Lateral view fulcrum bending radiographs predict postoperative hypokyphosis after selective thoracic fusion in adolescent idiopathic scoliosis

Fulcrum bending radiography is useful in assessing coronal and sagittal flexibility for preoperative planning. In patients with T5-12 kyphosis <12.5° on lateral view fulcrum bending radiographs, Ponte osteotomies or releases, or a decrease in convex side implant density should be considered to improve kyphosis restoration and reduce the risk of 2-year postoperative hypokyphosis.