Evidence map›Paper›PMID 40864230›Full record

ArticleSpine deformity2026

Behavior of the un-instrumented lumbar curve following exclusive tethering of the thoracic region.

Ritt R Givens, Matan S Malka, Christina Carin Rymond, Kevin Lu, Firoz Miyanji, Juan Carlos Rodriguez, Kevin Smit, Ron El-Hawary, Stefan Parent, Walter Huu Truong and 3 more

Abstract read
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In one paragraph

Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Ritt R GivensDivision of Pediatric Orthopedics, Columbia University Medical Center, New York, NY, USA. rrg2158@cumc.columbia.edu.ORCID http://orcid.org/0009-0005-1641-9855
Matan S MalkaDivision of Pediatric Orthopedics, Columbia University Medical Center, New York, NY, USA.
Christina Carin RymondDivision of Pediatric Orthopedics, Columbia University Medical Center, New York, NY, USA.
Kevin LuDivision of Pediatric Orthopedics, Columbia University Medical Center, New York, NY, USA.
Firoz MiyanjiBC Children's Hospital Orthopedics Research Department, Vancouver, BC, Canada.
Juan Carlos RodriguezDepartment of Orthopedic Surgery, NYU Orthopedic Hospital, New York, NY, USA.
Kevin SmitChildren's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Ron El-HawaryIWK Health Centre, Halifax, NS, Canada.
Stefan ParentCHU Sainte Justine, Montreal, QC, Canada.
Walter Huu TruongGillette Children's Specialty Healthcare, Saint Paul, MN, USA.
Michelle C WelbornShriners Hospital for Children, Portland Oregon, USA.
Michael G VitaleDivision of Pediatric Orthopedics, Columbia University Medical Center, New York, NY, USA.
Pediatric Spine Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAnterior vertebral body tethering (AVBT) has recently been utilized as a surgical alternative to posterior spinal fusion for a subset of pediatric scoliosis patients. Indications for AVBT are evolving and, while early results have been promising, there is a paucity of literature examining the behavior of the lumbar curve after exclusive tether of the thoracic region. It was hypothesized that thoracic tether leads to a spontaneous decrease in the un-instrumented lumbar curve.

methodsThe study population consisted of 166 patients with idiopathic scoliosis enrolled in the Pediatric Spine Study Group registry undergoing thoracic tether with a minimum of two-year follow-up. Exclusion criteria included: patients with non-idiopathic scoliosis, patients with prior spine surgery, and patients instrumented below L1.

resultsOverall curve correction was notable, with mean pre-op, immediate post-op, and two-year follow-up angles of 51.3°, 29.7°, and 30.3° respectively for the thoracic curve and 32.7°, 22.9°, and 24.1° respectively for the un-instrumented lumbar curve. Overall, 124 subjects (74.7%) had a decrease in lumbar curve > 5° immediately post-op. Over a two-year follow-up period, 32 subjects (19%) had a continued decrease in lumbar curve > 5°, 91 subjects (54%) had minimal change, and 43 subjects (26%) had an increase in lumbar curve > 5°. In a subgroup analysis of 36 subjects with a decrease in thoracic curve > 5° from post-op to two-year follow-up, 11 subjects (31%) had a concomitant decrease in lumbar curve with only 5 (14%) showing an increase in lumbar curve > 5°. The changes in lumbar curve from pre-op to post-op and from post-op to two-year follow-up were found to be associated with changes in the thoracic curve for the same periods (rho = 0.603, p < 0.001; rho = 0.413, p < 0.001 respectively). When considering Lenke lumbar modifiers, the un-instrumented lumbar curve corrected an average of 35%, 27%, and 20% following surgery and 27%, 30%, and 17% at two-year follow-ups for A, B, and C curves respectively (p < .001 for all data points compared to pre-op).

conclusionLumbar curves tended to mirror the behavior of the maximal thoracic curve in terms of correction or decompensation both during surgery and during the two-year follow-up. Furthermore, un-instrumented lumbar curves with a Lenke C modifier tended to achieve a lower percentage correction. These data provide clearer insights into the response of the lumbar curve following thoracic tethering and the effect of growth modulation.

Indexed as

Lumbar VertebraeScoliosisThoracic VertebraeVertebral BodyAdolescentChildFemaleFollow-Up StudiesHumansMaleSpinal FusionTreatment OutcomeAnterior vertebral body tetheringIdiopathic scoliosisLumbar curve behavior

Identifiers

PMID40864230

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.