{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:49:27Z","timestamp":1793306967483,"version":"4.5.0"},"reference-count":30,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: There is no solid consensus regarding which lowest instrumented vertebra (LIV) selection criterion is best to prevent distal adding-on (DA) after adolescent idiopathic scoliosis (AIS) surgery. This study aims to search out the LIV selection criteria in the literature and to compare the ability of each LIV selection criterion to prevent DA in patients with AIS. Methods: Patients who underwent thoracic fusion for AIS of Lenke type 1A or 1B were included in this study. Nine criteria for LIV selection were found in a literature review. For each patient, whether the postoperative actual location of LIV was met with the suggested locations of the LIV was assessed. The preventive ability of nine criteria against DA was evaluated using logistic regression analysis. The patients who met the LIV selection criteria but developed DA were investigated. Results: The study cohort consisted of 145 consecutive patients with a mean age of 14.8 years. The criteria of Suk (OR = 0.267), Parisini (OR = 0.230), Wang (OR = 0.289), and Qin (OR = 0.210) showed a significantly decreased risk of DA if the LIV selection criterion was chosen at each suggested landmark. As the additional levels were fused, there was no statistically significant benefit in further reducing the risk of DA. Among the patients who met each criterion, the incidence of DA was lower in criteria by Takahashi (5.9%), Qin (7.1%), and King (7.4%) than the others. Conclusions: Qin\u2019s criterion, using the substantially touching vertebra concept, has the highest preventive ability against DA development. Extending the instrumentation further distal to this suggested LIV criterion did not add further benefit.<\/jats:p>","DOI":"10.3390\/jcm13133859","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:06:07Z","timestamp":1719824767000},"page":"3859","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Optimal Lowest Instrumented Vertebra to Prevent the Distal Adding-On Phenomenon in Patients Undergoing Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis with Lenke Type 1A and 1B Curves: Comparison of Nine Selection Criteria"],"prefix":"10.3390","volume":"13","author":[{"given":"Se-Jun","family":"Park","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Sung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9114-0150","authenticated-orcid":false,"given":"Dong-Ho","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong-Suh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Haeundae Bumin Hospital, Busan 48094, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2400","DOI":"10.1097\/01.brs.0000240212.31241.8e","article-title":"Selective posterior thoracic fusions for adolescent idiopathic scoliosis: Comparison of hooks versus pedicle screws","volume":"31","author":"Dobbs","year":"2006","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1097\/BRS.0b013e318178872a","article-title":"Operative treatment of adolescent idiopathic scoliosis with posterior pedicle screw-only constructs: Minimum three-year follow-up of one hundred fourteen cases","volume":"33","author":"Lehman","year":"2008","journal-title":"Spine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.2106\/00004623-200108000-00006","article-title":"Adolescent idiopathic scoliosis: A new classification to determine extent of spinal arthrodesis","volume":"83","author":"Lenke","year":"2001","journal-title":"J. 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