ArticleSpine deformity2026
The SRS-Lenke-Aubin 3D classification of adolescent idiopathic scoliosis.
Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Comparison of cervical sagittal alignment in normal subjects and adolescents and young adults with 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 · 2026Article
- Transverse-plane descriptors and modifiers of the SRS-Lenke-Aubin 3D classification provide complementary and clinically informative 3D features beyond 2D assessment in Lenke 1 AIS curves.Spine deformity · 2026Article
- Geometric foundations of measurement uncertainty and clinical relevance in radiographic spinal angle assessment.Spine deformity · 2026Article
- Automating Adolescent Idiopathic Scoliosis Classification: An Interpretable, Workflow-Based Approach to Lenke Classification: Commentary on an article by Lingcong Xu, MD, et al.: " A Fully Automated Multistage Deep Learning System for Lenke Classification. Enhanced Diagnostic Precision in Adolescent Idiopathic Scoliosis ".The Journal of bone and joint surgery. American volume · 2026Article
- Complementary value of transverse plane descriptors in the SRS-Lenke-Aubin 3D classification for adolescent idiopathic scoliosis.Spine deformity · 2026Article
- Automated quantification of coronal balance in spinal deformity: a safety-aware clinical workflow.Scientific reports · 2026Article
- Advances in fusion level selection and surgical approaches for adolescent idiopathic scoliosis based on the Lenke classification system: a narrative review.BMC surgery · 2026Review
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
Abstract
purposeAdolescent idiopathic scoliosis (AIS) is a complex three-dimensional (3D) spinal deformity, with transverse plane rotational components increasingly targeted by modern surgical techniques. Yet, clinical evaluation remains predominantly based on 2D radiographic parameters, including the widely used Lenke classification. In response, the 3D Classification Task Force of the Scoliosis Research Society (SRS) developed a comprehensive, clinically relevant classification system that remains intuitive, reproducible, and readily applicable by spine surgeons. This manuscript introduces the proposed SRS-Lenke-Aubin 3D classification and evaluates its ability to provide a structured and clinically meaningful 3D characterization of spinal deformities in AIS.
methodsTo maintain continuity with standard clinical practices, the system builds upon the established Lenke classification and introduces two complementary 3D descriptors: the orientation of the regional plane of deformation (ORPD) and the apical vertebral rotation (AVR). These indices capture transverse plane deformities at the regional and local levels, respectively. Each was independently assessed for the proximal thoracic (PT), main thoracic (MT), and thoracolumbar/lumbar (TL/L) regions using calibrated 3D reconstructions from biplanar radiographs. A population-representative cohort of 285 AIS surgical cases was used to evaluate the system. ORPD and AVR values were translated into categorical modifiers using predefined clinical thresholds.
resultsThe new SRS-Lenke-Aubin 3D AIS classification adds two transverse plane modifiers per spinal region-the ORPD and AVR-yielding a modular 3-tiered, 4-modifier system: Curve type (1-6), Lumbar spine modifier (A, B, C), Thoracic sagittal profile modifier (-, N, +), Transverse plane regional modifier (ORPD: 1-3) and Transverse plane local modifier (AVR: s, m, l). A broad range of ORPD × AVR combinations was observed across the cohort, reflecting the system's ability to capture transverse plane heterogeneity. Notably, similar coronal curve types often exhibited divergent transverse morphologies, underscoring the added value of these 3D descriptors in identifying clinically relevant variation.
conclusionsThe SRS-Lenke-Aubin 3D classification enriches the existing Lenke framework by incorporating practical transverse plane descriptors compatible with standard imaging workflows. This system offers a clinically meaningful step toward more complete 3D characterization of AIS, with potential applications in improving surgical planning, assessing outcomes, and supporting future integration with automated 3D tools.
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