{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:09:06Z","timestamp":1789063746216,"version":"build-2803163510"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002345"],"award-info":[{"award-number":["UL1 TR002345"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"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>Posterior spinal fusion (PSF) surgery is the standard treatment for severe adolescent idiopathic scoliosis (AIS) and is effective in both preventing further progression of scoliosis and correcting spinal deformity. However, adolescents may face psychological and social challenges following surgery that are not captured by traditional clinical outcome measures. This study aimed to explore the long-term psychological impacts that spinal fusion surgery may have on adolescents by identifying factors, such as self-image, emotional well-being, and social functioning, that influence recovery and adjustment post-surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi-structured interviews were conducted with AIS patients who underwent PSF with primarily pedicle screw constructs with at least 10\u00a0years of follow-up. A grounded-theory approach to qualitative analysis identified key themes within each interview to structure an in-depth exploration of the patient experience after PSF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen participants completed qualitative interviews (12 female; mean follow-up: 16.5\u00a0years, range 12 \u2013 23\u00a0years). Thematic analysis identified key domains that influenced patient experiences before and after surgical treatment, including perceived long-term success, the role of reliable support systems (such as family and medical teams), and ongoing challenges related to insecurity, limited flexibility, and activity restrictions. 12 participants reported satisfaction with their surgical care and would elect to undergo surgery again. 11 participants described an improved self-image postoperatively, though individual reasons varied. Notably, all five participants who underwent bracing prior to surgery expressed significant dissatisfaction with their bracing experience. Additionally, three of the female patients noted trouble obtaining epidurals during pregnancy as a negative side-effect of PSF surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most patients who underwent PSF for AIS reported a positive experience and improved self-image post-surgery. Essential themes within this cohort include transparent communication and strong support from both families and the medical team, which promote an adolescent patient\u2019s long-term recovery and adjustment post-surgery. Understanding the themes that impact a patient\u2019s experience of PSF can inform shared decision-making and guide future research in AIS long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence.<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-026-01544-2","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:46:13Z","timestamp":1789062373000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the curve: long-term lived experiences and psychological outcomes of spinal fusion in adolescents with scoliosis"],"prefix":"10.1007","author":[{"suffix":"III","given":"Edward M.","family":"Barksdale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian E.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Speller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Budd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Boebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Marino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon Y.","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Brouillet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Bridwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7768-7929","authenticated-orcid":false,"given":"Blake K.","family":"Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"16","key":"1544_CR1","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.2106\/JBJS.18.01370","volume":"101","author":"L Helenius","year":"2019","unstructured":"Helenius L, Diarbakerli E, Grauers A, Lastikka M, Oksanen H, Pajulo O et al (2019) Back pain and quality of life after surgical treatment for adolescent idiopathic scoliosis at 5-year follow-up: comparison with healthy controls and patients with untreated idiopathic scoliosis. J Bone Joint Surg Am 101(16):1460\u20131466","journal-title":"J Bone Joint Surg Am"},{"key":"1544_CR2","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000005021","author":"GS Linden","year":"1976","unstructured":"Linden GS, Adhiyaman A, Zucker CP, Thakur A, Wisch JL, Hillstrom H et al (1976) The longitudinal effects