Effect of Vertebral Body Tether Tensioning on Vertebral Body Growth Modulation
Bibliographic record
Abstract
ABSTRACT Background The relationship between tether tension and spinal growth modulation following vertebral body tethering (VBT) has not been studied in growing children. Aims This study aims to explore the relationship between vertebral body growth modulation under varying tether tension. Materials and Methods A retrospective, multicenter pediatric registry was queried for idiopathic scoliosis patients treated with right‐sided VBT, with recorded intraoperative tension (using an ordinal scale of 0–3), and 3D reconstructions from biplanar radiographs at the first erect (FE) and 2‐year post‐operative visits. Custom MATLAB code was used to calculate vertebral height (mm) on the untethered and tethered sides from T5‐T12. Generalized linear mixed models were used to analyze the effect of tension on vertebral body growth. Results Fifty‐two subjects (47 female) were included with a mean age of 12.5 ± 1 years. Patients were skeletally immature (triradiate cartilage open in 23 patients) with Proximal Femoral Maturity Index scores of 2 (nine patients), 3 (21 patients), 4 (20 patients), and 5 (two patients). A total of 330 vertebral bodies were analyzed. Mean height change of the vertebral bodies from FE to 2 years was 1.6 + 1.9 mm (untethered) and 1.2 + 1.8 mm (tethered). On the tethered side, greater tension resulted in less height change, with the greatest differential growth observed between maximal tension and no tension (0.8 mm vs. 0.2 mm, p = 0.02). Greater tension resulted in less vertebral body growth and greater differential growth. Future studies should quantify forces applied during VBT surgery, as well as the forces maintained in the post‐operative period with spinal motion. Conclusion Intraoperative intervertebral tensioning significantly affects vertebral body growth over 2 years.
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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 | 0.003 |
| 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) | 0.002 | 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".