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This study sought to determine if a predicted 3D kyphosis, derived from 2D images, is a more robust predictor of FEV1 in patients with AIS than a traditional 2D analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\u00a0A retrospective, cross-sectional review of 259 AIS patients with surgical-range thoracic curves (&gt;\u200940\u00b0) was performed. We built two multivariate linear regression models to predict FEV1. Due to structural multicollinearity, the deformity measures were tested separately. Model A included\u00a0Main Thoracic Cobb,\u00a0BMI, and Age. Model B included\u00a0,\u00a0, and\u00a0. The models were compared using the Akaike Information Criterion (AIC) and adjusted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort (87% female, mean age 15.7\u2009\u00b1\u20093.3\u00a0years) presented with severe deformities (mean Main Thoracic Cobb 68.4\u00b0\u2009\u00b1\u200916.5\u00b0) and widespread restrictive impairment (71%). Multivariate Analysis revealed that Model A, (2D Main Thoracic Cobb) was statistically superior to Model B (Predicted 3D T5 \u2013 T12 Kyphosis) with a lower AIC (\u2212292.5 vs. \u2212265.9) and a higher adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      \u00a0(0.241 vs. 0.159). All factors were significant independent predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\u00a0The predicted 3D-based model was not superior, while a parsimonious 2D-based multivariate model including\u00a0Main Thoracic Cobb,\u00a0BMI, and Age explained a significantly larger proportion of the variance in FEV1. This specific 2D-to-3D prediction algorithm is an imperfect proxy and is not a valid substitute for true 3D imaging in predicting pulmonary risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-026-01433-8","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T07:19:57Z","timestamp":1779347997000},"page":"2223-2231","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predicting pulmonary function in adolescent idiopathic scoliosis: is a simple 2D radiograph still the winner?"],"prefix":"10.1007","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9160-9246","authenticated-orcid":false,"given":"Rafael Garcia","family":"de Oliveira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarcisio Eloy Pessoa","family":"de Barros Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"de Oliveira Araujo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael Martus","family":"Marcon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arya","family":"Varthi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominick","family":"Tuason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cicero Ricardo","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Foga\u00e7a","family":"Cristante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"issue":"1","key":"1433_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.30","volume":"1","author":"JC Cheng","year":"2015","unstructured":"Cheng JC, Castelein RM, Chu WC, Danielsson AJ, Dobbs MB, Grivas TB et al (2015) Adolescent idiopathic scoliosis. 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