of posterior spinal fusion with derotation on axial deformity in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). https:\/\/doi.org\/10.1097\/brs.0000000000005021","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"1544_CR3","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1097\/MOP.0b013e32834ec982","volume":"24","author":"CK Kepler","year":"2012","unstructured":"Kepler CK, Meredith DS, Green DW, Widmann RF (2012) Long-term outcomes after posterior spine fusion for adolescent idiopathic scoliosis. Curr Opin Pediatr 24(1):68\u201375","journal-title":"Curr Opin Pediatr"},{"key":"1544_CR4","doi-asserted-by":"crossref","unstructured":"Ahonen M, Syv\u00e4nen J, Helenius L, Mattila M, Perokorpi T, Diarbakerli E, et al. (2023) Back pain and quality of life 10 years after segmental pedicle screw instrumentation for adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 48(10):665-671","DOI":"10.1097\/BRS.0000000000004641"},{"issue":"11","key":"1544_CR5","doi-asserted-by":"publisher","first-page":"995","DOI":"10.2106\/JBJS.21.00763","volume":"104","author":"ST Lander","year":"2022","unstructured":"Lander ST, Thirukumaran C, Saleh A, Noble KL, Menga EN, Mesfin A et al (2022) Long-term health-related quality of life after harrington instrumentation and fusion for adolescent idiopathic scoliosis: a minimum 40-year follow-up. J Bone Joint Surg Am 104(11):995\u20131003","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"1544_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-024-02052-7","volume":"29","author":"M Pishnamaz","year":"2024","unstructured":"Pishnamaz M, Migliorini F, Blume C, Kobbe P, Trobisch P, Delbruck H et al (2024) Long-term outcomes of spinal fusion in adolescent idiopathic scoliosis: a literature review. Eur J Med Res 29(1):534","journal-title":"Eur J Med Res"},{"key":"1544_CR7","doi-asserted-by":"crossref","unstructured":"Lykissas MG, Jain VV, Nathan ST, Pawar V, Eismann EA, Sturm PF, et al. (2013) Mid- to long-term outcomes in adolescent idiopathic scoliosis after instrumented posterior spinal fusion: a meta-analysis. Spine (Phila Pa 1976). 38(2):E113\u2013E119","DOI":"10.1097\/BRS.0b013e31827ae3d0"},{"issue":"9","key":"1544_CR8","doi-asserted-by":"publisher","first-page":"3140","DOI":"10.1007\/s00586-023-07849-4","volume":"32","author":"C Berlin","year":"2023","unstructured":"Berlin C, Tielemann S, Quante M, Halm H (2023) Correlation of radiographic parameters and patient satisfaction in adolescent idiopathic scoliosis treated with posterior screw-dual-rod instrumentation. Eur Spine J 32(9):3140\u20133148","journal-title":"Eur Spine J"},{"issue":"9","key":"1544_CR9","doi-asserted-by":"publisher","first-page":"761","DOI":"10.2106\/JBJS.18.01013","volume":"101","author":"C Louer Jr.","year":"2019","unstructured":"Louer C Jr., Yaszay B, Cross M, Bartley CE, Bastrom TP, Shah SA et al (2019) Ten-year outcomes of selective fusions for adolescent idiopathic scoliosis. J Bone Joint Surg Am 101(9):761\u2013770","journal-title":"J Bone Joint Surg Am"},{"key":"1544_CR10","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-025-08991-x","author":"S Zhang","year":"2025","unstructured":"Zhang S, Wang L, He Y, Li Z, Zuo G, Wang S et al (2025) Surgical vs non-surgical management of adolescent idiopathic scoliosis: a 10-year narrative review of health-related quality of life and radiographic progression in 3315 patients. Eur Spine J. https:\/\/doi.org\/10.1007\/s00586-025-08991-x","journal-title":"Eur Spine J"},{"key":"1544_CR11","doi-asserted-by":"crossref","unstructured":"Mens RH, Bisseling P, de Kleuver M, van Hooff ML. (2022) Relevant impact of surgery on quality of life for adolescent idiopathic scoliosis: a registry-based two-year follow-up cohort study. Bone Joint J. 104-B(2):265\u2013273","DOI":"10.1302\/0301-620X.104B2.BJJ-2021-1179.R1"},{"issue":"1","key":"1544_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-022-02035-4","volume":"20","author":"HT Mikkelsen","year":"2022","unstructured":"Mikkelsen HT, Sm\u00e5stuen MC, Haraldstad K, Helseth S, Skarstein S, Rohde G (2022) Changes in health-related quality of life in adolescents and the impact of gender and selected variables: a two-year longitudinal study. Health Qual Life Outcomes 20(1):123","journal-title":"Health Qual Life Outcomes"},{"issue":"10337","key":"1544_CR13","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1016\/S0140-6736(21)02725-2","volume":"399","author":"T Vaivada","year":"2022","unstructured":"Vaivada T, Lassi ZS, Irfan O, Salam RA, Das JK, Oh C et al (2022) What can work and how? An overview of evidence-based interventions and delivery strategies to support health and human development from before conception