{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:48:58Z","timestamp":1782935338433,"version":"3.54.5"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004212","name":"P\u00e4ivikki ja Sakari Sohlbergin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004212","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Vappu Uusp\u00e4\u00e4 Foundation"},{"DOI":"10.13039\/501100005609","name":"University of Turku","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005609","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) is a condition-specific instrument to assess health-related quality of life in children with early-onset scoliosis (EOS). Previous studies have raised concerns regarding ceiling effects, i.e. clustering of scores at the upper limit, which may reduce the ability of the EOSQ-24 to detect clinical improvements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A structured review of published clinical studies reporting EOSQ-24 scores was performed. Data were standardized to a 0\u2013100 scale. For each domain weighted mean scores, standard deviations (SD), and ceiling effect percentages were calculated. A ceiling effect\u2009\u2265\u200915% was considered significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 16 studies were included. Significant ceiling effects were observed in the following domains: pulmonary function (28%), physical function (25%), overall satisfaction (22%), transfer (20%), financial burden (22%), daily living (18%), fatigue\/energy level (18%), and emotion (16%). Lower ceiling effects were noted in general health, pain\/discomfort, parental burden, and child\/parent satisfaction domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Eight of EOSQ-24 domains exhibit marked ceiling effects, potentially limiting responsiveness to treatment effects in patients with high baseline function. These findings support consideration of revised scoring strategies or adjunctive measures in EOS outcome assessment. The presence of marked ceiling effect should be noted as a limitation in studies. Objective pulmonary function testing should be implemented in future studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-026-01293-2","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T11:26:08Z","timestamp":1769858768000},"page":"1417-1422","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ceiling effects in the EOSQ-24 may limit its ability to assess treatment outcomes in early-onset scoliosis"],"prefix":"10.1007","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-8491","authenticated-orcid":false,"given":"Antti Juhani","family":"Saarinen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"1293_CR1","doi-asserted-by":"publisher","first-page":"144","DOI":"10.3171\/2019.1.PEDS18704","volume":"38","author":"H Matsumoto","year":"2018","unstructured":"Matsumoto H, Williams B, Park HY, Yoshimachi JY, Roye BD, Roye JDP, Akbarnia BA, Emans J, Skaggs D, Smith JT, Li Y, Burke MC, Gagnier J, Caird MS, Farley FA, Hanbali Y, Perry T, Hanif A, Matsomotu H, Musmar H, Bader K, Ahmad AA, Mladenov K, Braunschweig L, Behrend J, Lorenz HM, von Deimling U, Hell AK, Matsumoto H, Williams B, Park HY, Yoshimachi JY, Roye BD, Roye JDP, Akbarnia BA, Emans J, Skaggs D, Smith JT (2018) The final 24-item early onset scoliosis questionnaires (EOSQ-24): validity, reliability and responsiveness. J Pediatr Orthop 38:144. https:\/\/doi.org\/10.3171\/2019.1.PEDS18704","journal-title":"J Pediatr Orthop"},{"key":"1293_CR2","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.2106\/JBJS.M.00253","volume":"96","author":"BA Williams","year":"2014","unstructured":"Williams BA, Matsumoto H, McCalla DJ, Akbarnia BA, Blakemore LC, Betz RR, Flynn JM, Johnston CE, McCarthy RE, Roye JDP (2014) Development and initial validation of the Classification of Early-Onset Scoliosis (C-EOS). JBJS 96:1359\u20131367","journal-title":"JBJS"},{"key":"1293_CR3","doi-asserted-by":"publisher","first-page":"803","DOI":"10.2106\/JBJS.20.00819","volume":"103","author":"BA