{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:54:47Z","timestamp":1781592887974,"version":"3.54.5"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Health-related quality-of-life (HRQOL) assessment provides insight into patient\u2019s subjective experiences that complement traditional clinical and radiological indicators. This study aims to characterize individual variability in long-term HRQOL recovery trajectories after spinal fusion for severe adolescent idiopathic scoliosis (AIS) and to identify preoperative and surgical factors associated with baseline HRQOL and the rate of improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective longitudinal cohort study included 388 patients with severe AIS (Cobb angle\u2009\u2265\u200945\u00b0) who underwent spinal fusion (mean age at surgery 15.3\u2009\u00b1\u20092.1\u00a0years). A total of 1,539 longitudinal SRS-22r and Spinal Appearance Questionnaire (SAQ) records with up to\u2009&gt;\u200920\u00a0years of follow-up were analyzed. Hierarchical multilevel growth models with random intercepts and random slopes (cubic time polynomial) were used to model recovery trajectories. Preoperative patient-reported outcome measures (PROM) level, age at surgery (continuous), sex, and curve magnitude were evaluated as trajectory moderators. \u201cGood recovery\u201d was defined as final-visit SRS-22r composite score\u2009\u2265\u20094.0 or SAQ mean score\u2009\u2264\u20094.2. Marginal and conditional\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      quantified explained variance; partial-effects plots illustrated predicted probabilities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Substantial individual variability existed; the population-average trajectory explained only 18% of variance in SRS-22r and 23% in SAQ scores. Preoperative PROM level was the strongest moderator (additional 54\u201358% variance explained), with patients having moderate baseline disability showing the greatest and most rapid gains. Younger age at surgery significantly hastened\u00a0recovery (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Most postoperative HRQOL improvement occurred within the first 4\u00a0years (SRS-22r) and 6\u00a0years (SAQ), after which scores plateaued at normative levels with no significant long-term decline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative PROM levels and younger age at surgery are dominant, modifiable moderators of both baseline HRQOL and subsequent postoperative recovery speed. These trajectory-based findings support individualized, patient-centered surgical timing discussions rather than rigid chronological thresholds and facilitate shared decision-making that aligns postoperative HRQOL gains with key psychosocial and educational milestones.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-026-01486-9","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:19:26Z","timestamp":1781590766000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal patient-reported outcomes after spinal fusion for adolescent idiopathic scoliosis: recovery trajectories and insights into surgical timing"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6973-1915","authenticated-orcid":false,"given":"Wai-Wang","family":"Chau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5684-3726","authenticated-orcid":false,"given":"Alec Lik-Hang","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2427-2719","authenticated-orcid":false,"given":"Tsz-Ping","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8153-364X","authenticated-orcid":false,"given":"Jack Chun-Yiu","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0321-8350","authenticated-orcid":false,"given":"Adam Yiu-Chung","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"issue":"9623","key":"1486_CR1","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1016\/S0140-6736(08)60658-3","volume":"371","author":"SL Weinstein","year":"2008","unstructured":"Weinstein SL, Dolan LA, Cheng JCY, Danielsson A, Morcuende JA (2008) Adolescent idiopathic scoliosis. 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