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OBJECTIVE To testify whether lateral lumbar interbody fusion (LLIF) decreases the grading of Lenke-Silva classification and determines the optimal fusion level in adult degenerative scoliosis (ADS) of global imbalance. METHODS Thirty-seven patients with ADS of level V and VI based on Lenke-Silva classification were included. After the first-stage LLIF, patients received reassessment and were divided into group A (the grading of Lenke-Silva classification changed) and group B (the grading unchanged). Posterior fixation was performed accor