European Spine Journal - 2026-05-01 - Journal Article
Interrelationships among 3D spinal alignment variables during active self-correction in adolescents with idiopathic scoliosis.
Żurawski A, Ha SY
Topics
Key Takeaway
Active 3D self-correction in AIS adolescents produced immediate improvements in trunk inclination, lateral deviation, and surface rotation, with baseline alignment parameters explaining up to 72% of correction magnitude variance (R²=0.720).
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Summary
This study assessed whether a standardized 30-minute active self-correction training session produces immediate 3D spinal alignment changes in AIS adolescents measured via DIERS Formetric 4D surface topography. Active self-correction significantly improved trunk inclination, lateral deviation, surface rotation, and thoracic kyphosis (p<0.05), while lumbar lordosis and pelvic tilt did not change. Baseline alignment parameters—not anthropometrics—were the dominant predictors of correction magnitude, with regression models achieving R² up to 0.720 and demonstrating coupled cross-planar interactions.
Key Limitation
The study captures only immediate post-training alignment changes with no follow-up, making it impossible to determine whether these corrections persist, translate to structural curve modification, or reduce progression risk.
Original Abstract
PURPOSE
This study aimed to (1) determine whether active three-dimensional (3D) self-correction induces immediate changes in spinal alignment compared with passive standing, (2) examine associations between anthropometric variables and spinal alignment parameters, and (3) identify coupled predictive relationships among alignment parameters during self-correction in adolescents with idiopathic scoliosis (AIS).
METHODS
Fifty-four adolescents with AIS (mean age 16.96 ± 2.61 years) were assessed using the DIERS Formetric 4D surface topography system under two conditions: passive standing and active self-correction following a standardized 30-minute training session. Measured variables included trunk inclination, lateral deviation, surface rotation, thoracic kyphosis, and lumbar lordosis. Between-condition differences were analyzed using the Wilcoxon signed-rank test. Associations with anthropometric variables were examined using Spearman's correlation. Multiple linear regression models were applied to identify predictors of correction magnitude based on baseline alignment parameters.
RESULTS
Significant improvements were observed during active self-correction in trunk inclination, lateral deviation, surface rotation, thoracic kyphosis, and trunk length (p < 0.05), with no significant changes in lumbar lordosis or pelvic tilt. Anthropometric variables showed no meaningful associations with alignment parameters (p > 0.05), except for a weak correlation between trunk inclination and body weight (r = -0.233). Regression analyses demonstrated that correction magnitude was strongly associated with baseline alignment parameters, with substantial explanatory power (R² up to 0.720). Significant cross-planar relationships indicated interdependence among coronal, sagittal, and transverse parameters.
CONCLUSION
Active 3D self-correction produces immediate, measurable improvements in spinal alignment in AIS. Correction responses are primarily determined by baseline biomechanical alignment rather than anthropometric factors and exhibit coupled, multi-planar interactions, supporting integrated PSSE approaches targeting coordinated control across all planes.