Comparison of Complications Among Growing Spinal Implants
Bibliographic record
Abstract
STUDY DESIGN: Retrospective review. OBJECTIVE: To evaluate the complication rate of various types of growing spinal implants. SUMMARY OF BACKGROUND DATA: Previous studies report a complication rate of 0.38 to 1.19 per patient in growing spine surgery, but this may be an underestimate. METHODS: Medical records of 36 children with early-onset spinal deformity treated with various types of growing implants by a single surgeon were evaluated for complications. Patients with primary chest wall deformities were excluded. Complications were defined as any neurologic injuries, and any unplanned surgeries for implant failure or infection. Patients were separated into 3 groups: (A) standard dual growing rods, (B) hybrid growing rods with rib anchors proximally and spine anchors distally, and (C) VEPTR (vertical expandable prosthetic titanium rib). Statistical analyses were performed to compare the complication rate among the 3 groups and to evaluate the effect of Cobb angle, kyphosis, age, and body mass index on the complication rate. RESULTS: Mean age at initial implantation was 4.8 years; mean follow-up was 51 months (24-117 months). A total of 72 unplanned surgeries occurred in 26 out of 36 patients (72%), including 18 revisions for rod breakage, 31 revisions for migrated anchors, and 18 irrigations and debridements for infection. Two children (5.6%) developed a neurologic deficit that required implant removal. Group A had 23 complications in 10 patients, with a complication rate of 2.3 per patient; group B had 6 complications in 7 patients, with a rate of 0.86 per patient; and group C had 45 complications in 19 patients, with a rate of 2.37 per patient. There was no significant difference between the 3 groups in terms of preoperative Cobb angle, kyphosis, age, and body mass index; these factors did not seem to influence the complication rate. CONCLUSION: To our knowledge, this is the first study directly comparing the complication rates of various types of growing spine implants. The complication rate in growing spine surgery is uniformly high but varies by implant type, with a trend toward fewer complications in hybrid constructs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".