Comparison of Magnetically Controlled Growing Rods with Other Distraction-Based Surgical Technologies for Early-Onset Scoliosis
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Severe and progressive early-onset scoliosis (EOS) has a serious prognosis including cardiopulmonary compromise. Growth-friendly technologies are the current surgical standard of care. Magnetically controlled growing rods (MCGRs) are newer implants with the potential for better quality of life and cost savings; however, they have not been well compared with the traditional distraction-based implants. The objective of this study was to compare the surgical outcomes, complications, metal ion levels, quality-of-life outcomes, and cost of MCGRs with other distraction-based surgical technologies for the treatment of EOS. METHODS: The MEDLINE, Embase, and Web of Science databases were searched. Record screening and data abstraction were completed in duplicate. Summary outcomes were calculated in a meta-analysis, if heterogeneity was appropriate, using a fixed-effects model. RESULTS: This systematic review and meta-analysis included 18 studies. MCGRs were as clinically effective as other distraction-based technologies, with no significant difference in the Cobb angle at the latest follow-up (mean difference [MD], 1.20°; 95% confidence interval [CI], -1.80° to 4.20°; p = 0.43) and a significantly lower complication rate (odds ratio, 0.42; 95% CI, 0.25 to 0.71; p = 0.001). Quality of life measured using the EOSQ-24 (24-Item Early-Onset Scoliosis Questionnaire) was better in the MCGR group compared with other technologies (MD, 2.18; 95% CI, 0.40 to 3.95; p = 0.02). Serum titanium levels were 2.98 ng/mL (95% CI, 1.41 to 4.55 ng/mL; p = 0.0002) greater in patients with MCGRs, but the clinical impact is unclear. MCGRs had greater cost for the device and insertion but became cost-neutral or cost-effective compared with other technologies by 4 years postoperatively. CONCLUSIONS: MCGRs are clinically equivalent and cost-effective in the long term compared with other distraction-based technologies for the treatment of EOS. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it