{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T08:34:14Z","timestamp":1793176454963,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective matched cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the association between body mass index (BMI) and postoperative cosmetic improvement in adolescent idiopathic scoliosis (AIS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 737 female AIS patients, the 10th percentile of the raw BMI distribution was used to define \u201cextremely low BMI\u201d. Lenke type 1 patients with extremely low BMI were matched 1:1 to non-extremely low BMI patients by age, apical vertebra, and preoperative Cobb angle. Sex, Risser sign category, curve pattern and surgical approach were standardized through the inclusion criteria. Pre- and 1-year postoperative radiographic and cosmetic parameters and SRS-22 scores were compared using paired analyses accounting for matched-pair design. The primary outcome was the between-group difference in postoperative cosmetic improvement; all other analyses were prespecified as secondary or exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The BMI threshold for extremely low BMI was 15.57 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Radiographic correction was comparable between cohorts. However, the non-extremely low BMI group improved more in shoulder area indices (SAI1\/SAI2), shoulder (SA) and axilla (AA) angles, right-left waist angle difference (RLWAD), and posterior superior iliac spine (PSIS) angle (all P &lt; 0.05). The extremely low BMI group had lower SRS-22 self-image (3.3\u00b10.6 vs. 4.2\u00b10.8) and mental health (3.4\u00b10.4 vs. 4.1\u00b10.3) scores (both P \u2264 0.010). Fisher\u2019s r-to-z test showed significantly weaker or directionally different radiographic\u2013cosmetic correlations in the extremely low BMI group (P&lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Extremely low BMI was associated with poorer cosmetic improvement, worse self-image, and weaker radiographic\u2013cosmetic correlations, suggesting a wider discrepancy between radiographic correction and cosmetic improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261501029","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:44:31Z","timestamp":1792820671000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Discrepancy Between Radiographic Correction and Cosmetic Improvement in Adolescent Idiopathic Scoliosis: The Role of Extremely Low BMI"],"prefix":"10.1177","author":[{"given":"Weihang","family":"Chu","sequence":"first","affiliation":[{"name":"Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdukahar","family":"Kiram","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Li","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongshan","family":"Hu","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-8525","authenticated-orcid":false,"given":"Benlong","family":"Shi","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Qiao","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9220-2619","authenticated-orcid":false,"given":"Saihu","family":"Mao","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7655-2635","authenticated-orcid":false,"given":"Xiaodong","family":"Qin","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4202-6092","authenticated-orcid":false,"given":"Yong","family":"Qiu","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University"},{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8569-3595","authenticated-orcid":false,"given":"Zezhang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University"},{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2027-8088","authenticated-orcid":false,"given":"Zhen","family":"Liu","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University"},{"name":"Nanjing Drum Tower Hospital"},{"name":"Nanjing University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2469"},{"issue":"1","key":"e_1_3_5_3_2","first-page":"26","article-title":"Health-related quality-of-life scores, spine-related symptoms, and reoperations in young adults 7 to 17 years after surgical treatment of adolescent idiopathic scoliosis","volume":"44","author":"Spanyer JM","year":"2015","unstructured":"Spanyer JM, Crawford CH, Canan CE, Burke LO, Heintzman SE, Carreon LY. 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