The Generational Differences in Growth-Friendly Treatment Utilization for Early-Onset Scoliosis
Bibliographic record
Abstract
Background: The development of new growth-friendly techniques for treating early onset scoliosis (EOS) has resulted in a rapidly changing landscape of available treatment strategies. There is no literature revealing how a surgeon’s years in practice (YIP) is related to the EOS techniques they learned in fellowship and how their YIP influences their decision making in selecting EOS constructs. Methods: A 25-question survey was electronically delivered to 144 surgeons who treat EOS, and 87 (60%) responded. Surgeons were divided into two groups: a younger group (YG) with 0-10 YIP and an older group (OG) with ＞10 YIP. Growth-friendly techniques queried included serial casting, traditional growing rods (TGR), Vertical Expandable Prosthetic Titanium Rib (VEPTR), non-VEPTR rib constructs, Magnetically Controlled Growing Rods (MCGR), and SHILLA. A Chi-square analysis was used to determine differences between the YIP groups with regards to which techniques surgeons learned in fellowship and which techniques they use in practice. Results: One-hundred percent (38/38) of the YG surgeons were fellowship trained, vs 87.8% (43/49) of the OG surgeons. More YG vs OG surgeons received fellowship training in serial casting (84.2% vs 38.8%, p<0.001), TGR (94.7% vs 63.3%, p<0.001), VEPTR (65.8% vs 28.6, p<0.001), non-VEPTR rib constructs (55.3% vs 16.3%, p<0.001), and MCGR (47.4% vs 2%, p<0.001). OG surgeons were more likely to use TGR in the last 3 years, with 26% of YG vs 6% of OG surgeons never utilizing TGR, and 5% of YG vs 31% of OG surgeons performing TGR cases > 10 times (p=.004). Regarding treatment preferences, more YG surgeons (84.2% vs 39.6%, p<0.001) preferred to delay intervention until final fusion, rather than use any growth-friendly techniques. Furthermore, YG surgeons see a limited need for growth-friendly constructs other than MCGR. Conclusions: YG surgeons were more likely to learn growth-friendly techniques in fellowship than OG surgeons, though in their practices the groups use growth-friendly techniques at similar rates. Compared to OG surgeons, YG surgeons prefer performing definitive fusions over utilizing any growth-friendly surgical techniques.
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How this classification was reachedexpand
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".