{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:16:35Z","timestamp":1757618195324,"version":"3.44.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>The purpose of this study is to evaluate if AR offers improved 3D kyphosis restoration during PSF for hypokyphosis in moderate AIS (&lt;\u200970\u00b0 coronal cobb), where the decision for AR is likely driven by sagittal concerns.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A multicenter pediatric spine registry was queried for hypokyphotic (&lt;\u200910\u00b0) Lenke 1\u20134 AIS patients aged\u2009&lt;\u200920\u00a0years with\u2009&gt;\u20092-year surgical follow-up. Coronal curves were limited to\u2009&lt;\u200970\u00b0. A linear mixed model was created to predict 2-year 3D kyphosis by treatment and pre-op 3D kyphosis, while controlling for age, sex, thoracic coronal deformity and flexibility, osteotomy use, implant characteristics, surgery recency, and surgeon.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>1384 patients were included with 53 (3.8%) undergoing PSF\u2009+\u2009AR. Mean preop 3D kyphosis was similar between PSF and PSF\u2009+\u2009AR groups (\u2212\u00a03.7\u00b0 vs. \u2212\u00a00.5\u00b0; <jats:italic>p<\/jats:italic>\u2009=\u20090.08). PSF-AR had similar 2-year 3D kyphosis (23.0\u00b0 [95% CI 20.5\u201325.4\u00b0] vs. 23.3\u00b0 [22.9\u201323.6\u00b0]) and correction (26.7\u00b0 [23.3\u201329.9\u00b0] vs. 23.7\u00b0 [23.3\u201324.2\u00b0]) compared to PSF. When controlling for covariates, the models demonstrated no difference between approach (<jats:italic>p<\/jats:italic>\u2009=\u20090.058) or interaction of approach and preop 3D kyphosis (p\u2009=\u20090.31). Post-hoc power analysis showed an adequate sample size to detect a difference of 5\u00b0 between approaches. PSF\u2009+\u2009AR had longer surgical times (324 vs. 266\u00a0min, p\u2009&lt;\u20090.001) though no significant increase in overall complications (17% vs. 12.4%) compared to PSF alone.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In AIS patients with coronal curve\u2009&lt;\u200970\u00b0 and 3D hypokyphosis of 10 to \u2212\u00a040\u00b0, treatment with PSF\u2009+\u2009AR did not improve 2-year sagittal correction more than PSF alone. Surgeon identity and surgery recency influenced post-operative kyphosis more than any other patient or surgical factor.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s43390-025-01119-7","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:32:29Z","timestamp":1748910749000},"page":"1465-1475","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anterior release is not needed to restore kyphosis in moderate AIS with hypokyphosis"],"prefix":"10.1007","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4450-4502","authenticated-orcid":false,"suffix":"Jr","given":"Craig R.","family":"Louer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6070-3205","authenticated-orcid":false,"given":"Jacquelyn S.","family":"Pennings","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maty","family":"Petcharaporn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9671-7713","authenticated-orcid":false,"given":"Arun R.","family":"Hariharan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2526-4489","authenticated-orcid":false,"given":"John S.","family":"Vorhies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-7406","authenticated-orcid":false,"given":"Michael P.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4885-0138","authenticated-orcid":false,"given":"Suken A.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9437-7973","authenticated-orcid":false,"given":"Peter O.","family":"Newton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9236-2284","authenticated-orcid":false,"given":"Burt","family":"Yaszay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harms Study","family":"Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"1119_CR1","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.2106\/JBJS.O.00148","volume":"97","author":"PO Newton","year":"2015","unstructured":"Newton PO, Fujimori T, Doan J, Reighard FG, Bastrom TP, Misaghi A (2015) Defining the \u201cThree-dimensional sagittal plane\u201d in thoracic adolescent idiopathic scoliosis. 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Authors not listed do not have interests to disclose. Craig Louer, J&J Med Tech: d\u2014speaker\u2019s bureau. Highridge Medical: d\u2014speaker\u2019s bureau. Globus Medical: a\u2014grants\/research support, d\u2014speaker\u2019s bureau. Orthopediatrics: b\u2013consultant. Arun Hariharan. Biedermann Motech: b\u2014consultant. Globus Medical: a\u2014grants\/research support, d\u2014speaker\u2019s bureau. Medtronic: b\u2014consultant. Highridge Medical: d\u2014speaker\u2019s bureau. Michael Kelly, Wolters Kluwer Publishers: g\u2014other financial or material support (royalties, patents, etc.). Suken Shah, J&J Med Tech: a-grants\/research support, b-consultant, g-royalties. Setting Scoliosis Straight Foundation (Harms Study Group): a-grants\/research support, e-board\/committee positions. Fox VCR Study Group: a-grants\/research support. Pediatric Spine Study Group: a-grants\/research support. Pediatric Orthopaedic Society of North America: e-board\/committee positions. Scoliosis Research Society: e-board\/committee positions. Peter Newton, J&J Med Tech: g\u2014other financial or material support (royalties, patents, etc.). Globus Medical: b\u2014consultant. Pacira Biosciences: b\u2014consultant, d\u2014speaker\u2019s bureau. Stryker Spine, Inc.: b\u2014consultant, g\u2014other financial or material support (royalties, patents, etc.). SeeAllAI: e\u2014advisory board or panel, g\u2014other financial or material support (royalties, patents, etc.). Burt Yaszay, Globus Medical: g\u2014other financial or material support (royalties, patents, etc.). J&J Med Tech: b\u2014consultant. Pacira Biosciences: b\u2014consultant. Orthopediatrics: g\u2014other financial or material support (royalties, patents, etc.). Stryker Spine, Inc.: b\u2014consultant, g\u2014other financial or material support (royalties, patents, etc.)","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"All sites participating in this multi-center prospective study have local institutional IRB approval. Data queries of the aggregate data are covered under the HSG central IRB approval: Study Title: Idiopathic Scoliosis Outcomes Database Registry (IRB 20080702).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patient-specific data were collected in a prospective manner following the patient and parent informed consent process.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}