{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:25:52Z","timestamp":1782350752055,"version":"3.54.5"},"reference-count":35,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"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\/Objective: Limited data exist regarding the long-term clinical outcomes and related factors after adult spinal deformity (ASD) surgery. This study aims to characterize patients who experienced poor clinical outcomes during long-term follow-up after ASD surgery. Methods: Patients who underwent ASD surgery with \u22655-vertebra fusion including the sacrum and \u22655-year follow-up were included. They were divided into two groups according to the Oswestry Disability Index (ODI) at the last follow-up: group P (poor outcome, ODI &gt; 40) and group NP (non-poor outcome, ODI \u2264 40). Clinical variables, including patient factors, surgical factors, radiographic parameters, and mechanical complications (proximal junctional kyphosis [PJK] and rod fracture), were compared between the groups. Results: A total of 105 patients were evaluated, with a mean follow-up of 100.6 months. The mean age was 66.3 years, and 94 patients (89.5%) were women. There were 52 patients in group P and 53 patients in group NP. Univariate analysis showed that low T-score, postoperative correction relative to age-adjusted pelvic incidence-lumbar lordosis, T1 pelvic angle (TPA) at last follow-up, and PJK development were significant factors for poor clinical outcomes. Multivariate analysis identified PJK as the single independent risk factor (odds ratio [OR] = 3.957 for PJK development relative to no PJK, OR = 21.141 for revision surgery for PJK relative to no PJK). Conclusions: PJK development was the single independent factor affecting poor clinical outcomes in long-term follow-up. Therefore, PJK prevention appears crucial for achieving long-term success after ASD surgery.<\/jats:p>","DOI":"10.3390\/jcm13196000","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T07:39:52Z","timestamp":1728459592000},"page":"6000","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Characterization of Patients with Poor Clinical Outcome after Adult Spinal Deformity Surgery: A Multivariate Analysis of Mean 8-Year Follow-Up Data"],"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"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8151-1084","authenticated-orcid":false,"given":"Hyun-Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri-si 11923, 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2719-1989","authenticated-orcid":false,"given":"Minwook","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2224-604X","authenticated-orcid":false,"given":"Kyunghun","family":"Jung","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":[[2024,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"776","DOI":"10.31616\/asj.2022.0376","article-title":"Adult Spinal Deformity: A Comprehensive Review of Current Advances and Future Directions","volume":"16","author":"Kim","year":"2022","journal-title":"Asian Spine J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/BRS.0000000000002435","article-title":"Under Correction of Sagittal Deformities Based on Age-adjusted Alignment Thresholds Leads to Worse Health-related Quality of Life Whereas over Correction Provides No Additional Benefit","volume":"43","author":"Scheer","year":"2018","journal-title":"Spine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1097\/BRS.0b013e31829ec563","article-title":"Change in classification grade by the SRS-Schwab Adult Spinal Deformity Classification predicts impact on health-related quality of life measures: Prospective analysis of operative and nonoperative treatment","volume":"38","author":"Smith","year":"2013","journal-title":"Spine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1007\/s00586-016-4872-y","article-title":"Are sagittal spinopelvic radiographic parameters significantly associated with quality of life of adult spinal deformity patients? Multivariate linear regression analyses for pre-operative and short-term post-operative health-related quality of life","volume":"26","author":"Takemoto","year":"2017","journal-title":"Eur. Spine J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"408","DOI":"10.3171\/2019.2.SPINE181486","article-title":"Factors influencing patient satisfaction after adult scoliosis and spinal deformity surgery","volume":"31","author":"Hayashi","year":"2019","journal-title":"J. Neurosurg. 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Neurosurg. Spine"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/19\/6000\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:09:30Z","timestamp":1760112570000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/19\/6000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,8]]},"references-count":35,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["jcm13196000"],"URL":"https:\/\/doi.org\/10.3390\/jcm13196000","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,8]]}}}