to 20 years. Lancet 399(10337):1810\u20131829","journal-title":"Lancet"},{"issue":"6","key":"1544_CR14","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1097\/CORR.0000000000003373","volume":"483","author":"LA Royse","year":"2025","unstructured":"Royse LA, Saparova D, Boeyer ME, Hoernschemeyer DG (2025) How do patients perceive success and satisfaction after vertebral body tethering and fusion for adolescent idiopathic scoliosis? A qualitative study. Clin Orthop Relat Res 483(6):1124\u20131138","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"1544_CR15","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/1525822X05279903","volume":"18","author":"G Guest","year":"2006","unstructured":"Guest G, Bunce A, Johnson L (2006) How many interviews are enough? An experiment with data saturation and variability. Field Methods 18(1):59\u201382","journal-title":"Field Methods"},{"issue":"10","key":"1544_CR16","doi-asserted-by":"publisher","first-page":"E596","DOI":"10.1097\/BRS.0000000000002918","volume":"44","author":"PWH Cheung","year":"1976","unstructured":"Cheung PWH, Wong CKH, Cheung JPY (1976) An insight into the health-related quality of life of adolescent idiopathic scoliosis patients who are braced, observed, and previously braced. Spine (Phila Pa 1976) 44(10):E596\u2013E605","journal-title":"Spine (Phila Pa 1976)"},{"issue":"Suppl 3","key":"1544_CR17","doi-asserted-by":"publisher","first-page":"107","DOI":"10.2106\/JBJS.H.01631","volume":"91","author":"DE Beaton","year":"2009","unstructured":"Beaton DE, Clark JP (2009) Qualitative research: a review of methods with use of examples from the total knee replacement literature. J Bone Joint Surg Am 91(Suppl 3):107\u2013112","journal-title":"J Bone Joint Surg Am"},{"key":"1544_CR18","doi-asserted-by":"publisher","DOI":"10.4135\/9781452230153","volume-title":"Basics of qualitative research (3rd ed): techniques and procedures for developing grounded theory","author":"J Corbin","year":"2008","unstructured":"Corbin J, Strauss A (2008) Basics of qualitative research (3rd ed): techniques and procedures for developing grounded theory. SAGE Publications, Inc., Thousand Oaks, California"},{"issue":"9","key":"1544_CR19","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.jhsa.2023.05.017","volume":"48","author":"AC Tian","year":"2023","unstructured":"Tian AC, Graesser EA, Tarkunde Y, Frantz L, Wall LB (2023) Caregiver versus surgeon concerns in new diagnosis of congenital hand and upper extremity anomalies. J Hand Surg Am 48(9):896\u2013903","journal-title":"J Hand Surg Am"},{"issue":"5","key":"1544_CR20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232076","volume":"15","author":"G Guest","year":"2020","unstructured":"Guest G, Namey E, Chen M (2020) A simple method to assess and report thematic saturation in qualitative research. PLoS ONE 15(5):e0232076. https:\/\/doi.org\/10.1371\/journal.pone.0232076","journal-title":"PLoS ONE"},{"issue":"9","key":"1544_CR21","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1097\/BRS.0000000000004585","volume":"48","author":"YL Chua","year":"1976","unstructured":"Chua YL, Toh AJN, Tan XYB, Pan DCY, Lee NKL, Lim KBL (1976) Aspects of patient experience associated with improved scoliosis research society-22 revised (SRS-22R) and European quality of life five-dimension five-level (EQ-5D-5L) scores in patients with adolescent idiopathic scoliosis managed with observation or bracing. Spine (Phila Pa 1976) 48(9):617\u2013624","journal-title":"Spine (Phila Pa 1976)"},{"issue":"5","key":"1544_CR22","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1016\/j.jadohealth.2019.05.024","volume":"65","author":"A Jordan","year":"2019","unstructured":"Jordan A, Joseph-Williams N, Edwards A, Holland-Hart D, Wood F (2019) I\u2019d like to have more of a say because it\u2019s my body\": adolescents\u2019 perceptions around barriers and facilitators to shared decision-making. J Adolesc Health 65(5):633\u2013642","journal-title":"J Adolesc Health"},{"issue":"2","key":"1544_CR23","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1093\/jpepsy\/jsab095","volume":"47","author":"GS Motyer","year":"2022","unstructured":"Motyer GS, Kiely PJ, Fitzgerald A (2022) Adolescents\u2019 experiences of idiopathic scoliosis in the presurgical period: a qualitative study. J Pediatr Psychol 47(2):225\u2013235","journal-title":"J Pediatr Psychol"},{"key":"1544_CR24","doi-asserted-by":"publisher","first-page":"e135","DOI":"10.1016\/j.pedn.2024.01.004","volume":"75","author":"J Li","year":"2024","unstructured":"Li J, Chan EA, Li M, Lam YP, Wong AYL, Cheung JPY et al (2024) Am i different?