and Scopus were searched from inception to 15 October 2025, following PRISMA 2020 guidelines, along with screening of reference lists. Eligible studies were controlled trials evaluating the effects of bracing on pulmonary parameters in AIS. Two reviewers independently screened and extracted data, evaluated methodological quality using the Cochrane Risk of Bias tool, and performed pooled analyses.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria, involving 548 participants. Pooled findings indicated short-term reductions in several pulmonary measures. Immediate decreases were observed in total lung capacity (SMD = - 0.83, p = 0.01) and functional residual capacity. FVC and FEV₁ showed significant short-term reductions at 1 month (SMD = - 0.68 to - 0.76, p < 0.001), followed by normalization at 2 months, and again a moderate decline at 6 months (SMD = - 0.62, p = 0.007). The FEV₁/FVC ratio was significantly reduced at 6 months (SMD = - 1.05, p = 0.007). Changes in peak expiratory flow and maximum voluntary ventilation were also reported across 1-8 months. Many assessments were conducted in‑brace, suggesting that the observed reductions may reflect transient mechanical restriction, rather than persistent physiological impairment. Out‑of‑brace or longer‑term measurements were generally non‑significant.</p><p><strong>Conclusions: </strong>Current evidence indicates that bracing in AIS may lead to short‑term or in‑brace reductions in lung volumes and ventilatory parameters, while persistent or irreversible impairment after brace removal has not been demonstrated. These findings support a mechanical rather than pathological explanation for most observed changes. Incorporating mitigating strategies, such as respiratory muscle training, may help manage short-term respiratory effects during brace treatment.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-perceived recovery after posterior spinal fusion: evaluating minimum clinically important difference (MCID) in adolescents with idiopathic scoliosis.","authors":"Leila Mehraban Alvandi, J Nicholas Charla, Zachariah Samuel, Edina Gjonbalaj, Mohamed Said, Jorden Xavier, Carolyn Rachofsky, Morgan Roche, Priya Singh, Yungtai Lo, Jacob Schulz, Jaime A Gomez, Eric D Fornari","doi":"10.1007/s43390-026-01374-2","DOIUrl":"https://doi.org/10.1007/s43390-026-01374-2","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) affects 1-3% of children in the United States, with approximately 38,000 patients undergoing posterior spinal fusion (PSF) annually. The relationship between preoperative patient-reported outcomes, postoperative recovery, and long-term clinical significance remains unclear. This study assesses longitudinal changes in Scoliosis Research Society-22r (SRS-22r) scores. It evaluates clinical significance using the Minimum Clinically Important Difference (MCID) in AIS patients undergoing PSF.</p><p><strong>Study design: </strong>Retrospective study using prospectively collected data.</p><p><strong>Methods: </strong>A retrospective study was conducted using prospectively collected data on AIS patients who underwent PSF at a single academic institution between 2012 and 2022. Patient-reported outcomes were assessed using the SRS-22r questionnaire at preoperative, 6-month, 1-year, and ≥ 2 years postoperative time points. MCID threshold achievements were determined using anchor-based criteria from Bago et al. The percentage of patients achieving MCID and predictors of MCID achievement were analyzed using logistic regression.</p><p><strong>Results: </strong>A total of 161 patients (mean age 15.26 ± 2.15 years; 65.8% female) were included. At 1 year, MCID achievement ranged from 30.1% (Self-Image) to 43.4% (Mental Health). By ≥ 2 years, MCID rates declined in Pain (25.9%) and Self-Image (22.8%) but increased in Function/Activity (44.1%). Lower preoperative SRS-22r scores consistently predicted MCID achievement across all domains. A documented mental-health history reduced the likelihood of Pain MCID at 1 year, and larger postoperative Cobb angles independently decreased the odds of achieving Self-Image MCID at both follow-up points. Neighborhood opportunity (Child Opportunity Index) was not associated with outcomes. Sensitivity analyses demonstrated that complete-case ≥ 2 year MCID rates were consistently bounded by best- and worst-case values and closely approximated LOCF estimates, supporting robustness despite attrition.</p><p><strong>Conclusion: </strong>Meaningful postoperative improvement after PSF varies substantially by SRS-22r domain. Pain and mental-health gains occurred early and stabilized, whereas function demonstrated ongoing recovery, and self-image improved rapidly and remained stable. MCID achievement was most likely in patients with greater preoperative symptom burden, while mental-health history and residual postoperative deformity diminished domain-specific improvements. The stability of MCID patterns across sensitivity analyses reinforces the reliability of long-term findings. These results highlight the importance of incorporating psychological assessment, expectation management, and attention to postoperative alignment into perioperative care for AIS patients.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of predictors for proximal junctional kyphosis and failure following all-posterior surgery for adolescent-onset kyphotic deformities.","authors":"Salih Kaya, Sinan Yılar","doi":"10.1007/s43390-026-01390-2","DOIUrl":"https://doi.org/10.1007/s43390-026-01390-2","url":null,"abstract":"<p><strong>Objective: </strong>To identify independent predictors of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) in patients with adolescent-onset kyphotic deformities.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients with kyphotic deformities presenting during adolescence who underwent all-posterior corrective surgery performed by a single experienced spine surgeon between 2015 and 2023. A total of 132 patients met the inclusion criteria. Demographic, radiographic, and surgical variables were collected. Patients were classified as PJK( +) or PJK(-). To address clinical relevance, a secondary analysis further stratified PJK( +) patients into asymptomatic radiographic PJK and a PJF-surrogate group. Group comparisons were performed using Mann-Whitney U and chi-square or Fisher's exact tests. Variables associated with PJK and the PJF-surrogate outcome were entered into multivariable logistic regression models.</p><p><strong>Results: </strong>The median age was 18 years (IQR, 16-22), with 68 females (51.5%) and 64 males (48.5%) and a median follow-up of 52 months (minimum 24 months). PJK developed in 36 of 132 patients (27.2%). Age, immediate postoperative proximal junctional angle (PJA), ΔPJA, and ΔSVA values were significantly higher in the PJK( +) group (all p < 0.05). In multivariable analysis, immediate postoperative PJA and sagittal vertical axis difference (ΔSVA) were independent predictors of PJK, with excellent model discrimination (AUC 0.95). In the secondary analysis, patients meeting PJF-surrogate criteria demonstrated significantly higher immediate postoperative PJA and greater ΔPJA from postoperative to final follow-up (all p < 0.05). Immediate postoperative PJA remained an independent predictor of PJF-surrogate status in multivariable analysis (OR 1.58; p = 0.012).</p><p><strong>Conclusions: </strong>Higher immediate postoperative PJA and ΔSVA were independently associated with the development of PJK. Early postoperative junctional alignment may serve as an indicator of patients at risk for clinically relevant junctional deterioration.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}