{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T18:08:27Z","timestamp":1771438107439,"version":"3.50.1"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["1R21AR078528-01A1"],"award-info":[{"award-number":["1R21AR078528-01A1"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess if vertebral location within posterior VBT construct affected the overall vertebral growth rate, % growth modulation, and to determine if the proximal and distal physes within each tethered disk space responded similarly to tethering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six hyper-kyphotic swine underwent multi-level posterior compressive tethering. Pulsed fluorochrome labeling was performed. Growth rates, % growth modulation, physeal zonal thicknesses, vertebral epiphyseal ossification, location of central nucleus pulposis, and vertebral shape by location within tether construct were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean growth rates were similar throughout the vertebral levels studied and no significant difference was found between tethered or adjacent levels. However, the mean thickness of tethered physes was thinner than the adjacent uninstrumented physes (621\u2009\u00b1\u200936\u00a0\u03bcm vs 728\u2009\u00b1\u200952\u00a0\u03bcm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001, adj\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and this difference appeared to be primarily due to differences in the proliferative zone. The most proximal instrumented vertebral level, that corresponded anatomically to the 2nd and 3rd most distal thoracic level), had the greatest % growth modulation (55\u2009\u00b1\u200917%) compared to other instrumented levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001, adj\n                      <jats:italic>p<\/jats:italic>\n                      value 0.004). No significant differences in growth rate, physeal thickness, or % growth modulation were found between the distal and proximal vertebral physes within each tethered disk. Adjacent level junctional kyphosis was observed through the significant reversal (negative) growth modulation at levels outside the construct (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001, adj\n                      <jats:italic>p<\/jats:italic>\n                      value 0.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mean vertebral growth was not significantly inhibited by a posterior tether. Despite uniform tensioning throughout each construct, the most proximal tethered level experienced the most growth modulation indicating that growth may not be modulated the same at each level within a construct. Additionally, asymmetric vertebral growth may contribute to junctional kyphosis in the growing spine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-025-01247-0","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T13:07:31Z","timestamp":1766149651000},"page":"335-348","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physeal effects of posterior VBT are not uniform throughout a multi-tether construct in the kyphotic swine model"],"prefix":"10.1007","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7481-2111","authenticated-orcid":false,"given":"Matthew A.","family":"Halanski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittney","family":"Kokinos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Jeffers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Crenshaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"issue":"5","key":"1247_CR1","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1097\/BSD.0b013e318241e3cf","volume":"26","author":"MA Halanski","year":"2013","unstructured":"Halanski MA, Cassidy JA (2013) Do multilevel Ponte osteotomies in thoracic idiopathic scoliosis surgery improve curve correction and restore thoracic kyphosis? J Spinal Disord Tech 26(5):252\u2013255","journal-title":"J Spinal Disord