AO Spine Knowledge Forum Deformity

A global clinical research group transforming spinal deformity care through impactful research

How the AO Spine Knowledge Forum Deformity improves patient care


AO Spine Knowledge Forum (KF) Deformity aims to improve the care for patients with a spinal deformity by generating and disseminating meaningful and impactful clinical evidence.

They do this by engaging leading clinicians, researchers, and spine centers from around the world to perform evidence-based research and by disseminating the research findings and newfound knowledge through publications and presentations.

Practical tools for clinicians treating patients with spinal deformities

These selected clinical tools and articles developed by the AO Spine Knowledge Forum Deformity will help clinicians in planning appropriate treatments, assessing patient suitability, training next generation surgeons, and providing the best evidence to support decision-making, ultimately enhancing clinical practice and outcomes for spine deformity patients.

 

ASD patient profile

AO ASD Patient Profile  

Classification systems

The AO Adult Spine Deformity Patient Profile is a classification tool to assist clinicians systematically consider all important factors so they can provide the best care for adult spine deformity patients.

AO Spine Knowledge Forum Deformity's award winning Scoli-RISK-1 study group at work

Scoli-RISK-1  

Seminal Study Results

This prospective multicenter observational study established the gold standard for the rate of neurologic complications in patients undergoing high-risk adult deformity surgery and identified key risk factors of poor surgical outcomes.

GSJ

Adult Spinal Deformity

Clinical practice recommendations

Articles combining top evidence and expert opinions offer clinicians evidence-based clinical practice recommendations for adult spinal deformity patients, including Spinopelvic Fixation—What are the Key Items to Understand Performance?

Global Spine Journal 15/3S Adult Spinal Deformity Special Focus Issue

GSJ Focus Issue card

The special issue guest edited by Stephen J. Lewis and Lawrence G. Lenke features articles identifying the main sources of perioperative concerns facing surgeons, with the goal of advancing the field and our understanding of this complex and heterogenous condition. Visit Adult Spinal Deformity: Understanding the Controversies and Looking to the Future to find out more.

Educational offerings and resources for spine professionals interested in spinal deformities


AO Spine offers gold-standard courses and resources in spinal deformities for spine surgeons at different stages of their career. The AO’s publishing and knowledge sharing platforms will further help boost their impact and improve the care of patients with spinal deformities.

Ongoing research projects

Principal investigator:
Stephen J. Lewis


Goal:
To understand the knowledge gaps and open questions regarding patients with adult spinal deformity, and to assess the effectiveness of knowledge translation for instruments and recommendations already developed by the AO Spine Knowledge Forum Deformity.

 

Principal investigator:
Krishna Kumar
Goal:
Intra Operative Neuromonitoring and Wake-Up Test forms an integral part of spinal deformity surgery. This survey aims to understand the current practice of usage of Intra Operative Neuromonitoring and Wake-Up Test among practicing spine surgeons.

Principal investigator:
Justin S. Smith

Co-Principal investigators:
Stephen J. Lewis, Michael P. Kelly

Goal:
To compare rod fracture rates after index surgery between patients having received supplementary rod constructs and patients having received dual-rod constructs

ClinicalTrials.gov Identifier: NCT06368245


Additional information
AO Spine Knowledge Forum Deformity launches study on supplementary rod constructs

 

Principal Investigator:
Stephen J. Lewis


Co-Principal Investigators:
Lawrence Lenke, Nasir Quraishi


Goals:
Aims to determine the incidence of intraoperative neuromonitoring alerts in complex, high-risk, spinal deformity surgeries and identify the events that lead to such alerts

ClinicalTrials.gov Identifier: NCT03880292


Remark: This project was awarded a Standard Research Grant (2018) from the Scoliosis Research Society (SRS).


Additional information: On the way to reducing neurological injury during surgery


Research Output: Publication summary

 

Principal investigator:
Stephen J. Lewis


Co-Principal investigator:
Sigurd Berven


Goals:
Aims to show an improvement in SRS-22 total score between baseline and 24 months and five years after surgery in patients at age 60 or older treated with major spinal reconstruction (spinal fusion of at least five levels) for adult spinal deformity

ClinicalTrials.gov Identifier: NCT02035280


Research Output: Publication summary

 

Principal investigator:
Stephen J. Lewis


Co-Principal investigator:
So Kato


Goal: To understand the current trends in perioperative adult spinal deformity surgery management based on an international survey


Remark: This project is in cooperation with the KF Degenerative.

 

Principal investigator:
Christopher Nielsen


Co-Principal investigator:
Stephen J. Lewis


Goals: To identify ideal sagittal parameters to minimize mechanical complications like proximal junctional kyphosis (PJK) and adjacent segment disease (ASD) following adult spinal deformity surgery. It involves two phases:

  1. a retrospective review of patients who underwent fusion surgery, using musculoskeletal models to calculate vertebral loading and investigate the association between vertebral forces and mechanical complications.
  2. an evaluation of the impact of various realignment criteria on adjacent forces to propose optimal alignment strategies
    * This AO Spine-sponsored study is executed with support from the AO Innovation Translation Center (AO ITC) Clinical Evidence.

