ArticleQuantitative imaging in medicine and surgery2025
Evaluation of cosmetic shoulder balance in Lenke type 1 and 2 adolescent idiopathic scoliosis across different observational perspectives.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Upper Instrumented Vertebra Selection Influences Proximal Balance but Not Long-Term Clinical Outcomes in Lenke Type 1 Adolescent Idiopathic Scoliosis.Journal of clinical medicine · 2026Article
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9 authors.
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Abstract
Background: Shoulder imbalance in patients with adolescent idiopathic scoliosis (AIS) contributes to a negative self-image and psychological distress, particularly in those with Lenke type 1 or 2 curves. Although previous studies have emphasized the significance of cosmetic shoulder balance (Sh.B) in informing clinical decisions and evaluating postoperative patient-reported outcomes (PROs), the observational perspective-a crucial factor-has often been overlooked in cosmetic assessment, potentially leading to inaccuracies and inconsistencies in measurements. Therefore, this study aimed to identify potential disparities in cosmetic Sh.B parameters across different observational points and to investigate their correlation with PROs. Methods: A total of 74 female patients with AIS and Lenke type 1 or 2 curves were included in this study. Full-spine radiographs were used to measure the following parameters: radiographic shoulder height difference (RSHD), first rib angle (FRA), clavicle-rib cage intersection (CRCI), coracoid process height (CPH), T1 tilt, clavicle angle (CA), clavicle-chest cage angle difference (CCAD), coronal balance distance (CBD), and Cobb angle. Cosmetic parameters, including shoulder angle (α Results: As compared to eye-level measurement, shoulder level-measurement produced significantly larger α Conclusions: Cosmetic measurements of Sh.B exhibited significant variability depending on observation point. Although cosmetic Sh.B measured from the anterior eye level may underestimate the patients' actual Sh.B, it more accurately reflects the patients' self-evaluation; meanwhile, cosmetic Sh.B evaluated from the posterior shoulder level better correlates with ΔSRS-22 scores during follow-up, suggesting its suitability in optimizing surgical strategies.
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