Postoperative Thoracic Kyphosis is Associated with Clinically Significant Pain Improvement at 1-Year Follow-Up in Adolescent Idiopathic Scoliosis: a Multicenter Study

To identify postoperative radiographic parameters independently associated with clinically meaningful pain improvement one year after surgery in a selected cohort of adolescents with idiopathic scoliosis (AIS) reporting substantial preoperative pain. This was a retrospective analysis of a prospectively collected multicenter database including 378 AIS patients treated with posterior spinal fusion. Patients with substantial preoperative pain (SRS-22 pain ≤ 4.0) and ≥ 1-year follow-up were included. A 0.6-point MCID in SRS-22 pain defined meaningful improvement. Groups were compared and significant postoperative radiographic variables plus preoperative pain entered a multivariate logistic regression model. Nagelkerke R² and ROC-AUC assessed performance. Eighty-eight patients met the inclusion criteria (mean age 14.7 ± 1.8 years; 77 females). Sixty-four patients (72.7