Ramo","year":"2021","unstructured":"Ramo BA, McClung A, Jo CH, Sanders JO, Yaszay B, Oetgen ME (2021) Effect of etiology, radiographic severity, and comorbidities on baseline parent-reported health measures for children with early-onset scoliosis. J Bone Jt Surg 103:803\u2013811. https:\/\/doi.org\/10.2106\/JBJS.20.00819","journal-title":"J Bone Jt Surg"},{"key":"1293_CR4","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jclinepi.2006.03.012","volume":"60","author":"CB Terwee","year":"2007","unstructured":"Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, Bouter LM, de Vet HCW (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34\u201342","journal-title":"J Clin Epidemiol"},{"key":"1293_CR5","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1007\/s43390-024-00861-8","volume":"12","author":"H Haapala","year":"2024","unstructured":"Haapala H, Salonen A, Suominen E, Syv\u00e4nen J, Repo J, Matsumoto H, Ahonen M, Helenius I, Saarinen A (2024) Reliability and validity of the adapted Finnish version of the early onset scoliosis questionnaire (EOSQ-24). Spine Deform 12:1137\u20131143. https:\/\/doi.org\/10.1007\/s43390-024-00861-8","journal-title":"Spine Deform"},{"key":"1293_CR6","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1097\/BPO.0000000000000378","volume":"35","author":"HG Demirkiran","year":"2015","unstructured":"Demirkiran HG, Kinikli GI, Olgun ZD, Kamaci S, Yavuz Y, Vitale MG, Yazici M (2015) Reliability and validity of the adapted Turkish version of the early-onset scoliosis-24-item questionnaire (EOSQ-24). J Pediatr Orthop 35:804\u2013809","journal-title":"J Pediatr Orthop"},{"key":"1293_CR7","doi-asserted-by":"publisher","DOI":"10.1051\/sicotj\/2019001","author":"Y Hanbali","year":"2019","unstructured":"Hanbali Y, Perry T, Hanif A, Matsomotu H, Musmar H, Bader K, Ahmad AA (2019) Reliability and validity of the Arabic version of the Early Onset Scoliosis 24 Items Questionnaire (EOSQ-24). SICOT J. https:\/\/doi.org\/10.1051\/sicotj\/2019001","journal-title":"SICOT J"},{"key":"1293_CR8","doi-asserted-by":"publisher","first-page":"513","DOI":"10.21037\/tp-19-177","volume":"9","author":"Z Li","year":"2020","unstructured":"Li Z, Yue Y, Matsumoto H, Vitale MG, Roye JDP, Song X, Xu N (2020) Reliability and validity of the simplified Chinese version of the Early Onset Scoliosis-24-Item Questionnaire (EOSQ-24). Transl Pediatr 9:513","journal-title":"Transl Pediatr"},{"key":"1293_CR9","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1007\/s43390-025-01064-5","volume":"13","author":"I Green-Petersen","year":"2025","unstructured":"Green-Petersen I, Cheng T, Blixt S, Gerdhem P (2025) Translation and validation of the Swedish version of the early-onset scoliosis 24-item questionnaire. Spine Deform 13:1253\u20131261. https:\/\/doi.org\/10.1007\/s43390-025-01064-5","journal-title":"Spine Deform"},{"key":"1293_CR10","doi-asserted-by":"publisher","first-page":"123","DOI":"10.4055\/cios24210","volume":"17","author":"CJ Hwang","year":"2025","unstructured":"Hwang CJ, Chang SY, Park K-B, Lee D-H, Cho JH, Matsumoto H, Park S (2025) Validation of the Korean version of the 24-item early-onset scoliosis questionnaire: a multicenter study from the Korean Research Society of Spinal Deformity. Clin Orthop Surg 17:123\u2013129. https:\/\/doi.org\/10.4055\/cios24210","journal-title":"Clin Orthop Surg"},{"key":"1293_CR11","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/1471-2288-14-135","volume":"14","author":"X Wan","year":"2014","unstructured":"Wan X, Wang W, Liu J, Tong T (2014) Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range. BMC Med Res Methodol 14:135","journal-title":"BMC Med Res Methodol"},{"key":"1293_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2024.111308","author":"A Saarinen","year":"2024","unstructured":"Saarinen A, Pakarinen O, Vaajala M, Liukkonen R, Ponkilainen V, Kuitunen I, Uimonen M (2024) Randomized controlled trials reporting patient-reported outcomes with no significant differences between study groups are potentially susceptible to unjustified