{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:28:12Z","timestamp":1794324492078,"version":"4.9.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,29]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Conventional segmental pedicle screw fixation for thoracic adolescent idiopathic scoliosis (AIS) often compromises the ability to restore physiological thoracic kyphosis (TK). The vertebral coplanar alignment (VCA) technique addresses 3D deformity correction on the convex side in thoracic scoliosis. In particular, it enhances sagittal plane correction by adding kyphotic contouring via the concave-side rod while preserving the ideal thoracic curvature, including the physiological TK apex location on the convex side. This multicenter cohort study aimed to analyze the surgical outcomes of the VCA technique and demonstrate its effectiveness in restoring physiological TK in hypokyphotic AIS patients with &lt; 10\u00b0 of kyphosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Data from 127 consecutive patients who underwent corrective surgery using the VCA technique for hypokyphotic (TK &lt; 10\u00b0) thoracic AIS at 13 institutions, with a minimum follow-up of 2 years, were retrospectively analyzed. Outcome measures included patient demographics, radiographic parameters, TK apex location, and Scoliosis Research Society (SRS)\u201322 scores assessed preoperatively and at 2 years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The mean main thoracic Cobb angle improved significantly from 55.0\u00b0 to 14.1\u00b0 at 2 years postoperatively, with a mean correction rate of 74%. The mean TK (T5\u201312) increased significantly from 4.4\u00b0 to 19.5\u00b0. The proportion of patients with the TK apex located at T6\u20138 significantly increased from 22% to 73%. The mean SRS-22 total score improved from 3.6 to 4.5 at 2 years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This multicenter study highlights the advantages of VCA, particularly in restoring physiological TK in hypokyphotic (TK &lt; 10\u00b0) thoracic AIS. The VCA procedure contributed to maintaining an ideal thoracic shape with the physiological TK apex on the convex side prior to rod placement and before performing various manipulations via the rod on the concave side.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.1.spine251203","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:01:00Z","timestamp":1779840060000},"page":"245-253","source":"Crossref","is-referenced-by-count":0,"title":["Advantages of vertebral coplanar alignment technique for restoring physiological thoracic kyphosis in hypokyphotic adolescent idiopathic scoliosis with &lt; 10\u00b0 of kyphosis"],"prefix":"10.3171","volume":"45","author":[{"given":"Katsutaka","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Yokohama Brain and Spine Center, Kanagawa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Uchino","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Yokohama Brain and Spine Center, Kanagawa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Moridaira","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Dokkyo Medical University Nikko Medical Center, Tochigi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Dokkyo Medical University, Tochigi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Nojiri","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Juntendo University, Tokyo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arihisa","family":"Shimura","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Juntendo University, Tokyo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Tomori","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Saitama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Ehime University School of Medicine, Ehime;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Katayanagi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Akeda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Mie;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Miyazaki, Miyazaki;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Occupational and Environmental Health, Fukuoka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kudanzaka Hospital, Tokyo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Nikaido","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikito","family":"Tsushima","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Konan Kosei Hospital, Aichi; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka Metropolitan University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Taneichi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Dokkyo Medical University, Tochigi;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Child Orthop","first-page":"3","article-title":"Epidemiology of adolescent idiopathic scoliosis","volume":"7","author":"Konieczny MR","year":"2013","unstructured":"Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop. 2013;7(1):3\u20139. doi:10.1007\/s11832-012-0457-4"},{"issue":"18","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"2040","article-title":"Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis","volume":"29","author":"Kim YJ","year":"2004","unstructured":"Kim YJ, Lenke LG, Cho SK, Bridwell KH, Sides B, Blanke K. Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. 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Selective posterior thoracic fusions for adolescent idiopathic scoliosis: comparison of hooks versus pedicle screws. Spine (Phila Pa 1976). 2006;31(20):2400\u20132404. doi:10.1097\/01.brs.0000240212.31241.8e"},{"issue":"4","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"448","article-title":"Coronal and sagittal plane correction in adolescent idiopathic scoliosis: a comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs","volume":"32","author":"Lowenstein JE","year":"2007","unstructured":"Lowenstein JE, Matsumoto H, Vitale MG,  Coronal and sagittal plane correction in adolescent idiopathic scoliosis: a comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs. 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