ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024
Restoring the ideal Roussouly sagittal alignment in Lenke 5 adolescent idiopathic scoliosis patients: a method for decreasing the risk of proximal junctional kyphosis.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 3 citations in OpenAlex.
- Achieving "ideal" sagittal alignment does not influence HRQoL outcomes 5 years following PSF for lenke 1 AIS.Spine deformity · 2026Article
- Sagittal Profiles and Their Reciprocal Changes Manifesting in Proximal Junctional Kyphosis Following Deformity Correction in Adolescent Idiopathic Scoliosis.Global spine journal · 2026Article
- Thoracolumbar Biomechanical Analysis of Lenke Type 1 Adolescent Idiopathic Scoliosis Across Roussouly Classifications.JOR spine · 2025Article
- Outcomes following instrumentation removal after posterior corrective fixation in adolescent idiopathic scoliosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review.Children (Basel, Switzerland) · 2024Review
- Letter to the Editor concerning "The contribution of preoperative balanced halo-pelvic traction to severe rigid spinal deformity correction" by Z. Zhou et al. (Eur Spine J [2023]; doi: 10/1007/s00586-023-07916-w).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
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6 authors at 2 institutions in 1 country.
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Abstract
purposeAlthough the Roussouly classification has been widely used in surgical planning for adult scoliosis patients, little is known about whether it can be used to guide sagittal correction for adolescent idiopathic scoliosis (AIS) patients. The purpose of this study was to explore whether the Roussouly classification could be used to help surgeons restore the ideal sagittal alignment for AIS patients to avoid the development of proximal junctional kyphosis (PJK).
methodsIn this retrospective cohort study, eighty-seven patients with Lenke 5 AIS who underwent surgery from January 2010 to August 2020 were enrolled and divided into two groups: the PJK group and the non-PJK group. All patients were classified into "current types" and "ideal types" according to two versions of the Roussouly classification, and the mismatch rate was evaluated in terms of the consistency between their current type and ideal type. Student's t test, Mann‒Whitney U test, Pearson's Chi-square test, and others were used to compare the two groups regarding patient demographic characteristics (age, sex, Risser sign, etc.) and radiographic parameters (sagittal vertical axis [SVA]; thoracic kyphosis [TK]; thoracolumbar junctional kyphosis [TLK]; lumbar lordosis [LL]; pelvic incidence [PI]; pelvic tilt [PT]; sacral slope [SS]; upper instrumented vertebra [UIV]; lower instrumented vertebra [LIV]; etc.). Multivariate logistic regression with backwards stepwise selection was performed to identify the risk factors for PJK.
resultsPJK was observed in 16 out of 87 patients (18.4%) until the final follow-up. The incidence of PJK was significantly higher in the patients not matching their ideal type than in those who did after surgery (60.9% vs. 3.1%, p = 0.000). The patients with ideal Type 1 had the highest incidence of PJK, while the lowest incidence was observed in patients with ideal Type 2 (50.0% vs. 5.1%, p = 0.000). The PJK group had greater TK, LL, and PI-LL than the non-PJK group before and after surgery. The postoperative PJA in the PJK group was also larger than that in the non-PJK group. Multivariate logistic regression revealed that postoperative Roussouly type mismatch was significantly associated with the occurrence of PJK (OR = 64.2, CI = 9.6-407.1, p = 0.000).
conclusionsThe Roussouly classification could serve as a prognostic tool for PJK in Lenke 5 AIS patients. Corrective surgery should restore sagittal alignment with respect to the patient's ideal sagittal profile (according to the Roussouly classification based on the PI) to decrease the incidence of PJK in AIS patients.
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