{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:08:54Z","timestamp":1777658934959,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective single-center study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We investigated the risk factors of postoperative shoulder imbalance (PSI) in patients with Lenke type 2 adolescent idiopathic scoliosis (AIS) including the position of preoperative upper end vertebra (UEV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Seventy-five patients with Lenke type 2 AIS who underwent posterior correction and fusion surgeries from 2008 to 2018 were included. We included only patients whose upper instrumented vertebrae were at T2. The patients were divided into 2 groups based on radiographic shoulder height (RSH) at final follow-up, namely PSI group and non-PSI group, and PSI was defined as RSH &gt; 10\u2009mm. UEV, RSH, Cobb angle, curve flexibility, T1 and T2 tilt, correction rate, Risser grade, Scoliosis Research Society-22 scores, and demographic data were compared between the groups using independent t-tests or chi-square tests. Variables with P value &lt; 0.20 in univariate analysis were assessed in logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirty-four patients in the PSI group and 37 patients in the non-PSI group were analyzed. Univariate analysis revealed that there were more patients with UEV at T1 (PSI: 85%, non-PSI: 54%, P &lt; 0.01) and Risser grade \u2265 3 (PSI: 88%, non-PSI: 62%; P &lt; 0.05) in the PSI group than in the non-PSI group. Logistic regression analysis revealed that UEV at T1 (odds ratio [OR] = 4.1 [1.2\u201314.4], P &lt; 0.05) and Risser grade \u2265 3 (OR = 3.9 [1.1\u201314.5], P &lt; 0.05) are significantly associated with PSI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>UEV at T1 and Risser grade \u2265 3\u2009at the time of surgery are significant risk factors of PSI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682211023049","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T05:10:05Z","timestamp":1623647405000},"page":"1223-1229","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Upper End Vertebra of Proximal Thoracic Curve At T1 is a Novel Risk Factor of Postoperative Shoulder Imbalance in Lenke Type 2 Adolescent Idiopathic Scoliosis"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9365-530X","authenticated-orcid":false,"given":"Norihiro","family":"Isogai","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Department of Orthopaedic Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nao","family":"Otomo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Nori","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osahiko","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8267-5789","authenticated-orcid":false,"given":"Narihito","family":"Nagoshi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0402-0389","authenticated-orcid":false,"given":"Eijiro","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuyuki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Keio Spine Research Group, Tokyo, Japan"},{"name":"Department of Orthopaedic Surgery, Fujita Health University, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaya","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morio","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4830-4690","authenticated-orcid":false,"given":"Kota","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan"},{"name":"Keio Spine Research Group, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"bibr1-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001516"},{"key":"bibr2-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-4016-9"},{"key":"bibr3-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001399"},{"key":"bibr4-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181dccd63"},{"key":"bibr5-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1186\/s13013-017-0123-1"},{"key":"bibr6-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318279b666"},{"key":"bibr7-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200209150-00009"},{"key":"bibr8-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-0902-3"},{"key":"bibr9-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e318185a36b"},{"key":"bibr10-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2697-5"},{"key":"bibr11-21925682211023049","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198971090-00005"},{"key":"bibr12-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000088480.08179.35"},{"key":"bibr13-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1007\/s005860050227"},{"key":"bibr14-21925682211023049","doi-asserted-by":"publisher","DOI":"10.3171\/2016.6.PEDS16162"},{"key":"bibr15-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000325"},{"key":"bibr16-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181f51e95"},{"key":"bibr17-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-017-5289-y"},{"key":"bibr18-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31828f0bcd"},{"key":"bibr19-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1007\/s11420-015-9451-y"},{"key":"bibr20-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2274-3"},{"key":"bibr21-21925682211023049","doi-asserted-by":"publisher","DOI":"10.3171\/2010.3.SPINE09497"},{"key":"bibr22-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200109150-00006"},{"key":"bibr23-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2017.10.036"},{"key":"bibr24-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198703000-00012"},{"key":"bibr25-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000211239.21835.ad"},{"key":"bibr26-21925682211023049","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003088"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682211023049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682211023049","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682211023049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:17:36Z","timestamp":1777447056000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682211023049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,14]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1177\/21925682211023049"],"URL":"https:\/\/doi.org\/10.1177\/21925682211023049","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,14]]}}}