{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:56:27Z","timestamp":1792065387742,"version":"4.4.0"},"reference-count":30,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thespinejournalonline.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Spine Journal"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.spinee.2026.07.007","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:33:15Z","timestamp":1784356395000},"page":"2217-2227","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global sagittal mismatch, not isolated L1 pelvic angle achievement, is associated with mechanical failure after adult spinal deformity surgery"],"prefix":"10.1016","volume":"26","author":[{"given":"Timothy Y.","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Lombardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Menger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin H.","family":"Pham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee A.","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Tuchman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Osorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"10193","key":"10.1016\/j.spinee.2026.07.007_bib0001","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/S0140-6736(19)31125-0","article-title":"Adult spinal deformity","volume":"394","author":"Diebo","year":"2019","journal-title":"Lancet"},{"key":"10.1016\/j.spinee.2026.07.007_bib0002","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1227\/NEU.0000000000000938","article-title":"Degenerative spinal deformity","volume":"77","author":"Ailon","year":"2015","journal-title":"Neurosurgery"},{"issue":"1","key":"10.1016\/j.spinee.2026.07.007_bib0003","doi-asserted-by":"crossref","first-page":"051","DOI":"10.1055\/s-0032-1326950","article-title":"Current status of adult spinal deformity","volume":"3","author":"Youssef","year":"2013","journal-title":"Glob Spine J"},{"issue":"2","key":"10.1016\/j.spinee.2026.07.007_bib0004","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jos.2015.12.013","article-title":"Update on pathology and surgical treatment for adult spinal deformity","volume":"21","author":"Taneichi","year":"2016","journal-title":"J Orthop Sci"},{"issue":"16","key":"10.1016\/j.spinee.2026.07.007_bib0005","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1097\/BRS.0b013e3181ac5fcd","article-title":"Operative versus nonoperative treatment of leg pain in adults with scoliosis: a retrospective review of a prospective multicenter database with two-year follow-up","volume":"34","author":"Smith","year":"2009","journal-title":"Spine"},{"issue":"1","key":"10.1016\/j.spinee.2026.07.007_bib0006","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1227\/01.NEU.0000347005.35282.6C","article-title":"Improvement of back pain with operative and nonoperative treatment in adults with scoliosis","volume":"65","author":"Smith","year":"2009","journal-title":"Neurosurgery"},{"issue":"1","key":"10.1016\/j.spinee.2026.07.007_bib0007","doi-asserted-by":"crossref","first-page":"137","DOI":"10.14444\/8018","article-title":"Complications after adult spinal deformity surgeries: all are not created equal","volume":"15","author":"Dinizo","year":"2021","journal-title":"Int J Spine Surg"},{"issue":"18","key":"10.1016\/j.spinee.2026.07.007_bib0008","doi-asserted-by":"crossref","first-page":"2109","DOI":"10.1097\/01.brs.0000231725.38943.ab","article-title":"A clinical impact classification of scoliosis in the adult","volume":"31","author":"Schwab","year":"2006","journal-title":"Spine"},{"issue":"12","key":"10.1016\/j.spinee.2026.07.007_bib0009","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/BRS.0b013e31823e15e2","article-title":"Scoliosis Research Society\u2014Schwab adult spinal deformity classification: a validation study","volume":"37","author":"Schwab","year":"2012","journal-title":"Spine"},{"issue":"1","key":"10.1016\/j.spinee.2026.07.007_bib0010","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/BRS.0000000000001171","article-title":"Defining spino-pelvic alignment thresholds: should operative goals in adult spinal deformity surgery account for age?","volume":"41","author":"Lafage","year":"2016","journal-title":"Spine"},{"issue":"19","key":"10.1016\/j.spinee.2026.07.007_bib0011","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1097\/BRS.0000000000004414","article-title":"The T4-L1-hip axis: defining a normal sagittal spinal alignment","volume":"47","author":"Hills","year":"2022","journal-title":"Spine"},{"issue":"2","key":"10.1016\/j.spinee.2026.07.007_bib0012","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.jspd.2018.08.009","article-title":"Moderate interrater and substantial intrarater reproducibility of the roussouly classification system in patients with adult spinal deformity","volume":"7","author":"Bari","year":"2019","journal-title":"Spine Deform"},{"issue":"8","key":"10.1016\/j.spinee.2026.07.007_bib0013","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1007\/s00586-017-5111-x","article-title":"Classification of normal sagittal spine alignment: refounding the Roussouly classification","volume":"27","author":"Laouissat","year":"2018","journal-title":"Eur Spine J"},{"issue":"3","key":"10.1016\/j.spinee.2026.07.007_bib0014","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1097\/01.brs.0000152379.54463.65","article-title":"Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position","volume":"30","author":"Roussouly","year":"2005","journal-title":"Spine"},{"issue":"6","key":"10.1016\/j.spinee.2026.07.007_bib0015","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1007\/s00586-022-07200-3","article-title":"The impact of lumbar alignment targets on mechanical complications after adult lumbar scoliosis surgery","volume":"31","author":"Dial","year":"2022","journal-title":"Eur Spine J"},{"issue":"5","key":"10.1016\/j.spinee.2026.07.007_bib0016","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/j.spinee.2019.11.006","article-title":"Modified