Efficacy of Anterior Vertebral Body Tethering in Skeletally Mature Children with Adolescent Idiopathic Scoliosis: A Preliminary Report
Bibliographic record
Abstract
ABSTRACT Background: Anterior vertebral body tethering (AVBT) offers a dynamic fusionless correction option for children with adolescent idiopathic scoliosis (AIS). Few existing clinical studies evaluating novel AVBT in skeletally immature children have questioned the midterm efficacy with concerns of overcorrection and curve progression with remaining growth. The current study investigates the effect of this technique in skeletally mature children (Risser ≥ 4 and Sanders ≥ 7) with AIS with limited remaining growth potential. Methods: We evaluated skeletally mature children with AIS who underwent the AVBT technique for a single structural major curve between 40° and 80° with ≥50% flexibility on dynamic radiographs and a minimum of 1 year of follow-up. Pertinent clinical and radiographic data collected include skeletal maturity, curve type, Cobb angle, sagittal parameters, and a patient-reported outcome measure Scoliosis Research Society-22 (SRS-22) questionnaire. Results: All 10 children were female with a mean age of 14.9 ± 2.7 years at the time of surgery. The mean follow-up was 24.1 ± 3.6 months. The mean Risser and Sanders scores were 4.2 ± 0.6 and 7.2 ± 0.6, respectively. Three patients had major thoracic curves, and 7 patients had thoracolumbar/lumbar curves. Cranial and caudal instrumented levels were T5 and L4. Mean preoperative Cobb9s angle was 52.0° ± 11.6° and was corrected to 15.9° ± 6.8° on the first erect postoperative radiograph, with stabilization of corrected curve at the 1-year follow-up (mean Cobb9s angle of 15.3° ± 8.7°). Mean preoperative and postoperative SRS-22 scores were 78.0 ± 3.2 and 92.5 ± 3.1, respectively (P < .01). No complications were noted until the last follow-up. Conclusion: Our preliminary experience with this novel AVBT as an alternative technique to fusion to stabilize progressive idiopathic scoliosis in skeletally mature children is promising. Level of Evidence: 4.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.001 | 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".