Mimura T, et al. - A total of 101 consecutive individuals who underwent posterior spinal fusion for adolescent idiopathic scoliosis (AIS) and who were followed for a minimum of 2 years were involved to analyze for factors adding to postoperative pain in AIS, involving those of sagittal alignment and lumbar disc degeneration. A worsened pain score 2 years following surgery was noted in patients with a lower preoperative pain score (ie, higher pain) or higher postoperative T5-12 kyphotic angle. No striking variations for Lenke curve type, age, BMI, coronal radiographic parameters, lumbar disc degeneration, correction rate, number of fused vertebrae, or lowest instrumented vertebra were observed. Higher preoperative Risser grade and lower preoperative Scoliosis Research Society-22r (SRS-22r) mental health scores were significantly associated with a reduced preoperative SRS-22r pain score. In conclusion, higher preoperative pain and postoperative T5-12 kyphotic angle had notable relationships with augmented postoperative pain while preoperative lumbar disc degeneration was not related to pre- or postoperative pain in AIS. Greater preoperative pain was associated with heightened Risser grade and lower mental health scores.