{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:57:55Z","timestamp":1780333075586,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Vertebral body tethering (VBT) uses a flexible tether affixed across the curve convexity with tension applied at each segment to treat scoliosis. Intraoperative tether tension may be achieved directly with a counter\u2010tensioner or with an extension spring tube. The purpose of this study was to quantify the force generated with and without the extension spring tube using current FDA\u2010approved VBT instrumentation, to understand the variation between surgeons using the same instrumentation, and to define the force range that is generated intra\u2010operatively. Using a benchtop mechanical testing setup to simulate a spinal segment, we affixed the tether and applied tension using a tensioner and counter\u2010tensioner alone (method T1) or by adding an extension spring tube (method T2). Eight orthopedic surgeons used T1 and T2 at six tensioner settings, and one surgeon completed three trials. A two\u2010way ANOVA with a Tukey's HSD post hoc test (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) compared the tensioner methods and testing levels. Inter\u2010 and intra\u2010rater reliabilities were calculated using intraclass correlation coefficients (ICCs). Methods T1 and T2 exhibited linear tension\u2010setting relationships, with high determination coefficients (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009&gt;\u20090.93). T2 consistently produced higher forces (increase of 62.1\u2009N\/setting), compared to T1 (increase of 50.6\u2009N\/setting, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Inter\u2010rater reliability exhibited excellent agreement (ICC\u2009=\u20090.951 and 0.943 for T1 and T2, respectively), as did intra\u2010rater reliability (ICC\u2009=\u20090.971).<\/jats:p><\/jats:sec>","DOI":"10.1002\/jor.25995","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T02:58:27Z","timestamp":1728615507000},"page":"441-445","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Defining the segmental tension generated in a vertebral body tethering system for scoliosis"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2635-9823","authenticated-orcid":false,"given":"Vidyadhar V.","family":"Upasani","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of California San Diego San Diego California USA"},{"name":"Division of Orthopedics and Scoliosis Rady Children's Hospital San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7615-3749","authenticated-orcid":false,"given":"Christine L.","family":"Farnsworth","sequence":"additional","affiliation":[{"name":"Division of Orthopedics and Scoliosis Rady Children's Hospital San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P.","family":"Caffrey","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Olmert","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Brink","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Biomedical Engineering Boise State University Boise Idaho USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoebe","family":"Cain","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Biomedical Engineering Boise State University Boise Idaho USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Mannen","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Biomedical Engineering Boise State University Boise Idaho USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-024-08363-x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-024-00897-w"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-024-00874-3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-024-00857-4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-024-00942-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.23.01229"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000005072"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-024-00855-6"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000472"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.00980"},{"issue":"4","key":"e_1_2_8_12_1","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.OA.19.00026","article-title":"Non\u2010fusion surgical correction of thoracic idiopathic scoliosis using a novel, braided vertebral body tethering device: minimum follow\u2010up of 4 years","volume":"4","author":"Wong H\u2010K","year":"2019","journal-title":"JB JS Open Access"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.5606\/tgkdc.dergisi.2019.17889"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-020-00226-x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001590"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.102B12.BJJ-2020-0426.R1"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.01176"},{"key":"e_1_2_8_18_1","volume-title":"Standard Test Method for Spinal Implant Constructs in a Vertebrectomy Model","author":"ASTM 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