Tech"},{"issue":"2","key":"1247_CR2","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1097\/BRS.0b013e318269fab1","volume":"38","author":"LG Lenke","year":"2013","unstructured":"Lenke LG, Newton PO, Sucato DJ, Shufflebarger HL, Emans JB, Sponseller PD et al (2013) Complications after 147 consecutive vertebral column resections for severe pediatric spinal deformity: a multicenter analysis. Spine 38(2):119\u2013132","journal-title":"Spine"},{"issue":"6","key":"1247_CR3","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.jspd.2015.03.007","volume":"3","author":"MC Marks","year":"2015","unstructured":"Marks MC, Bastrom TP, Petcharaporn M, Shah SA, Betz RR, Samdani A et al (2015) The effect of time and fusion length on motion of the unfused lumbar segments in adolescent idiopathic scoliosis. Spine Deform 3(6):549\u2013553","journal-title":"Spine Deform"},{"issue":"9","key":"1247_CR4","doi-asserted-by":"publisher","first-page":"769","DOI":"10.2106\/JBJS.19.01176","volume":"102","author":"PO Newton","year":"2020","unstructured":"Newton PO, Bartley CE, Bastrom TP, Kluck DG, Saito W, Yaszay B (2020) Anterior spinal growth modulation in skeletally immature patients with idiopathic scoliosis: a comparison with posterior spinal fusion at 2 to 5 years postoperatively. J Bone Joint Surg 102(9):769\u2013777","journal-title":"J Bone Joint Surg"},{"issue":"19","key":"1247_CR5","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.2106\/JBJS.18.00287","volume":"100","author":"PO Newton","year":"2018","unstructured":"Newton PO, Kluck DG, Saito W, Yaszay B, Bartley CE, Bastrom TP (2018) Anterior spinal growth tethering for skeletally immature patients with scoliosis: a retrospective look two to four years postoperatively. J Bone Joint Surg 100(19):1691\u20131697","journal-title":"J Bone Joint Surg"},{"key":"1247_CR6","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-014-3706-z","author":"AF Samdani","year":"2014","unstructured":"Samdani AF, Ames RJ, Kimball JS, Pahys JM, Grewal H, Pelletier GJ et al (2014) Anterior vertebral body tethering for immature adolescent idiopathic scoliosis: one-year results on the first 32 patients. Eur Spine J. https:\/\/doi.org\/10.1007\/s00586-014-3706-z","journal-title":"Eur Spine J"},{"issue":"4","key":"1247_CR7","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1007\/s43390-022-00471-2","volume":"10","author":"TC McDonald","year":"2022","unstructured":"McDonald TC, Shah SA, Hargiss JB, Varghese J, Boeyer ME, Pompliano M et al (2022) When successful, anterior vertebral body tethering (VBT) induces differential segmental growth of vertebrae: an in vivo study of 51 patients and 764 vertebrae. Spine Deform 10(4):791\u2013797","journal-title":"Spine Deform"},{"issue":"5","key":"1247_CR8","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1002\/jor.24992","volume":"39","author":"CR D'Andrea","year":"2021","unstructured":"D\u2019Andrea CR, Alfraihat A, Singh A, Anari JB, Cahill PJ, Schaer T et al (2021) Part 2. Review and meta\u2010analysis of studies on modulation of longitudinal bone growth and growth plate activity: a micro\u2010scale perspective. J Orthop Res 39(5):919\u2013928","journal-title":"J Orthop Res"},{"issue":"16","key":"1247_CR9","doi-asserted-by":"publisher","first-page":"1776","DOI":"10.1097\/01.brs.0000227263.43060.50","volume":"31","author":"JT Braun","year":"2006","unstructured":"Braun JT, Hines JL, Akyuz E, Vallera C, Ogilvie JW (2006) Relative versus absolute modulation of growth in the fusionless treatment of experimental scoliosis. Spine 31(16):1776\u20131782","journal-title":"Spine"},{"issue":"5","key":"1247_CR10","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1007\/s11999-010-1587-y","volume":"469","author":"H Zhang","year":"2011","unstructured":"Zhang H, Sucato DJ (2011) Neurocentral synchondrosis screws to create and correct experimental deformity: a pilot study. Clin Orthop Relat Res 469(5):1383\u20131390","journal-title":"Clin Orthop Relat