Management of early-onset scoliosis: modern Luque trolley technique led to fewer reoperations within 3 years than other growth-friendly techniques, a prospective cohort study with matched historical controls
Bibliographic record
Abstract
PURPOSE: Management of early-onset scoliosis (EOS) remains challenging with high reoperation rates. The modern Luque trolley technique (MLT) was developed to reduce open lengthening and complications. This study aimed to compare the reoperation rates between the MLT and other growth-friendly surgical techniques. METHODS: Prospective EOS patients were recruited and treated with MLT; matched historical controls were selected from the Pediatric Spine Study Group (PSSG) database. The primary objective was to test if within 3 years of surgery MLT patients would have fewer reoperations. Secondary outcomes were growth, curve correction, and quality of life using the 24-item early-onset scoliosis questionnaire (EOSQ-24). Safety analysis was performed for the MLT patients. RESULTS: MLT (N = 18) and control patients (N = 43) had similar baseline age, body measurements, etiology, Cobb angle, and spinal length. Within 3 years of surgery, 1/18 MLT patients required a reoperation compared with 30/43 controls, conditional Poisson regression rate ratio = 0.02 (95% CI 0; 0.12) (P < 0.001). The median time to first reoperation was MLT, 5.4 years and control, 0.8 years. The MLT achieved the same curve correction as the controls at 3 years. The total spinal growth (T1-S1) was similar between the groups, although the thoracic spinal growth (T1-T12) was less in the MLT group. No difference was observed in standing heights and EOSQ-24 scores. Within 3 years, 2 MLT patients had recurrence of deformity (risk = 11.1%, 95% CI 1.4; 34.7) and 1 had implant loosening (risk = 5.6%, 95% CI 0.1; 27.3). CONCLUSION: MLT patients had fewer reoperations within 3 years than control patients and a low risk of implant failure. LEVELS OF EVIDENCE: Level II. TRIAL REGISTRATION NUMBER: NCT01672749. Date of registration: 2012-08-24.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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".