Does screw alignment affect tether breakage in vertebral body tethering?
Bibliographic record
Abstract
PURPOSE: Vertebral body tethering (VBT) is a non-fusion surgery for treating idiopathic scoliosis, with tether breakage as a common complication that occurs in 19–52% of patients. It has been reported in mechanical studies that screw malalignment > 1 mm may cause tether breakage. This is a clinical study aiming to assess the effect of screw alignment on tether breakage. METHODS: This was a retrospective multicenter cohort study of 115 patients with idiopathic scoliosis who underwent VBT. Clinical data and radiographic parameters such as Cobb angle, screw malalignment, and inter-screw angle were evaluated postoperatively and at 2-year and 3-year follow-ups. Tether breakage was defined as increase in inter-screw angle ≥ 5°, while screw malalignment was defined as > 25% displacement relative to adjacent screws. Mean screw malalignment was compared between broken and intact tether segments. RESULTS: Mean screw malalignment across all levels was 20.6 ± 17%. Overall, screw malalignment was not found to be significantly associated with tether breakage. For the 36 screws (6%) and 5 screws (0.7%) with moderate and severe malalignment, none were associated with tether breakage. DISCUSSION: In this cohort with satisfactory overall screw alignment, screw malalignment was not found to be associated with tether breakage. Other risk factors that could contribute to tether breakage should be investigated. While excellent screw alignment is unlikely to prevent tether breakage, relative alignment should still be achieved to maintain curve correction and avoid damage to nearby organs.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".