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Updated: Mar 10, 2026
Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis
Published on: December 2, 2025
Does Thoracic Hypokyphosis Matter in Lenke Type 1 Adolescent Idiopathic Scoliosis?
Steven D Glassman1, Daniel J Sucato2, Leah Y Carreon1
1Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA.
Study Design:
We analyzed a prospective cohort of Lenke 1ABC adolescent idiopathic scoliosis (AIS) patients based on differences in T5-T12 sagittal alignment.
Objective:
Our objective was to determine whether patients with hypokyphotic scoliosis demonstrate unique characteristics in terms of baseline health status and response to surgery.
Background Summary:
Right thoracic AIS often presents as a hypokyphotic scoliosis, with rotatory deformity resulting in a diminution of the normal thoracic kyphosis. The perceived importance is indicated by the inclusion of a sagittal plane modifier within Lenke's classification system for AIS and studies examining reduction strategies to restore thoracic kyphosis.
Methods:
We grouped patients based on thoracic kyphosis, measured from T5 to T12, as either less than 10° (hypokyphotic) or greater than or equal to 10° (normal/kyphotic). We used Student t test for independent samples to compare continuous variables between the hypokyphotic and normal/kyphotic groups.
Results:
There was a significant difference in age between groups (mean age, 14.9 years in the hypokyphotic group versus 13.4 years in the normal/kyphotic group; p = .007). Differences in baseline health status measures were statistically significant but small. Hypokyphotic patients reported less pain than normal/kyphotic patients, with a mean Scoliosis Research Society (SRS) Pain score of 4.15 versus 4.03 (p = .044), better SRS Mental Domain scores (4.06 vs. 3.92; p = .026), and better SRS Total scores (3.92 vs. 3.83, p = .027). The hypokyphotic group also had better SRS Appearance (3.36 vs. 3.30) and Activity scores (4.20 vs. 4.13), but these differences did not reach statistical significance.
Conclusions:
There were no differences in baseline or 2-year postoperative outcome scores in Lenke 1 AIS patients with hypokyphosis compared with patients with normal sagittal alignment. Maintenance of or restoration to normal kyphosis in hypokyphotic patients with Lenke 1 AIS may not improve clinical outcome compared with patients who remain lordotic after surgical correction.
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