Vertebral Body Tethering Surgery
Notice bibliographique
Résumé
BACKGROUND: Much enthusiasm has been generated around vertebral body tethering (VBT) as an alternative to fusion treatment. However, the majority of studies have shown little difference between coronal curve magnitude on the first postoperative erect radiograph and that at final follow-up, suggesting that VBT is not consistently modulating spine growth in a manner that substantially affects coronal curve magnitude. METHODS: All patients with adolescent idiopathic scoliosis (AIS) who underwent VBT between December 2013 and June 2020 and subsequently had at least 2 years of follow-up in a multicenter registry were reviewed. The change in coronal curve magnitude was calculated by subtracting the magnitude at the time of final follow-up from that on the first postoperative erect radiograph. A change of <5° was considered to be within normal measurement variability. RESULTS: One hundred and ten patients met the inclusion criteria (racial breakdown: 94 White, 6 Black/African American, 3 Asian, 2 Middle Eastern, 1 mixed race, and 4 uncertain/unspecified; ethnicity: 87 not Hispanic or Latino, 1 Hispanic/Latino, and 22 did not report their ethnicity). Their mean age was 12.9 years (standard deviation [SD], 1.3 years) and the mean follow-up was 3.7 years (range, 2.0 to 6.9 years). A mean of 6.6 levels were tethered. The preoperative mean coronal curve magnitude was 51.0° (range, 32° to 75°), which corrected to a mean of 27.3° (range, 10° to 53°) on the first postoperative erect radiograph. At the time of final follow-up, the mean coronal curve magnitude was 30.9° (range, -50° to 69°), and 49.1% (54) of the 110 curves were stable (the coronal curve magnitude at final follow-up was within 5° of that on the first postoperative erect radiograph). A total of 42.7% (47) had >5° of increase in coronal curve magnitude following the initial postoperative erect radiograph, whereas 8.2% (9) showed a >5° increase during the follow-up period. Five of the 9 patients (4.5% of the series) had a >10° decrease, with 2 of the 5 having overcorrection, ending up with 31° and 50° curves in the opposite direction. CONCLUSIONS: Although VBT holds promise and many (49.1%) of the 110 curves in this series remained stable from the first postoperative erect to the final follow-up radiograph, only 9 demonstrated a decrease in coronal curve magnitude over time, including 2 that overcorrected. Further research is needed to identify the factors differentiating among patients who had curve progression, did not have progression, or had overcorrection to determine which patients are more likely to benefit from VBT. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».