{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:57:36Z","timestamp":1780491456907,"version":"3.54.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-86330-2","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:53:00Z","timestamp":1736920380000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Machine learning analysis of cervical balance in early-onset scoliosis post-growing rod surgery: a case-control study"],"prefix":"10.1038","volume":"15","author":[{"given":"Bo","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junrui Jonathan","family":"Hai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aixing","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingjie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Hai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"86330_CR1","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/CM9.0000000000000614","volume":"133","author":"YB Zhang","year":"2020","unstructured":"Zhang, Y. B. & Zhang, J. G. Treatment of early-onset scoliosis: Techniques, indications, and complications. Chin. Med. J. (Engl). 133, 351\u2013357 (2020).","journal-title":"Chin. Med. J. (Engl)"},{"key":"86330_CR2","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1136\/adc.46.249.623","volume":"46","author":"G Davies","year":"1971","unstructured":"Davies, G. & Reid, L. Effect of scoliosis on growth of Alveoli and pulmonary arteries and on right ventricle. Arch. Dis. Child. 46, 623\u2013632 (1971).","journal-title":"Arch. Dis. Child."},{"issue":"1","key":"86330_CR3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0709","volume":"137","author":"S Yang","year":"2016","unstructured":"Yang, S., Andras, L. M., Redding, G. J. & Skaggs, D. L. Early-onset scoliosis: A review of history, current treatment, and future directions. Pediatrics 137(1), e20150709. https:\/\/doi.org\/10.1542\/peds.2015-0709 (2016).","journal-title":"Pediatrics"},{"issue":"15","key":"86330_CR4","doi-asserted-by":"publisher","first-page":"4472","DOI":"10.3390\/jcm13154472","volume":"13","author":"AN Johnson","year":"2024","unstructured":"Johnson, A. N. & Lark, R. K. Current concepts in the treatment of early onset scoliosis. J. Clin. Med. 13(15), 4472. https:\/\/doi.org\/10.3390\/jcm13154472 (2024).","journal-title":"J. Clin. Med."},{"key":"86330_CR5","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1097\/BPO.0000000000000386","volume":"35","author":"JT Smith","year":"2015","unstructured":"Smith, J. T., Johnston, C., Skaggs, D., Flynn, J. & Vitale, M. A new classification system to report complications in growing spine surgery: A Multicenter Consensus Study. J. Pediatr. Orthop. 35, 798\u2013803 (2015).","journal-title":"J. Pediatr. Orthop."},{"key":"86330_CR6","first-page":"654","volume":"8","author":"Y Fukase","year":"2024","unstructured":"Fukase, Y. et al. A case of early onset scoliosis with trisomy 1Q and monosomy 21Q. Spine surg. Relat. Res. 8, 654\u2013658 (2024).","journal-title":"Relat. Res."},{"key":"86330_CR7","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1093\/neuros\/nyaa582","volume":"88","author":"JK Scheer","year":"2021","unstructured":"Scheer, J. K. et al. Alignment, classification, clinical evaluation, and Surgical Treatment for adult cervical deformity: A complete guide. Neurosurgery 88, 864\u2013883 (2021).","journal-title":"Neurosurgery"},{"key":"86330_CR8","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s43390-020-00029-0","volume":"8","author":"L Piantoni","year":"2020","unstructured":"Piantoni, L. et al. Proximal junction kyphosis after posterior spinal Fusion for early-onset scoliosis. Spine Deform. 8, 311\u2013316 (2020).","journal-title":"Spine Deform"},{"key":"86330_CR9","doi-asserted-by":"crossref","unstructured":"Tang, J. A. et al. The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery. Neurosurgery. 76 (Suppl 1), S14-S21, discussion S21 (2015).","DOI":"10.1227\/01.neu.0000462074.66077.2b"},{"key":"86330_CR10","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1080\/01616412.2017.1296654","volume":"39","author":"K Yokoyama","year":"2017","unstructured":"Yokoyama, K. et al. Age-related variations in global spinal alignment and sagittal balance in asymptomatic Japanese adults. Neurol. Res. 39, 414\u2013418 (2017).","journal-title":"Neurol. Res."},{"key":"86330_CR11","unstructured":"Zhao, T. & Liu, H. Sparse additive machine. In Appearing in Proceedings of the 15th International Conference on Artificial Intelligence and Statistics. Canary Islands (2012)."},{"key":"86330_CR12","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1097\/01.brs.0000169451.76359.49","volume":"30","author":"RC Glattes","year":"2005","unstructured":"Glattes, R. C. et al. