Spinal energy balance can predict post-operative spine alignment in Lenke 1 Adolescent Idiopathic Scoliosis
Abstract
Purpose: The preoperative planning of adolescent idiopathic scoliosis (AIS) remains largely debated. We hypothesized that adopting a biomechanical energetic framework could provide valuable insights for exploring the impact of spinal arthrodesis. Using this approach, we conducted a comparative analysis to quantify discrepancies between in silico simulations derived from preoperative radiographs and the actual three-dimensional spinal alignment obtained from post-operative imaging. Methods: Fifty-two consecutive patients with Lenke Type 1 AIS (mean age: 16 years; mean thoracic Cobb angle: 52°) who underwent posterior spinal fusion were included in the analysis. All patients had complete biplanar radiographs at three time points: preoperatively, post-operatively and at two-year follow-up. Discrepancies between in silico simulated surgery, calculated using preoperative radiographs and a biomechanical model, and actual clinical outcomes were quantified using two metrics: maximum coronal/sagittal deviations (MaxC/MaxS) from T1 to L5, and a comprehensive predictability factor (ac and as) measuring cumulative 3D position discrepancies across 17 vertebral levels, normalized by total spinal length. Results: Mean MaxC was 4.7 mm (SD=4.9) and MaxS was 5.7 mm (SD=3.8). Mean values of ac were 3.4% (SD=3.8) and as were 4.1% (SD=2.6). Of the cohort, 44 patients (90%) showed very good or good agreement in the coronal in silico simulation and 43 patients (88%) in the sagittal in silico simulation. When the coronal and sagittal results were combined, 38 patients (78%) showed very good or good agreement. Conclusion: The distribution of biomechanical energy obtained from preoperative radiographs is reliable to simulate spine alignment after arthrodesis in a Lenke 1 AIS cohort.
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BibTeX
@article{langlais2026spinal,
title = {{Spinal energy balance can predict post-operative spine alignment in Lenke 1 Adolescent Idiopathic Scoliosis}},
author = {Tristan Langlais and Jérôme Sales de Gauzy and Joe Rassi and Mathilde Bony and Baptiste Brun-Cottan and Amandine Eon and Franck Accadbled and Pascal Swider and Pauline Assemat},
journal = {Spine Deformity},
year = {2026},
month = oct,
doi = {10.1007/s43390-026-01353-7},
url = {https://hal.science/hal-05616293v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Spinal energy balance can predict post-operative spine alignment in Lenke 1 Adolescent Idiopathic Scoliosis
AU - Tristan Langlais
AU - Jérôme Sales de Gauzy
AU - Joe Rassi
AU - Mathilde Bony
AU - Baptiste Brun-Cottan
AU - Amandine Eon
AU - Franck Accadbled
AU - Pascal Swider
AU - Pauline Assemat
PY - 2026
DA - 2026/10/19
JO - Spine Deformity
DO - 10.1007/s43390-026-01353-7
UR - https://hal.science/hal-05616293v1
AB - Purpose: The preoperative planning of adolescent idiopathic scoliosis (AIS) remains largely debated. We hypothesized that adopting a biomechanical energetic framework could provide valuable insights for exploring the impact of spinal arthrodesis. Using this approach, we conducted a comparative analysis to quantify discrepancies between in silico simulations derived from preoperative radiographs and the actual three-dimensional spinal alignment obtained from post-operative imaging. Methods: Fifty-two consecutive patients with Lenke Type 1 AIS (mean age: 16 years; mean thoracic Cobb angle: 52°) who underwent posterior spinal fusion were included in the analysis. All patients had complete biplanar radiographs at three time points: preoperatively, post-operatively and at two-year follow-up. Discrepancies between in silico simulated surgery, calculated using preoperative radiographs and a biomechanical model, and actual clinical outcomes were quantified using two metrics: maximum coronal/sagittal deviations (MaxC/MaxS) from T1 to L5, and a comprehensive predictability factor (ac and as) measuring cumulative 3D position discrepancies across 17 vertebral levels, normalized by total spinal length. Results: Mean MaxC was 4.7 mm (SD=4.9) and MaxS was 5.7 mm (SD=3.8). Mean values of ac were 3.4% (SD=3.8) and as were 4.1% (SD=2.6). Of the cohort, 44 patients (90%) showed very good or good agreement in the coronal in silico simulation and 43 patients (88%) in the sagittal in silico simulation. When the coronal and sagittal results were combined, 38 patients (78%) showed very good or good agreement. Conclusion: The distribution of biomechanical energy obtained from preoperative radiographs is reliable to simulate spine alignment after arthrodesis in a Lenke 1 AIS cohort.
SN - 2212-134X
SN - 2212-1358
ER -