Res"},{"issue":"Suppl 3","key":"1247_CR11","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1007\/s00586-011-1909-0","volume":"20","author":"A Caballero","year":"2011","unstructured":"Caballero A, Barrios C, Burgos J, Hevia E, Correa C (2011) Vertebral growth modulation by hemicircumferential electrocoagulation: an experimental study in pigs. Eur Spine J Off Publi Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 20(Suppl 3):367\u2013375","journal-title":"Eur Spine J Off Publi Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc"},{"issue":"1","key":"1247_CR12","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s00586-011-1966-4","volume":"21","author":"M Driscoll","year":"2012","unstructured":"Driscoll M, Aubin CE, Moreau A, Wakula Y, Sarwark JF, Parent S (2012) Spinal growth modulation using a novel intravertebral epiphyseal device in an immature porcine model. Eur Spine J 21(1):138\u2013144","journal-title":"Eur Spine J"},{"issue":"12","key":"1247_CR13","doi-asserted-by":"publisher","first-page":"2695","DOI":"10.2106\/JBJS.G.01424","volume":"90","author":"PO Newton","year":"2008","unstructured":"Newton PO, Upasani VV, Farnsworth CL, Oka R, Chambers RC, Dwek J et al (2008) Spinal growth modulation with use of a tether in an immature porcine model. J Bone Joint Surg Am 90(12):2695\u20132706","journal-title":"J Bone Joint Surg Am"},{"issue":"11","key":"1247_CR14","doi-asserted-by":"publisher","first-page":"2460","DOI":"10.2106\/JBJS.G.01493","volume":"90","author":"H Zhang","year":"2008","unstructured":"Zhang H, Sucato DJ (2008) Unilateral pedicle screw epiphysiodesis of the neurocentral synchondrosis: production of idiopathic-like scoliosis in an immature animal model. J Bone Joint Surg Am 90(11):2460\u20132469","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"1247_CR15","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1097\/BRS.0b013e31816950a0","volume":"33","author":"PO Newton","year":"2008","unstructured":"Newton PO, Farnsworth CL, Faro FD, Mahar AT, Odell TR, Mohamad F et al (2008) Spinal growth modulation with an anterolateral flexible tether in an immature bovine model: disc health and motion preservation. Spine 33(7):724\u2013733","journal-title":"Spine"},{"issue":"2","key":"1247_CR16","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/BRS.0b013e3181cc8fce","volume":"36","author":"PO Newton","year":"2011","unstructured":"Newton PO, Farnsworth CL, Upasani VV, Chambers RC, Varley E, Tsutsui S (2011) Effects of intraoperative tensioning of an anterolateral spinal tether on spinal growth modulation in a porcine model. Spine 36(2):109\u2013117","journal-title":"Spine"},{"issue":"23","key":"1247_CR17","doi-asserted-by":"publisher","first-page":"2608","DOI":"10.1097\/01.brs.0000188267.66847.bf","volume":"30","author":"PO Newton","year":"2005","unstructured":"Newton PO, Faro FD, Farnsworth CL, Shapiro GS, Mohamad F, Parent S et al (2005) Multilevel spinal growth modulation with an anterolateral flexible tether in an immature bovine model. Spine 30(23):2608\u20132613","journal-title":"Spine"},{"issue":"10","key":"1247_CR18","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1097\/01.brs.0000162278.68000.91","volume":"30","author":"EJ Wall","year":"2005","unstructured":"Wall EJ, Bylski-Austrow DI, Kolata RJ, Crawford AH (2005) Endoscopic mechanical spinal hemiepiphysiodesis modifies spine growth. Spine 30(10):1148\u20131153","journal-title":"Spine"},{"issue":"1","key":"1247_CR19","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1097\/BRS.0b013e3181b790a0","volume":"35","author":"H Zhang","year":"2010","unstructured":"Zhang H, Sucato DJ, Nurenberg P, McClung A (2010) Morphometric analysis of neurocentral synchondrosis using magnetic resonance imaging in the normal skeletally immature spine. Spine 35(1):76\u201382","journal-title":"Spine"},{"issue":"6","key":"1247_CR20","first-page":"672","volume":"90","author":"IW Nachlas","year":"1950","unstructured":"Nachlas