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: Incidence, outcomes, and risk factor analysis. Spine 30, 1643\u20131649 (2005).","journal-title":"Spine"},{"key":"86330_CR13","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1097\/BRS.0b013e3181c77f8c","volume":"35","author":"MD Helgeson","year":"2010","unstructured":"Helgeson, M. D. et al. Evaluation of proximal junctional kyphosis in adolescent idiopathic scoliosis following pedicle screw, hook, or hybrid instrumentation. Spine 35, 177\u2013181 (2010).","journal-title":"Spine"},{"key":"86330_CR14","doi-asserted-by":"publisher","first-page":"E60","DOI":"10.1097\/BRS.0b013e3181eeaee2","volume":"36","author":"M Yagi","year":"2011","unstructured":"Yagi, M., Akilah, K. B., Boachie-Adjei, O. & Incidence risk factors and classification of proximal junctional kyphosis: Surgical outcomes review of adult idiopathic scoliosis. Spine 36, E60\u2013E68 (2011).","journal-title":"Spine"},{"key":"86330_CR15","doi-asserted-by":"publisher","first-page":"E1223","DOI":"10.1097\/BRS.0b013e31829fedde","volume":"38","author":"R Hart","year":"2013","unstructured":"Hart, R. et al. Identification of decision criteria for revision surgery among patients with proximal junctional failure after surgical treatment of spinal deformity. Spine 38, E1223\u2013E1227 (2013).","journal-title":"Spine"},{"key":"86330_CR16","doi-asserted-by":"publisher","first-page":"2423","DOI":"10.1007\/s00586-016-4564-7","volume":"25","author":"CM Jalai","year":"2016","unstructured":"Jalai, C. M. et al. A comparative analysis of the prevalence and characteristics of cervical malalignment in adults presenting with thoracolumbar spine deformity based on variations in treatment approach over 2 years. Eur. Spine J. 25, 2423\u20132432 (2016).","journal-title":"Eur. Spine J."},{"key":"86330_CR17","doi-asserted-by":"publisher","first-page":"E259","DOI":"10.1097\/BSD.0b013e318261f346","volume":"25","author":"CS Lee","year":"2012","unstructured":"Lee, C. S. et al. Analysis of Sagittal spinal alignment in 181 asymptomatic children. J. Spinal Disord. Tech. 25, E259\u2013E263 (2012).","journal-title":"J. Spinal Disord Tech."},{"key":"86330_CR18","doi-asserted-by":"publisher","first-page":"3226","DOI":"10.1007\/s00586-016-4701-3","volume":"25","author":"A Hiyama","year":"2016","unstructured":"Hiyama, A. et al. Sagittal alignment of the cervical spine in adolescent idiopathic scoliosis: A comparative study of 42 adolescents with idiopathic scoliosis and 24 normal adolescents. Eur. Spine J. 25, 3226\u20133233 (2016).","journal-title":"Eur. Spine J."},{"key":"86330_CR19","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12893-019-0471-2","volume":"19","author":"W Pepke","year":"2019","unstructured":"Pepke, W. et al. Cervical spine alignment following surgery for adolescent idiopathic scoliosis (Ais): A pre-to-post analysis of 81 patients. BMC Surg. 19, 7 (2019).","journal-title":"Bmc Surg."},{"key":"86330_CR20","doi-asserted-by":"publisher","first-page":"E41","DOI":"10.1097\/BSD.0b013e3182396301","volume":"25","author":"SH Lee","year":"2012","unstructured":"Lee, S. H. et al. The influence of thoracic inlet alignment on the craniocervical sagittal balance in asymptomatic adults. J. Spinal Disord. Tech. 25, E41\u2013E47 (2012).","journal-title":"J. Spinal Disord Tech."},{"key":"86330_CR21","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1007\/s00586-015-4244-z","volume":"25","author":"S Pesenti","year":"2016","unstructured":"Pesenti, S. et al. Interest of T1 parameters for sagittal alignment evaluation of adolescent idiopathic scoliosis patients. Eur. Spine J. 25, 424\u2013429 (2016).","journal-title":"Eur. Spine J."},{"key":"86330_CR22","doi-asserted-by":"publisher","first-page":"E1233","DOI":"10.1097\/BSD.0000000000000427","volume":"30","author":"Q Chen","year":"2017","unstructured":"Chen, Q. et al. Degenerative spondylolisthesis in the fifth lumbar vertebra and radiographic parameters: A correlation analysis. Clin. Spine Surg. 30, E1233\u2013E1238 (2017).","journal-title":"Clin. Spine Surg."},{"key":"86330_CR23","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1097\/BRS.0000000000001221","volume":"41","author":"S Iyer","year":"2016","unstructured":"Iyer, S. et al. Impact of cervical sagittal alignment parameters on neck disability. Spine 41, 371\u2013377 (2016).","journal-title":"Spine"},{"key":"86330_CR24","doi-asserted-by":"publisher","first-page":"3114","DOI":"10.1007\/s00586-016-4488-2","volume":"25","author":"MS Youn","year":"2016","unstructured":"Youn, M. S. et al. Relationship between cervical sagittal alignment and health-related quality of life in adolescent idiopathic scoliosis. Eur. Spine J. 25, 3114\u20133119 (2016).","journal-title":"Eur. Spine J."