{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:41:25Z","timestamp":1792734085173,"version":"4.5.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National University Ireland, Galway"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Selective posterior thoracic fusion (sPTF) for Lenke 1\/2 adolescent idiopathic scoliosis (AIS) aims to reconcile multi-planar correction with motion preservation. Nevertheless, postoperative coronal imbalance (CIB) frequently compromises these objectives. This study developed an interpretable machine learning architecture to stratify CIB risk and identify key predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 282 patients were analyzed. Following dual-stage dimensionality reduction (Boruta and LASSO) on 24 candidate predictors, ten machine learning architectures were trained and evaluated using split-sample internal validation. Model efficacy was evaluated via area under the curve (AUC), Brier score, and decision curve analysis, using SHapley Additive exPlanations (SHAP) framework for algorithmic transparency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The LightGBM model demonstrated favorable performance, achieving peak AUC of 0.885 (training) and 0.824 (internal validation). SHAP identified three key predictors: the spatial relationship between the lowest instrumented vertebra and the last substantially touching vertebra (LIV-LSTV), regional lumbar adaptability (Lumbar Modifier), and skeletal maturity (Risser grade). Lower LIV-LSTV values, Lumbar Modifiers C, and lower Risser grades were associated with a higher predicted risk of CIB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This framework incorporates information on distal instrumentation selection, lumbar curve morphology, and skeletal maturity. The model may provide a preliminary basis for future preoperative CIB risk estimation and support a more informed assessment of the trade-off between deformity correction and preservation of lumbar motion segments. Independent external validation is required before the model can be used to guide surgical decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-026-06953-6","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T01:09:03Z","timestamp":1784336943000},"page":"2963-2975","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting postoperative coronal imbalance in Lenke 1\/2 adolescent idiopathic scoliosis: A machine learning model with clinical interpretability"],"prefix":"10.1007","volume":"50","author":[{"given":"Tao","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaofeng","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sha","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"6953_CR1","doi-asserted-by":"publisher","unstructured":"Rose PS, Lenke LG (2007) Classification of operative adolescent idiopathic scoliosis: treatment guidelines. 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