Objective The purpose of this study was to investigate which radiographic parameters immediately after posterior spinal fusion for adolescent idiopathic scoliosis best correlate with subjacent disc wedging at a minimum 2-year follow-up.Methods Sixty-four consecutive adolescent idiopathic scoliosis patients who underwent posterior pedicle screw-only instrumentation were studied retrospectively Preoperative and postoperative radiographs were obtained to measure various parameters regarding global coronal, shoulder,sagittal and regional balance.Specific correlation of these parameters to selected 2-year postoperative disc wedging and lowest instrumented vertebra (LIV) tilt and translation were analyzed.Results The average disc angle changed from 4.59±4.75 preoperatively to 1.46±2.82 at 2-weeks and 2.81±6.43 at 2-years postoperatively.Two-year postoperative disc angle significantly correlated with 2-week postoperative disc angle, C7 plumbline relative to the posterior superior comer of the first sacral vertebra (C7-SSEP) distance and LIV-center sacral vertical line (CSVL) distance (r2 =0.7433, P<0.0001).Two-year postoperative LIV tilt significantly correlated with 2-week postoperative LIV tilt, T12-LIV lordosis, LIV-CSVL distance and C7-CSVL distance (r2=0.8879, P<0.0001).Two-year postoperative LIV-CSVL significantly correlated with 2-week postoperative LIV-CSVL distance and disc angle (r2 =0.6104, P<0.0001).Conclusion In summary, the two-year postoperative disc wedging, LIV tilt and LIV translation occurred most often when disc wedging and LIV deviation or obliquity existed immediately postoperatively.Our study has identified a potential indicator for adolescent idiopathic scoliosis repair.Preoperative surgical planning and intraoperative correction are important to avoid subjacent regional imbalance after scoliosis fusion.