\" Coping and mental health among teenagers with adolescent idiopathic scoliosis: a qualitative study. J Pediatr Nurs 75:e135\u2013e141","journal-title":"J Pediatr Nurs"},{"key":"1544_CR25","doi-asserted-by":"crossref","unstructured":"Liu JJ, Zhong XX, Li XH. (2025) Perceived social support and mental health in adolescent idiopathic scoliosis: mediating effects of resilience. Psychol Health Med. 1\u201319","DOI":"10.1080\/13548506.2025.2581570"},{"issue":"18","key":"1544_CR26","doi-asserted-by":"publisher","first-page":"E653","DOI":"10.1097\/BRS.0b013e3181b2008f","volume":"34","author":"S Tsutsui","year":"1976","unstructured":"Tsutsui S, Pawelek J, Bastrom T, Lenke L, Lowe T, Betz R et al (1976) Dissecting the effects of spinal fusion and deformity magnitude on quality of life in patients with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 34(18):E653\u2013E658","journal-title":"Spine (Phila Pa 1976)"},{"key":"1544_CR27","doi-asserted-by":"crossref","unstructured":"Verma K, Lonner B, Hoashi JS, Lafage V, Dean L, Engel I, et al. (2010) Demographic factors affect scoliosis research society-22 performance in healthy adolescents: a comparative baseline for adolescents with idiopathic scoliosis. Spine (Phila Pa 1976). 35(24):2134\u20132139.","DOI":"10.1097\/BRS.0b013e3181cb474f"},{"issue":"1","key":"1544_CR28","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.jos.2021.08.014","volume":"28","author":"M Yagi","year":"2023","unstructured":"Yagi M, Ames CP, Hosogane N, Smith JS, Shaffrey CI, Schwab FJ et al (2023) Comparable satisfaction and clinical outcomes after surgery for adolescent idiopathic scoliosis in the adult (AISA) between the US and Japan. J Orthop Sci 28(1):92\u201397","journal-title":"J Orthop Sci"},{"issue":"11","key":"1544_CR29","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1097\/BRS.0000000000003373","volume":"45","author":"M Ohashi","year":"1976","unstructured":"Ohashi M, Bastrom TP, Marks MC, Bartley CE, Newton PO (1976) The benefits of sparing lumbar motion segments in spinal fusion for adolescent idiopathic scoliosis are evident at 10 years postoperatively. Spine (Phila Pa 1976) 45(11):755\u2013763","journal-title":"Spine (Phila Pa 1976)"},{"issue":"7","key":"1544_CR30","doi-asserted-by":"publisher","first-page":"1978","DOI":"10.1007\/s00586-021-06874-5","volume":"30","author":"CK Chiu","year":"2021","unstructured":"Chiu CK, Tan CS, Chung WH, Mohamad SM, Kwan MK, Chan CYW (2021) Mid-long-term outcome and degeneration of the remaining unfused lumbar intervertebral disc in adolescent idiopathic scoliosis patients who had posterior spinal fusion surgery. Eur Spine J 30(7):1978\u20131987","journal-title":"Eur Spine J"},{"key":"1544_CR31","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191710585","author":"MC Cheung","year":"2022","unstructured":"Cheung MC, Law D, Yip J, Cheung JPY (2022) Adolescents\u2019 experience during brace treatment for scoliosis: a qualitative study. Int J Environ Res Public Health. https:\/\/doi.org\/10.3390\/ijerph191710585","journal-title":"Int J Environ Res Public Health"},{"key":"1544_CR32","doi-asserted-by":"crossref","unstructured":"Misterska E, Glowacki M, Latuszewska J. (2012) Female patients\u2019 and parents\u2019 assessment of deformity- and brace-related stress in the conservative treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 37(14):1218\u20131223.","DOI":"10.1097\/BRS.0b013e31824b66d4"},{"key":"1544_CR33","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.1016\/j.wneu.2019.01.095","volume":"126","author":"T Lin","year":"2019","unstructured":"Lin T, Meng Y, Ji Z, Jiang H, Shao W, Gao R et al (2019) Extent of depression in juvenile and adolescent patients with idiopathic scoliosis during treatment with braces. World Neurosurg 126:e27\u2013e32","journal-title":"World Neurosurg"}],"container-title":["Spine Deformity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-026-01544-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43390-026-01544-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-026-01544-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:46:16Z","timestamp":1789062376000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43390-026-01544-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":33,"alternative-id":["1544"],"URL":"https:\/\/doi.org\/10.1007\/s43390-026-01544-2","relation":{},"ISSN":["2212-134X","2212-1358"],"issn-type":[{"value":"2212-134X","type":"print"},{"value":"2212-1358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"assertion":[{"value":"3 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors have no other competing interests to declare that are relevant to the content of this article.","order":1,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}