Adjacent level proximal kyphosis was significantly increased with pedicle screws, but the clinical significance of this is unclear. A potential solution is the substitution of hooks at the upper-instrumented vertebrae, but further investigation is required.

The fists on clavicles position for lateral radiograph acquisition has less negative shift in SVA, and in patients with spinal instrumentation, less compensatory posterior rotation of the pelvis. This position is more representative of a patient's functional balance while still allowing adequate lateral radiographic visualization of the spine.

An increased pelvic incidence, associated with both thoracic and thoracolumbar curves when compared with the normal adolescent population, does not appear to be the potential determinant of the development of thoracic versus thoracolumbar scoliosis, but may be a risk factor for the development of adolescent idiopathic scoliosis. The theory of anterior overgrowth may be supported by the identification of thoracic hypokyphosis, despite an increased pelvic incidence and lumbar lordosis, in patients with thoracic scoliosis. The association between sagittal measurements and the etiology of thoracolumbar curve formation is less clear; however, regional anterior overgrowth in the lumbar spine may also be responsible for the deformity.

Patients with neuromuscular scoliosis are at high risk of developing perioperative complications after surgical correction of their deformity (overall rate, 33.1%).

The thoracoscopic approach for instrumentation of scoliosis has advantages of reduced chest wall morbidity compared with the open thoracotomy method but allows comparable curve correction.