conclusions\u2014a systematic review. J Clin Epidemiol. https:\/\/doi.org\/10.1016\/j.jclinepi.2024.111308","journal-title":"J Clin Epidemiol"},{"key":"1293_CR13","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/j.spinee.2020.11.007","volume":"21","author":"JVC Lemans","year":"2021","unstructured":"Lemans JVC, Wijdicks SPJ, Castelein RM, Kruyt MC (2021) Spring distraction system for dynamic growth guidance of early onset scoliosis: two-year prospective follow-up of 24 patients. Spine J 21:671\u2013681. https:\/\/doi.org\/10.1016\/j.spinee.2020.11.007","journal-title":"Spine J"},{"key":"1293_CR14","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1007\/s43390-020-00175-5","volume":"8","author":"H Matsumoto","year":"2020","unstructured":"Matsumoto H, Auran E, Fields MW, Hung CW, Hilaire TS, Roye B, Sturm P, Garg S, Sanders J, Oetgen M, Levine S, Roye D, Vitale M (2020) Serial casting for early onset scoliosis and its effects on health-related quality of life during and after discontinuation of treatment. Spine Deform 8:1361\u20131367. https:\/\/doi.org\/10.1007\/s43390-020-00175-5","journal-title":"Spine Deform"},{"key":"1293_CR15","doi-asserted-by":"publisher","first-page":"554","DOI":"10.14444\/8253","volume":"16","author":"A Sleem","year":"2022","unstructured":"Sleem A (2022) Health-related quality of life assessment in idiopathic early-onset scoliosis treated by serial Mehta casting. Int J Spine Surg 16:554\u2013558. https:\/\/doi.org\/10.14444\/8253","journal-title":"Int J Spine Surg"},{"key":"1293_CR16","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1007\/s43390-022-00572-y","volume":"11","author":"KA Shaw","year":"2023","unstructured":"Shaw KA, Ramo B, McClung A, Thornberg D, Yazsay B, Sturm P, Jo C-H, Oetgen ME (2023) Impact of surgical treatment on parent-reported health related quality of life measures in early-onset scoliosis: stable but no improvement at 2 years. Spine Deform 11:213\u2013223. https:\/\/doi.org\/10.1007\/s43390-022-00572-y","journal-title":"Spine Deform"},{"key":"1293_CR17","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1007\/s43390-023-00777-9","volume":"12","author":"JVC Lemans","year":"2024","unstructured":"Lemans JVC, Top A, Tabeling CS, Scholten EP, Stempels HW, Schl\u00f6sser TPC, Castelein RM, Kruyt MC (2024) Health-related quality of life in early onset scoliosis patients treated with the spring distraction system: what to expect in the first 2 years after surgery. Spine Deform 12:489\u2013499. https:\/\/doi.org\/10.1007\/s43390-023-00777-9","journal-title":"Spine Deform"},{"key":"1293_CR18","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002988","author":"A Saarinen","year":"2025","unstructured":"Saarinen A, Andras L, Boachie-Adjei O, Cahill P, Guillaume T, Snyder B, Sponseller P, Sturm P, Vitale M, Helenius I (2025) High preoperative body mass index is associated with implant breakage in patients treated with magnetically controlled growing rods for early-onset scoliosis. J Pediatr Orthop. https:\/\/doi.org\/10.1097\/BPO.0000000000002988","journal-title":"J Pediatr Orthop"},{"key":"1293_CR19","doi-asserted-by":"publisher","first-page":"e390","DOI":"10.1097\/BPO.0000000000002096","volume":"42","author":"H Matsumoto","year":"2022","unstructured":"Matsumoto H, Fano AN, Ball J, Roye BD, George A, Garg S, Erickson M, Samdani A, Skaggs D, Roye DP, Vitale MG (2022) Uncorrected pelvic obliquity is associated with worse health-related quality of life (HRQoL) in children and their caregivers at the end of surgical treatment for early onset scoliosis (EOS). J Pediatr Orthop 42:e390\u2013e396. https:\/\/doi.org\/10.1097\/BPO.0000000000002096","journal-title":"J Pediatr Orthop"},{"key":"1293_CR20","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s43390-020-00173-7","volume":"9","author":"H Matsumoto","year":"2021","unstructured":"Matsumoto H, Skaggs DL, Akbarnia BA, Pawelek JB, Hilaire TS, Levine S, Sturm P, Perez-Grueso FJS, Luhmann SJ, Sponseller PD, Smith JT, White KK, Vitale MG (2021) Comparing health-related quality of