The silent segment speaks: functional and clinical impact of concomitant spondylolysis in adolescent idiopathic scoliosis. Retrospective cohort study

This study establishes spondylolysis as a clinically impactful comorbidity in adolescent idiopathic scoliosis, associated with increased postoperative pain, dysfunction, and distal junctional complications. Routine preoperative identification and tailored surgical strategies are warranted. By positioning pars defects as modifiable risk factors, our findings support a paradigm shift toward biomechanically-informed, individualized approaches in AIS surgical planning and long-term management.