IW, Borden JN (1950) Experimental scoliosis; the role of the epiphysis. Surg Gynecol Obstet 90(6):672\u2013680","journal-title":"Surg Gynecol Obstet"},{"issue":"5","key":"1247_CR21","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1007\/s11999-010-1750-5","volume":"469","author":"A Patel","year":"2011","unstructured":"Patel A, Schwab F, Lafage R, Lafage V, Farcy JP (2011) Does removing the spinal tether in a porcine scoliosis model result in persistent deformity? A pilot study. Clin Orthop Relat Res 469(5):1368\u20131374","journal-title":"Clin Orthop Relat Res"},{"issue":"12","key":"1247_CR22","doi-asserted-by":"publisher","first-page":"1314","DOI":"10.1097\/01.brs.0000218662.78165.b1","volume":"31","author":"JT Braun","year":"2006","unstructured":"Braun JT, Hoffman M, Akyuz E, Ogilvie JW, Brodke DS, Bachus KN (2006) Mechanical modulation of vertebral growth in the fusionless treatment of progressive scoliosis in an experimental model. Spine 31(12):1314\u20131320","journal-title":"Spine"},{"issue":"13","key":"1247_CR23","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1097\/01.brs.0000219869.01599.6b","volume":"31","author":"JT Braun","year":"2006","unstructured":"Braun JT, Ogilvie JW, Akyuz E, Brodke DS, Bachus KN (2006) Creation of an experimental idiopathic-type scoliosis in an immature goat model using a flexible posterior asymmetric tether. Spine 31(13):1410\u20131414","journal-title":"Spine"},{"issue":"19","key":"1247_CR24","doi-asserted-by":"publisher","first-page":"2198","DOI":"10.1097\/01.BRS.0000085095.37311.46","volume":"28","author":"JT Braun","year":"2003","unstructured":"Braun JT, Ogilvie JW, Akyuz E, Brodke DS, Bachus KN, Stefko RM (2003) Experimental scoliosis in an immature goat model: a method that creates idiopathic-type deformity with minimal violation of the spinal elements along the curve. Spine 28(19):2198\u20132203","journal-title":"Spine"},{"issue":"1","key":"1247_CR25","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1097\/BRS.0b013e3181b79169","volume":"35","author":"A Patel","year":"2010","unstructured":"Patel A, Schwab F, Lafage V, Patel A, Obeidat MM, Farcy JP (2010) Computed tomographic validation of the porcine model for thoracic scoliosis. Spine 35(1):18\u201325","journal-title":"Spine"},{"issue":"21","key":"1247_CR26","doi-asserted-by":"publisher","first-page":"2305","DOI":"10.1097\/BRS.0b013e3181b1fdd0","volume":"34","author":"YG Zhang","year":"2009","unstructured":"Zhang YG, Zheng GQ, Zhang XS, Wang Y (2009) Scoliosis model created by pedicle screw tethering in immature goats: the feasibility, reliability, and complications. Spine 34(21):2305\u20132310","journal-title":"Spine"},{"issue":"6","key":"1247_CR27","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.spinee.2013.02.043","volume":"13","author":"AK Roth","year":"2013","unstructured":"Roth AK, Bogie R, Jacobs E, Arts JJ, van Rhijn LW (2013) Large animal models in fusionless scoliosis correction research: a literature review. Spine J 13(6):675\u2013688","journal-title":"Spine J"},{"issue":"5","key":"1247_CR28","doi-asserted-by":"publisher","first-page":"406","DOI":"10.2106\/JBJS.17.00182","volume":"100","author":"MA Halanski","year":"2018","unstructured":"Halanski MA, Hildahl B, Amundson LA, Leiferman E, Gendron-Fitzpatrick A, Chaudhary R et al (2018) Maternal diets deficient in vitamin D increase the risk of kyphosis in offspring: a novel kyphotic porcine model. J Bone Joint Surg 100(5):406\u2013415","journal-title":"J Bone Joint Surg"},{"issue":"10","key":"1247_CR29","first-page":"2133","volume":"88","author":"F Damborg","year":"2006","unstructured":"Damborg F, Engell V, Andersen M, Kyvik KO, Thomsen K (2006) Prevalence, concordance, and heritability of Scheuermann kyphosis based on a study of twins. J Bone Joint Surg Am 88(10):2133\u20132136","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"1247_CR30","doi-asserted-by":"publisher","first-page":"602","DOI":"10.3109\/17453674.2011.618919","volume":"82","author":"F