life and burden of care between early-onset scoliosis patients treated with magnetically controlled growing rods and traditional growing rods: a multicenter study. Spine Deform 9:239\u2013245. https:\/\/doi.org\/10.1007\/s43390-020-00173-7","journal-title":"Spine Deform"},{"key":"1293_CR21","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/BPO.0000000000002006","volume":"42","author":"BD Roye","year":"2022","unstructured":"Roye BD, Fano AN, Matsumoto H, Fields MW, Emans JB, Sponseller P, Smith JT, Thompson GH, White KK, Vitale MG (2022) The impact of unplanned return to the operating room on health-related quality of life at the end of growth-friendly surgical treatment for early-onset scoliosis. J Pediatr Orthop 42:17\u201322. https:\/\/doi.org\/10.1097\/BPO.0000000000002006","journal-title":"J Pediatr Orthop"},{"key":"1293_CR22","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-025-01107-x","author":"KD Sborov","year":"2025","unstructured":"Sborov KD, Agarwal M, Heffernan MJ, Anari JB, Roye B, Parent S, Miyanji F, Poon SC (2025) Complications in vertebral body tethering: what are the short term effects on patient reported outcomes? Spine Deform. https:\/\/doi.org\/10.1007\/s43390-025-01107-x","journal-title":"Spine Deform"},{"key":"1293_CR23","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/BPO.0000000000002165","volume":"42","author":"JA Gomez","year":"2022","unstructured":"Gomez JA, Ge DH, Boden E, Hanstein R, Alvandi LM, Lo Y, Hwang S, Samdani AF, Sponseller PD, Garg S, Skaggs DL, Vitale MG, Emans J (2022) Posterior-only resection of single Hemivertebrae with 2-level versus >2-level fusion: can we improve outcomes? J Pediatr Orthop 42:354\u2013360. https:\/\/doi.org\/10.1097\/BPO.0000000000002165","journal-title":"J Pediatr Orthop"},{"key":"1293_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2025.07.011","author":"AJ Saarinen","year":"2025","unstructured":"Saarinen AJ, Flynn JM, Thompson GH, Emans JB, Sturm PF, Sponseller PD, Helenius IJ (2025) Traditional versus magnetically controlled growing rods for idiopathic early-onset scoliosis: outcomes at 5-year follow-up. Spine J. https:\/\/doi.org\/10.1016\/j.spinee.2025.07.011","journal-title":"Spine J"},{"key":"1293_CR25","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1302\/0301-620X.106B6.BJJ-2023-1417.R2","volume":"106","author":"AJ Saarinen","year":"2024","unstructured":"Saarinen AJ, Sponseller P, Thompson GH, White KK, Emans J, Cahill PJ, Hwang S, Helenius I (2024) Outcomes after completing growth-friendly surgical treatment for early-onset scoliosis in patients with skeletal dysplasia. Bone Jt J 106:596\u2013602. https:\/\/doi.org\/10.1302\/0301-620X.106B6.BJJ-2023-1417.R2","journal-title":"Bone Jt J"},{"key":"1293_CR26","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.25.00122","author":"AE Manning","year":"2025","unstructured":"Manning AE, Redding G, Bauer J, Yaszay B, Yang S (2025) Pulmonary function in early-onset scoliosis: a literature review. JBJS Rev. https:\/\/doi.org\/10.2106\/JBJS.RVW.25.00122","journal-title":"JBJS Rev"}],"container-title":["Spine Deformity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-026-01293-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43390-026-01293-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-026-01293-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:08:40Z","timestamp":1782929320000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43390-026-01293-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,31]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["1293"],"URL":"https:\/\/doi.org\/10.1007\/s43390-026-01293-2","relation":{},"ISSN":["2212-134X","2212-1358"],"issn-type":[{"value":"2212-134X","type":"print"},{"value":"2212-1358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,31]]},"assertion":[{"value":"29 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable (literature review).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable (literature review).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}