{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:28:58Z","timestamp":1782350938806,"version":"3.54.5"},"reference-count":34,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Beijing Natural Science Foundation","award":["20L2211"],"award-info":[{"award-number":["20L2211"]}]},{"name":"Beijing Natural Science Foundation","award":["22kcjjyb-5"],"award-info":[{"award-number":["22kcjjyb-5"]}]},{"name":"science and technology innovation fund of Beijing Chaoyang Hospital","award":["20L2211"],"award-info":[{"award-number":["20L2211"]}]},{"name":"science and technology innovation fund of Beijing Chaoyang Hospital","award":["22kcjjyb-5"],"award-info":[{"award-number":["22kcjjyb-5"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: We aimed to propose the apical vertebras distribution modifier to supplement the coronal balance (CB) classification for adult idiopathic scoliosis (AdIS). An algorithm to predict postoperative coronal compensation and avoid postoperative coronal imbalance (CIB) was proposed. Methods: Patients were categorized into CB and CIB groups according to the preoperative coronal balance distance (CBD). The apical vertebras distribution modifier was defined as negative (\u2212) if the centers of the apical vertebras (CoAVs) were on either side of the central sacral vertical line (CSVL) and positive (+) if the CoAVs were on the same side of the CSVL. Results: A total of 80 AdIS patients, with an average age of 25.97 \u00b1 9.20 years, who underwent posterior spinal fusion (PSF) were prospectively recruited. The mean Cobb angle of the main curve was 107.25 \u00b1 21.11 degrees at preoperation. The mean follow-up time was 3.76 \u00b1 1.38 (2\u20138) years. At postoperation and follow-up, CIB occurred in 7 (70%) and 4 (40%) CB\u2212 patients, 23 (50%) and 13 (28.26%) CB+ patients, 6 (60%) and 6 (60%) CIB\u2212 patients, and 9 (64.29%) and 10 (71.43%) CIB+ patients. Health-related quality of life (HRQoL) was significantly better in the CIB\u2212 group compared with that of the CIB+ group in the dimension of back pain. To avoid postoperative CIB, the correction rate of the main curve (CRMC) should match the compensatory curve for CB\u2212\/+ patients; the CRMC should be greater than the compensatory curve for CIB\u2212 patients; and the CRMC should be less than the compensatory curve for CIB+ patients, and the inclination of the LIV needs to be reduced. Conclusions: CB+ patients have the least postoperative CIB rate and the best coronal compensatory ability. CIB+ patients are at a high risk of postoperative CIB and have the poorest coronal compensatory capacity in the event of postoperative CIB. The proposed surgical algorithm facilitates the handling of each type of coronal alignment.<\/jats:p>","DOI":"10.3390\/jpm13060897","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:19:37Z","timestamp":1685204377000},"page":"897","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Apical Vertebras Distribution Modifier for Coronal Balance Classification in Adult Idiopathic Scoliosis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-4680","authenticated-orcid":false,"given":"Aixing","family":"Pan","sequence":"first","affiliation":[{"name":"Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-325X","authenticated-orcid":false,"given":"Yong","family":"Hai","sequence":"additional","affiliation":[{"name":"Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"New York-Presbyterian Och Spine Hospital, New York, NY 10034, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaomin","family":"Zheng","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510062, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jincai","family":"Yang","sequence":"additional","affiliation":[{"name":"Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1016\/S0140-6736(08)60658-3","article-title":"Adolescent idiopathic scoliosis","volume":"371","author":"Weinstein","year":"2008","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.clinbiomech.2017.11.011","article-title":"Are we simplifying balance evaluation in adolescent idiopathic scoliosis?","volume":"51","author":"Pasha","year":"2018","journal-title":"Clin. 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