** Award-winning project

Completed research projects title

  • Principal investigators:

    Stephen J. Lewis, Lawrence Lenke

     

    Goal:

    Aims to provide a thorough review of the current status of adult spinal deformity surgery and highlight areas of controversy. The issue provides guidance through the current literature and help identify future directions to help answer some of the difficulties encountered in treating this complex and highly variable disorder. Visit Global Spine Journal Volume 15 Issue 3 Supplement to read the articles.

  • Principal investigator:

    Marinus de Kleuver

     

    Co-Principal investigator:

    Manabu Ito

     

    Goals:

    Established an international consensus on what constitutes optimal operative care for adolescent idiopathic scoliosis patients between 12 and 20 years of age with curves ranging from 40 to 90 degrees Cobb angle

     

    Research Output:

    Publication summary

Principal investigator:
Sigurd Berven


Co-Principal investigator:
Marinus de Kleuver


Goals:
Identified the goals of care and management strategies that are appropriate for adult spinal deformity patients based upon worldwide expert opinion


Research Output:
Publication summary

 

Principal investigator:
Marinus de Kleuver


Co-Principal investigator:
David Polly


Goals:
Developed a core outcome set specific to spinal deformity that represents the minimum that should be measured and reported in all outcome registries of a specific condition


Research Output:
Publication summary

 

Principal investigator:
Kenny Kwan


Co-Principal investigators:
Kenneth Cheung, Ahmet Alanay


Goals:
Identified the dynamic radiograph(s) that can most accurately predict the curve behavior after surgical correction in patients diagnosed with adolescent idiopathic scoliosis

ClinicalTrials.gov Identifier: NCT03296228


Research Output:
Publication summary

 

Principal investigator:
J Naresh-Babu


Co-Principal investigators:
Manabu Ito, Jong-Beom Park, Kenny Kwan


Goals:
Developed a comprehensive classification that separates patients into clinically different subgroups that require different treatment strategies


Additional information:
AO Spine Adult Spinal Deformity Patient Profile—a new tool to optimize treatment of ASD


Research Outputs:
Publication summary

AO Spine ASD Patient Profile

Principal investigator:
Tim O’Connor


Co-Principal investigators:
Mary O’Hehir, Jeffrey Mullin


Goals:
Determined the optimal tension required for junctional tether systems by using cadaveric models and finite element analysis

 

Principal investigator:
Federico Landriel


Co-Principal investigator:
Santiago Hem


Goals:
Evaluated the effect of AI-assistance in the automatic calculation of radiographic spinal alignment parameters from whole spine x-rays on both measurement precision and time demand.

 

Principal investigator:
Ganesh Swamy


Co-Principal investigators:
David Hart, Paul Salo, Neil Duncan, Antoine Dufour


Goals:

  1. Characterized the matrix proteome/degradome of the annulus fibrosus from patients with degenerative scoliosis and degenerative spondylolisthesis as compared to control IVDs.
  2. Characterized the structure of elastin in the annulus fibrosus from patients with degenerative scoliosis and degenerative spondylolisthesis and its degradation products as compared to control IVDs.

Principal investigator:
Caglar Yilgor


Co-Principal investigators:
Ahmet Alanay, Altug Yucekul


Goal:
Using MRI, mid-term viability of the discs and facet joints of the intermediate and adjacent thoracic and lumbar levels were assessed for signs of degeneration, and the study evaluated signs of spontaneous fusion.

Principal investigator:
Lawrence G. Lenke


Co-Principal investigator:
Michael G. Fehlings


Goals:
Aim was to establish the risk of neurologic deficit related to surgical correction of adult spinal deformity and to identify characteristics associated with increased risk of neurologic complications related to the surgery

ClinicalTrials.gov Identifier: NCT01305343

ClinicalTrials.gov Identifier: NCT02949245


Remark:
This project received co-funding from the Scoliosis Research Society (SRS) and Norton Healthcare


Additional Information:
Evaluation of neurologic complications in adult spinal deformity surgery: insights from the landmark Scoli-RISK study


Research Output:
Publication summary

* This AO Spine-sponsored study is executed with support from the AO Innovation Translation Center (AO ITC) Clinical Evidence.

