In spine surgery, measuring success isn’t always as simple as “X-rays look straighter, job well done.” Deformity surgeons have long wrestled with the minimal clinically important difference (MCID)—that statistical line in the sand that supposedly separates “meaningful improvement” from “meh.” But what if our measuring stick has been a little…off?
A new study out of Peking Union Medical College Hospital, published August 5, 2025, in The Journal of Bone and Joint Surgery, suggests it’s time to upgrade to a sharper tool: the smallest worthwhile effect (SWE). And according to the authors, SWE doesn’t just measure what’s “clinically important”—it measures whether the patient thinks it was worth it.
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