Damborg","year":"2011","unstructured":"Damborg F, Engell V, Nielsen J, Kyvik KO, Andersen MO, Thomsen K (2011) Genetic epidemiology of Scheuermann\u2019s disease. Acta Orthop 82(5):602\u2013605","journal-title":"Acta Orthop"},{"issue":"2","key":"1247_CR31","first-page":"77","volume":"14","author":"S Lings","year":"1982","unstructured":"Lings S, Mikkelsen L (1982) Scheuermann\u2019s disease with low localization. A problem of under-diagnosis. Scand J Rehabil Med 14(2):77\u201379","journal-title":"Scand J Rehabil Med"},{"issue":"2","key":"1247_CR32","doi-asserted-by":"publisher","first-page":"236","DOI":"10.2106\/00004623-199302000-00011","volume":"75","author":"PM Murray","year":"1993","unstructured":"Murray PM, Weinstein SL, Spratt KF (1993) The natural history and long-term follow-up of Scheuermann kyphosis. J Bone Joint Surg Am 75(2):236\u2013248","journal-title":"J Bone Joint Surg Am"},{"key":"1247_CR33","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1093\/jas\/skaa146","volume":"98","author":"LA Amundson","year":"2020","unstructured":"Amundson LA, Crenshaw TD (2020) Lessons learned from the hypovitaminosis D kyphotic pig model. J Animal Sci 98:S52","journal-title":"J Animal Sci"},{"issue":"17 Suppl","key":"1247_CR34","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1097\/01.brs.0000175175.41471.d4","volume":"30","author":"TG Lowe","year":"2005","unstructured":"Lowe TG, Wilson L, Chien JT, Line BG, Klopp L, Wheeler D et al (2005) A posterior tether for fusionless modulation of sagittal plane growth in a sheep model. Spine 30(17 Suppl):S69-74","journal-title":"Spine"},{"issue":"1","key":"1247_CR35","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.jspd.2012.09.002","volume":"1","author":"KF Skaggs","year":"2013","unstructured":"Skaggs KF, Myung KS, Brasher AE, Skaggs DL (2013) Improvement of Kyphoscoliosis in a 9-year-old using growth modulation with a posterior tether: a case report. Spine Deform 1(1):79\u201383","journal-title":"Spine Deform"},{"issue":"7","key":"1247_CR36","doi-asserted-by":"publisher","first-page":"2677","DOI":"10.1007\/s00586-024-08297-4","volume":"33","author":"M Aydogan","year":"2024","unstructured":"Aydogan M, Pehlivanoglu T, Erdag Y, Akturk UD, Akar A (2024) Flexible posterior vertebral tethering for the management of Scheuermann\u2019s kyphosis: correction by using growth modulation-clinical and radiographic outcomes of the first 10 patients with at least 3 years of follow-up. Eur Spine J 33(7):2677\u20132687","journal-title":"Eur Spine J"},{"issue":"13","key":"1247_CR37","doi-asserted-by":"publisher","first-page":"4905","DOI":"10.2527\/jas.2012-5173","volume":"90","author":"LA Rortvedt","year":"2012","unstructured":"Rortvedt LA, Crenshaw TD (2012) Expression of kyphosis in young pigs is induced by a reduction of supplemental vitamin D in maternal diets and vitamin D, Ca, and P concentrations in nursery diets. J Anim Sci 90(13):4905\u20134915","journal-title":"J Anim Sci"},{"key":"1247_CR38","doi-asserted-by":"publisher","DOI":"10.14670\/HH-18-875","author":"G Ozaki","year":"2025","unstructured":"Ozaki G, Byrd J, Foley B, Farell A, Williams G, Twedt M et al (2025) Use of digital image analysis to improve rigor and efficiency of physeal bone growth measurements. Histol Histopathol. https:\/\/doi.org\/10.14670\/HH-18-875","journal-title":"Histol Histopathol"},{"issue":"23","key":"1247_CR39","doi-asserted-by":"publisher","first-page":"2691","DOI":"10.1097\/01.brs.0000146101.53784.b1","volume":"29","author":"PJ Roughley","year":"2004","unstructured":"Roughley PJ (2004) Biology of intervertebral disc aging and degeneration: involvement of the extracellular matrix. Spine 29(23):2691\u20132699","journal-title":"Spine"},{"issue":"4","key":"1247_CR40","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1002\/jor.21232","volume":"29","author":"GD O'Connell","year":"2011","unstructured":"O\u2019Connell