{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T09:25:09Z","timestamp":1787045109156,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Posterior spinal fusion (PSF) provides reliable deformity correction for adolescent idiopathic scoliosis (AIS); however, it reduces lumbar mobility because of the fusion of motion segments. Hybrid fixation, which combines thoracic PSF with thoracolumbar\/lumbar vertebral body tethering (VBT), aims to preserve lumbar function while maintaining satisfactory deformity correction. Methods: This retrospective, non-randomized comparative cohort study included 66 adolescents with double-major AIS treated with hybrid fixation (n = 30) or posterior long fusion (n = 36) at a single tertiary referral spine deformity center. Radiographic outcomes, lumbar flexibility, sagittal range of motion (ROM), lumbar core muscle strength (LCMS), SRS-22r Function scores, complications, and revision surgery were assessed after a minimum follow-up of 24 months. Multivariable regression analyses were used to identify independent predictors of postoperative functional outcomes. Results: Both procedures achieved excellent correction of the main thoracic curve and satisfactory global spinal alignment. Posterior long fusion provided greater thoracolumbar\/lumbar curve correction (p &lt; 0.001), whereas hybrid fixation resulted in significantly better lumbar flexibility, sagittal ROM, and LCMS (all p \u2264 0.006). Radiographic tether breakage occurred in eight hybrid patients (26.7%), though most were asymptomatic; revision surgery was required in two patients (6.7% vs. 0%, p = 0.20). Conclusions: Hybrid fixation was associated with better objective lumbar function than posterior long fusion, with satisfactory deformity correction, in adolescents with double-major AIS. This benefit should be weighed against a higher complication rate driven mainly by tether breakage, supporting individualized, shared decision-making for motion-preserving strategies.<\/jats:p>","DOI":"10.3390\/jcm15166340","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:01:26Z","timestamp":1786968086000},"page":"6340","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional, Radiographic, and Patient-Reported Outcomes of Hybrid Fixation Versus Posterior Long Fusion for Double-Major Adolescent Idiopathic Scoliosis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9044-6898","authenticated-orcid":false,"given":"Burak","family":"Abay","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Demiroglu Bilim University, 34381 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9589-7560","authenticated-orcid":false,"given":"Selmin Ervin","family":"Arsoy","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Demiroglu Bilim University, 34381 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1385-5721","authenticated-orcid":false,"given":"Hamisi Mwarindano","family":"Mraja","sequence":"additional","affiliation":[{"name":"Scoliosis and Spine Center\u2014Istanbul, Istanbul Florence Nightingale Hospital, 34381 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3425-3220","authenticated-orcid":false,"given":"Ilyas","family":"Dolas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Demiroglu Bilim University, 34381 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3263-9290","authenticated-orcid":false,"given":"Meric","family":"Enercan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Demiroglu Bilim University, 34381 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-2617","authenticated-orcid":false,"given":"Azmi","family":"Hamzaoglu","sequence":"additional","affiliation":[{"name":"Scoliosis and Spine Center\u2014Istanbul, Istanbul Florence Nightingale Hospital, 34381 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E1405","DOI":"10.1097\/BRS.0b013e3182a4038b","article-title":"Loss in Spinal Motion From Inclusion of a Single Midlumbar Level in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis","volume":"38","author":"Lee","year":"2013","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Hammad, A., Balsano, M., and Ahmad, A.A. 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