{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T16:52:54Z","timestamp":1782579174230,"version":"3.54.5"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Although it is well known that major curve severity in adolescent idiopathic scoliosis (AIS) is inversely related to self-image, surgeons often encounter patients who complain of low self-image with preoperatively mild curves or postoperatively well-corrected main curves, suggesting the presence of other factors. This study examined factors contributing to self-image in AIS.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A total of 86 consecutive patients who underwent posterior spinal fusion for AIS Lenke 1 or 2 curves and were followed for a minimum of 2 years were included in this study of patient self-image based on data that included scores reported on the Scoliosis Research Society survey (SRS-22r). The authors evaluated sex, BMI, Risser grade, age, angle of trunk rotation, Cobb angle of the main thoracic (MT) curve, Cobb angle of the thoracolumbar\/lumbar (TL\/L) curve, apical vertebral translation (AVT), T5\u201312 kyphotic angle, and clavicular angle. Univariate and multivariate general linear models were employed to identify preoperative and 2-year postoperative factors that impact self-image.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Univariate analysis revealed no significant correlation between preoperative MT curve Cobb angle and SRS-22r self-image score (p = 0.51), although patients with a higher MT curve AVT had a significantly worse preoperative self-image (p &lt; 0.01). Two years postoperatively, larger Cobb angle of the TL\/L curve (p = 0.01) and higher Risser grade (p = 0.03) resulted in significantly lower self-image scores. In multivariate testing, preoperative MT curve AVT remained significantly related to diminished self-image (p &lt; 0.01). Two years later, higher TL\/L curve (p &lt; 0.01), Risser grade (p = 0.03), and MT curve AVT (p = 0.03) had significant associations with lower self-image scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Preoperative MT curve AVT appears more strongly related to self-image than does Cobb angle. Two years postoperatively, persistent TL\/L region curvature and high Risser grade may also be associated with diminished patient self-image.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2020.2.peds19656","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T07:06:45Z","timestamp":1587712005000},"page":"211-216","source":"Crossref","is-referenced-by-count":10,"title":["Residual thoracolumbar\/lumbar curve is related to self-image after posterior spinal fusion for Lenke 1 and 2 curves in adolescent idiopathic scoliosis patients"],"prefix":"10.3171","volume":"26","author":[{"given":"Tetsuhiko","family":"Mimura","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shugo","family":"Kuraishi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Uehara","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Oba","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Takizawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Munakata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terue","family":"Hatakenaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiko","family":"Koseki","sequence":"additional","affiliation":[{"name":"Faculty of Textile Science and Technology, Shinshu University, Ueda, Nagano, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"18","key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2381","DOI":"10.1097\/00007632-200009150-00018","article-title":"Further development and validation of the Scoliosis Research Society (SRS) outcomes instrument","volume":"25","author":"Asher MA","year":"2000","unstructured":"Asher MA, Min Lai S, Burton DC. 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