GD, Vresilovic EJ, Elliott DM (2011) Human intervertebral disc internal strain in compression: the effect of disc region, loading position, and degeneration. J Orthop Res 29(4):547\u2013555","journal-title":"J Orthop Res"},{"issue":"3","key":"1247_CR41","doi-asserted-by":"publisher","first-page":"e1065","DOI":"10.1002\/jsp2.1065","volume":"2","author":"SE Bezci","year":"2019","unstructured":"Bezci SE, Werbner B, Zhou M, Malollari KG, Dorlhiac G, Carraro C et al (2019) Radial variation in biochemical composition of the bovine caudal intervertebral disc. JOR Spine 2(3):e1065","journal-title":"JOR Spine"},{"issue":"3","key":"1247_CR42","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1007\/s10237-018-1105-9","volume":"18","author":"B Yang","year":"2019","unstructured":"Yang B, O\u2019Connell GD (2019) GAG content, fiber stiffness, and fiber angle affect swelling-based residual stress in the intact annulus fibrosus. Biomech Model Mechanobiol 18(3):617\u2013630","journal-title":"Biomech Model Mechanobiol"},{"key":"1247_CR43","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.actbio.2019.09.035","volume":"100","author":"B Yang","year":"2019","unstructured":"Yang B, O\u2019Connell GD (2019) Intervertebral disc swelling maintains strain homeostasis throughout the annulus fibrosus: a finite element analysis of healthy and degenerated discs. Acta Biomater 100:61\u201374","journal-title":"Acta Biomater"},{"key":"1247_CR44","doi-asserted-by":"publisher","first-page":"685799","DOI":"10.3389\/fbioe.2021.685799","volume":"9","author":"M Zhou","year":"2021","unstructured":"Zhou M, Lim S, O\u2019Connell GD (2021) A robust multiscale and multiphasic structure-based modeling framework for the intervertebral disc. Front Bioeng Biotechnol 9:685799","journal-title":"Front Bioeng Biotechnol"},{"key":"1247_CR45","doi-asserted-by":"publisher","first-page":"104292","DOI":"10.1016\/j.jmbbm.2020.104292","volume":"115","author":"M Zhou","year":"2021","unstructured":"Zhou M, Werbner B, O\u2019Connell GD (2021) Fiber engagement accounts for geometry-dependent annulus fibrosus mechanics: a multiscale, structure-based finite element study. J Mech Behav Biomed Mater 115:104292","journal-title":"J Mech Behav Biomed Mater"},{"issue":"2","key":"1247_CR46","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.bone.2007.04.180","volume":"41","author":"IA Stokes","year":"2007","unstructured":"Stokes IA, Clark KC, Farnum CE, Aronsson DD (2007) Alterations in the growth plate associated with growth modulation by sustained compression or distraction. Bone 41(2):197\u2013205","journal-title":"Bone"},{"issue":"2","key":"1247_CR47","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/S8756-3282(01)00488-4","volume":"29","author":"AG Robling","year":"2001","unstructured":"Robling AG, Duijvelaar KM, Geevers JV, Ohashi N, Turner CH (2001) Modulation of appositional and longitudinal bone growth in the rat ulna by applied static and dynamic force. Bone 29(2):105\u2013113","journal-title":"Bone"},{"issue":"10","key":"1247_CR48","doi-asserted-by":"publisher","first-page":"1843","DOI":"10.1359\/jbmr.2002.17.10.1843","volume":"17","author":"X Wang","year":"2002","unstructured":"Wang X, Mao JJ (2002) Accelerated chondrogenesis of the rabbit cranial base growth plate by oscillatory mechanical stimuli. J Bone Miner Res 17(10):1843\u20131850","journal-title":"J Bone Miner Res"},{"issue":"2","key":"1247_CR49","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1359\/jbmr.2002.17.2.284","volume":"17","author":"N Ohashi","year":"2002","unstructured":"Ohashi N, Robling AG, Burr DB, Turner CH (2002) The effects of dynamic axial loading on the rat growth plate. J Bone Miner Res 17(2):284\u2013292","journal-title":"J Bone Miner Res"},{"issue":"4","key":"1247_CR50","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1007\/s10237-015-0733-6","volume":"15","author":"R Kaviani","year":"2016","unstructured":"Kaviani