global alignment and proportion scoring with body mass index and bone mineral density (GAPB) for improving predictions of mechanical complications after adult spinal deformity surgery","volume":"20","author":"Noh","year":"2020","journal-title":"Spine J"},{"issue":"23","key":"10.1016\/j.spinee.2026.07.007_bib0017","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.23.00372","article-title":"The T4-L1-hip axis: sagittal spinal realignment targets in long-construct adult spinal deformity surgery: early impact","volume":"106","author":"Hills","year":"2024","journal-title":"JBJS"},{"key":"10.1016\/j.spinee.2026.07.007_bib0018","first-page":"10","article-title":"Mechanical failures as predicted by achieving local vs global T4-L1 hip axis goals: a single center experience","author":"Joseph","year":"2025","journal-title":"Spine"},{"issue":"18","key":"10.1016\/j.spinee.2026.07.007_bib0019","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1097\/BRS.0000000000001020","article-title":"Radiographical and implant-related complications in adult spinal deformity surgery: incidence, patient risk factors, and impact on health-related quality of life","volume":"40","author":"Soroceanu","year":"2015","journal-title":"Spine"},{"issue":"6","key":"10.1016\/j.spinee.2026.07.007_bib0020","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.spinee.2024.12.023","article-title":"Cause and effect of revisions in adult spinal deformity surgery: a multicenter study on outcomes based on etiology","volume":"25","author":"Passias","year":"2025","journal-title":"Spine J"},{"issue":"23","key":"10.1016\/j.spinee.2026.07.007_bib0021","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.23.00372","article-title":"The T4-L1-hip axis: sagittal spinal realignment targets in long-construct adult spinal deformity surgery: early impact","volume":"106","author":"Hills","year":"2024","journal-title":"JBJS"},{"key":"10.1016\/j.spinee.2026.07.007_bib0022","first-page":"10","article-title":"Incidence and risk factors of proximal junctional complications and rod fractures after long-segment fusion surgery with anterior column realignment for adult spinal deformity: a minimum 2-year follow-up","author":"Kang","year":"2022","journal-title":"Neurosurgery"},{"issue":"6","key":"10.1016\/j.spinee.2026.07.007_bib0023","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/BRS.0000000000004828","article-title":"Functional alignment within the fusion in adult spinal deformity (ASD) improves outcomes and minimizes mechanical failures","volume":"49","author":"Ani","year":"2024","journal-title":"Spine"},{"issue":"11","key":"10.1016\/j.spinee.2026.07.007_bib0024","doi-asserted-by":"crossref","first-page":"4003","DOI":"10.1007\/s00586-023-07920-0","article-title":"L1-pelvic angle: a convenient measurement to attain optimal deformity correction","volume":"32","author":"Chanbour","year":"2023","journal-title":"Eur Spine J"},{"key":"10.1016\/j.spinee.2026.07.007_bib0025","unstructured":"Khanna R, Eastlack R, Mundis Jr G, et al. Does achievement of ideal L1 pelvic angle with MIS techniques in adult spinal deformity correction lead to better outcomes? Spine. 10\u20131097."},{"key":"10.1016\/j.spinee.2026.07.007_bib0026","article-title":"Identifying distinct risk factors for early-onset and late-onset PJK in ASD: a comparative analysis across non-PJK, early-onset PJK, and late-onset PJK groups","author":"Huang","year":"2025","journal-title":"Glob Spine J"},{"issue":"1","key":"10.1016\/j.spinee.2026.07.007_bib0027","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.spinee.2025.07.004","article-title":"The impact of obesity on radiographic and clinical outcomes following adult spinal deformity surgery\u2013a systematic review and meta-analysis","volume":"26","author":"Pajak","year":"2025","journal-title":"Spine J"},{"issue":"3","key":"10.1016\/j.spinee.2026.07.007_bib0028","doi-asserted-by":"crossref","first-page":"319","DOI":"10.3171\/2022.9.SPINE22549","article-title":"Proximal junctional failure in primary thoracolumbar fusion\/fixation to the sacrum\/pelvis for adult symptomatic lumbar scoliosis: long-term follow-up of a prospective multicenter cohort of 160 patients","volume":"38","author":"Lazaro","year":"2022","journal-title":"J Neurosurg Spine"},{"issue":"6","key":"10.1016\/j.spinee.2026.07.007_bib0029","doi-asserted-by":"crossref","first-page":"994","DOI":"10.3171\/2014.9.SPINE131176","article-title":"Prospective multicenter assessment of risk factors for rod fracture following surgery for adult spinal deformity","volume":"21","author":"Smith","year":"2014","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2026.07.007_bib0030","doi-asserted-by":"crossref","first-page":"e530","DOI":"10.1016\/j.wneu.2018.06.071","article-title":"Rod fracture after apparently solid radiographic fusion in adult spinal deformity patients","volume":"117","author":"Daniels","year":"2018","journal-title":"World Neurosurg"}],"container-title":["The Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1529943026005838?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1529943026005838?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:32:32Z","timestamp":1792063952000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1529943026005838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":30,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S1529943026005838"],"URL":"https:\/\/doi.org\/10.1016\/j.spinee.2026.07.007","relation":{},"ISSN":["1529-9430"],"issn-type":[{"value":"1529-9430","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Global sagittal mismatch, not isolated L1 pelvic angle achievement, is associated with mechanical failure after adult spinal deformity surgery","name":"articletitle","label":"Article Title"},{"value":"The Spine Journal","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.spinee.2026.07.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}