},{"key":"86330_CR25","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1212\/WNL.0000000000003466","volume":"88","author":"MJ McKay","year":"2017","unstructured":"McKay, M. J. et al. Normative reference values for strength and flexibility of 1,000 children and adults. Neurology 88, 36\u201343 (2017).","journal-title":"Neurology"},{"issue":"5","key":"86330_CR26","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1007\/s10143-019-01163-8","volume":"43","author":"QD Buchlak","year":"2020","unstructured":"Buchlak, Q. D. et al. Machine learning applications to clinical decision support in neurosurgery: An artificial intelligence augmented systematic review. Neurosurg. Rev. 43(5), 1235\u20131253. https:\/\/doi.org\/10.1007\/s10143-019-01163-8 (2020).","journal-title":"Neurosurg. Rev."},{"key":"86330_CR27","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1016\/j.jspd.2018.03.003","volume":"6","author":"JS Kim","year":"2018","unstructured":"Kim, J. S. et al. Predicting Surgical complications in patients undergoing elective adult spinal deformity procedures using machine learning. Spine Deform. 6, 762\u2013770 (2018).","journal-title":"Spine Deform"},{"key":"86330_CR28","doi-asserted-by":"publisher","first-page":"2067","DOI":"10.1097\/00007632-199609150-00003","volume":"21","author":"T Kasai","year":"1996","unstructured":"Kasai, T., Ikata, T., Katoh, S., Miyake, R. & Tsubo, M. Growth of the cervical spine with special reference to its lordosis and mobility. Spine 21, 2067\u20132073 (1996).","journal-title":"Spine"},{"key":"86330_CR29","doi-asserted-by":"publisher","first-page":"E337","DOI":"10.1097\/BSD.0000000000000661","volume":"31","author":"A Pan","year":"2018","unstructured":"Pan, A., Hai, Y., Yang, J., Zhang, Y. & Zhang, Y. Upper Instrumented vertebrae distal to T2 leads to a higher incidence of proximal junctional kyphosis during growing-rod treatment for early onset scoliosis. Clin. Spine Surg. 31, E337\u2013E341 (2018).","journal-title":"Clin. Spine Surg."},{"key":"86330_CR30","doi-asserted-by":"publisher","first-page":"2350","DOI":"10.1097\/00007632-200211010-00008","volume":"27","author":"JM Rhee","year":"2002","unstructured":"Rhee, J. M. et al. Sagittal plane analysis of adolescent idiopathic scoliosis: The effect of anterior versus posterior instrumentation. Spine 27, 2350\u20132356 (2002).","journal-title":"Spine"},{"key":"86330_CR31","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.1007\/s00586-018-5640-y","volume":"27","author":"E Ferrero","year":"2018","unstructured":"Ferrero, E. et al. Proximal junctional kyphosis in thoracic adolescent idiopathic scoliosis: Risk factors and compensatory mechanisms in a Multicenter National Cohort. Eur. Spine J. 27, 2241\u20132250 (2018).","journal-title":"Eur. Spine J."},{"key":"86330_CR32","doi-asserted-by":"publisher","first-page":"E428","DOI":"10.1097\/BSD.0000000000000127","volume":"29","author":"K Watanabe","year":"2016","unstructured":"Watanabe, K. et al. Risk factors for proximal junctional kyphosis associated with dual-rod growing-rod surgery for early-onset scoliosis. Clin. Spine Surg. 29, E428\u2013E433 (2016).","journal-title":"Clin. Spine Surg."},{"key":"86330_CR33","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1097\/BPO.0000000000000599","volume":"37","author":"R El-Hawary","year":"2017","unstructured":"El-Hawary, R. et al. What is the risk of developing proximal junctional kyphosis during growth friendly treatments for early-onset scoliosis? J. Pediatr. Orthop. 37, 86\u201391 (2017).","journal-title":"J. Pediatr. Orthop."},{"key":"86330_CR34","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1097\/BRS.0000000000001352","volume":"41","author":"CN Carender","year":"2016","unstructured":"Carender, C. N. et al. Low pelvic incidence is associated with proximal junctional kyphosis in patients treated with growing rods. Spine 41, 792\u2013797 (2016).","journal-title":"Spine"},{"key":"86330_CR35","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1093\/neuros\/nyx479","volume":"83","author":"PG Passias","year":"2018","unstructured":"Passias, P. G. et al. Cervical alignment changes in patients developing proximal junctional kyphosis following surgical correction of adult spinal deformity. Neurosurgery 83, 675\u2013682 (2018).","journal-title":"Neurosurgery"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-86330-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-86330-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-86330-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:03:00Z","timestamp":1774418580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-86330-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["86330"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-86330-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]},"assertion":[{"value":"8 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was approved by the Department of Ethics, Beijing Chaoyang Hospital, Capital Medical University (2017-KE-67).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"We state that we have consent for publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We state that we have consented to participate.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"2024"}}