** Award-winning project

KF Deformity Steering Committee

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Michael Kelly

Co-chair
Stanford University, Stanford,
California, USA

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Michael Kelly

Co-chair
University of Virginia
Charlottesville, USA

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Stephen Lewis

Past Chairperson
Toronto Western Hospital
Toronto, Canada

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Caglar Yilgor

Koç University Hospital
Istanbul, Turkey

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Kenny Kwan

University of Hong Kong
Hong Kong

So Kato

So Kato

The University of Tokyo
Tokyo, Japan

Ch Ames

Christopher Ames

University of California SF,
San Francisco, CA, USA

E Klineberg

Eric Klineberg

UT Health Houston
Houston, TX, USA

Saumyajit Basu

Saumyajit Basu

Kothari Medical Center and Park Clinic
Kolkata, India

KF Advisory Board

  • Kenneth Cheung, The University of Hong Kong (Co-Chairperson 2011-2013)
  • David Polly, University of Minnesota, Minneapolis, USA
  • Yong Qiu, Nanjing University, China
  • Christopher Shaffrey, Duke University Medical Center, Durham, USA
  • Lawrence Lenke, Columbia University New York, USA (Co-Chairperson/Chairperson 2011-2015)
  • Sigurd Berven, University of California San Francisco, San Francisco, USA
  • Ferran Pellise Urquiza, Hospital Vall d'Hebron / Barcelona Spine Institute Hospital Quiron, Barcelona, Spain
  • Yukihiro Matsuyama, Hamamatsu University School of Medicine, Hamamatsu, Japan
  • Ahmet Alanay, Acibadem Mehmet Ali Aydinlar, University School of Medicine, Istanbul, Turkey

Ahmed Abdelgawaad, Helios Hospitals Erfurt, Erfurt, Germany
Nelson Astur, Hospital Israelita Albert Einstein – Sao Paulo, Sao Paulo, Brazil
Pedro Berjano, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Aaron J. Buckland, Melbourne Orthopaedic Group Australia, Melbourne Australia
Anastasios Charalampidis, Karolinska University Hospital, Solna, Sweden
Elias Elias, University of Texas, Texas, USA
Swamy Ganesh, University of Calgary, Calgary, Canada
Yoshida Go, Hamamatsu University School of Medicine, Tokyo, Japan
Munish Gupta, Hospital for Special Surgery, New York, NY, USA
Jeffrey Hills, UT Health San Antonio, San Antonio, USA
Miranda van Hooff, Radboud University Medical Center/Sint Maartenskliniek, Nijmegen, Netherlands
Serena Hu, Stanford University, Stanford, CA, USA
Yashar Javidan, University of California, Davis Health, Davis, CA, USA
Thorsten Jentzsch, Balgrist Universitätsklinik, Zürich, Switzerland
Kristen Jones, Duke University, Durham, NC, USA
Krishna Kumar, VPS Lakeshore Hospital, Kochi, India
Darryl Lau, NYU Langone Health, New York, NY, USA
Brian Neuman, Washington University, St. Louis, MO, USA
Fred Nicholls, University of Calgary, Calgary, Canada
Christopher Nielsen, Toronto Western Hospital, Toronto, Canada
Colby Oitment, Scarborough General Hospital, Toronto, Ontario, Canada
Robert Ravinsky, Permanente Oakland Medical Center, Oakland, CA, USA
Anna Rienmueller, Medizinische Universität Wien, Wien Austria
Brett Rocos, Duke University Medical Center, Durham, USA
Zeeshan Sardar, Columbia University, New York, NY, USA
Juan Sardi, University of Texas Southwestern Medical Center, Texas, USA
Jonathan Sembrano, University of Minnesota Medical School, Minnesota MN, USA
Alekos Theologis, University of California San Francisco, San Francisco, CA, USA
Hiroki Ushirozako Hamamatsu, University School of Medicine, Hamamatsu, Japan
Kota Watanabe, Keio University School of Medicine, Tokyo, Japan
Zhu Zezhang, Nanjing University Medical School, Nanjing, China
Alisson Teles, Santa Casa de Porto Alegre.Porto Algere, Brazil
Bhavuk Garg, All India Institute of Medical Sciences, New Delhi, India 
Mauricio Andres Campos Daziano, Pontificia Universidad Católica de Chile, Santiago, Chile
Nan Wu, Peking Union Medical College Hospital, Bejing, China
Rajendra Sakhrekar, Royal Perth Hospital, Perth, Australia
Shin Oe, Hamamatsu University School of Medicine, Hamamatsu, Japan
Sultan Aldebeyan, King Fahad Medical City, Riyadh, Saudi Arabia
Arthur Odotei Sackeyfio, Focos Orthopaedic Hospital, Accra, Ghana
Omar Alnori, Hamad Medical Corporation, Doha, Qatar
Reuben Soh, Singapore General Hospital, Singapore, Singapore
Saman Shabani, Medical College of Wisconsin, Milwaukee, WI, USA
Sameh Abolfotouh, MEDCARE Hospital Dubai, UAE
Fatemeh Alavi, University Health Network, Toronto, Canada
Ioannis Avramis, Baylor University Medical Center, Dallas, TX, USA
Alpaslan Senkoylu, Gazi University Department of Orthopaedics and Traumatology, Ankara, Turkey

AO Spine KF Deformity at the Global Spine Congress 2026

Knowledge Forum Manager

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Marta Morawska

Project Manager

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“There is a myriad of outcome studies and instruments out there; everybody uses different tools to measure their quality of care. We help bring more rationale to the options that are available.”

Marinus de Kleuver, Past Chairperson KF Deformity