A Novel and Simple Technique to Correct Shoulder Balance in Patients Undergoing Surgery for Adolescent Idiopathic Scoliosis

Objective : This study aims to analyze common radiographic parameters in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) and determine their role in postoperative shoulder imbalance. Methods : In this descriptive case series, all patients who underwent surgical correction of AIS in 2020 were retrospectively analyzed over a one-month period (June 20 to July 20, 2024). Results : A total of 62 patients were assessed. Significant changes were observed in radiographic shoulder height (RSH) from 7.18 ± 9.65 preoperatively to -0.03 ± 12.23 postoperatively (p = 0.001). Clavicle angle also showed significant changes (0.29 ± 2.19 to -1.85 ± 1.70, p < 0.001). Medial shoulder balance parameters, such as T1 tilt angle and 1st rib angle, also exhibited significant changes (T1 tilt: -0.34 ± 9.53 to 4.97 ± 5.77, 1st rib angle: -1.65 ± 6.53 to 3.76 ± 4.33, p < 0.001 for both). Pearson’s correlation analysis indicated that only the preoperative clavicle angle had a significant correlation with preoperative RSH (r = 0.526, p < 0.001). Conclusion : The clavicle angle is positively correlated with RSH and can be utilized to assess shoulder balance, thereby enhancing patient appearance and satisfaction. However, medial radiologic parameters such as T1 tilt and 1st rib angle do not show significant correlation with shoulder balance and should not be used as predictors.