R, Londono I, Parent S, Moldovan F, Villemure I (2016) Growth plate cartilage shows different strain patterns in response to static versus dynamic mechanical modulation. Biomech Model Mechanobiol 15(4):933\u2013946","journal-title":"Biomech Model Mechanobiol"},{"issue":"11","key":"1247_CR51","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1001\/jama.2013.1013","volume":"309","author":"S Agrawal","year":"2013","unstructured":"Agrawal S, Taitsman J, Cassel C (2013) Educating physicians about responsible management of finite resources. JAMA 309(11):1115","journal-title":"JAMA"},{"issue":"2","key":"1247_CR52","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s43390-021-00429-w","volume":"10","author":"M Erkilinc","year":"2022","unstructured":"Erkilinc M, Baldwin KD, Pasha S, Mistovich RJ (2022) Proximal junctional kyphosis in pediatric spinal deformity surgery: a systematic review and critical analysis. Spine Deform 10(2):257\u2013266","journal-title":"Spine Deform"},{"issue":"8","key":"1247_CR53","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1016\/j.spinee.2017.03.021","volume":"17","author":"T Lange","year":"2017","unstructured":"Lange T, Schmoelz W, Gosheger G, Eichinger M, Heinrichs CH, Boevingloh AS et al (2017) Is a gradual reduction of stiffness on top of posterior instrumentation possible with a suitable proximal implant? A biomechanical study. Spine J 17(8):1148\u20131155","journal-title":"Spine J"},{"issue":"2","key":"1247_CR54","doi-asserted-by":"publisher","first-page":"120","DOI":"10.22603\/ssrr.2022-0100","volume":"7","author":"J Dubousset","year":"2023","unstructured":"Dubousset J, Diebo BG (2023) Proximal junctional kyphosis in modern spine surgery: why is it so common? Spine Surg Relat Res 7(2):120\u2013128","journal-title":"Spine Surg Relat Res"},{"key":"1247_CR55","doi-asserted-by":"publisher","first-page":"100770","DOI":"10.1016\/j.xnsj.2025.100770","volume":"24","author":"M Rasouligandomani","year":"2025","unstructured":"Rasouligandomani M, Arco Ad, Villa T, La Barbera L, Gonz\u00e1lez Ballester MA, Galbusera F et al (2025) Implant density reduction to avoid proximal junctional failure in adult spine surgery: computer models and simulations. North Am Spine Soc J (NASSJ) 24:100770","journal-title":"North Am Spine Soc J (NASSJ)"},{"issue":"2","key":"1247_CR56","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s005860100346","volume":"11","author":"TH Smit","year":"2002","unstructured":"Smit TH (2002) The use of a quadruped as an in vivo model for the study of the spine - biomechanical considerations. Eur Spine J 11(2):137\u2013144","journal-title":"Eur Spine J"},{"issue":"6","key":"1247_CR57","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1097\/01241398-200411000-00024","volume":"24","author":"KJ Noonan","year":"2004","unstructured":"Noonan KJ, Farnum CE, Leiferman EM, Lampl M, Markel MD, Wilsman NJ (2004) Growing pains: are they due to increased growth during recumbency as documented in a lamb model? J Pediatr Orthop 24(6):726\u2013731","journal-title":"J Pediatr Orthop"},{"key":"1247_CR58","doi-asserted-by":"crossref","unstructured":"Halanski MA, Kokinos B, Leiferman E, Zhou M, Abubakr Y, Twedt M et al. (2025) The growth modulating effects of tether tension on vertebral growth are biphasic: a study of posterior vertebral body tethering (pVBT) in a novel kyphotic porcine model. Spine Deform","DOI":"10.1007\/s43390-025-01168-y"}],"container-title":["Spine Deformity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-025-01247-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43390-025-01247-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43390-025-01247-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T17:11:04Z","timestamp":1771434664000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43390-025-01247-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":58,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["1247"],"URL":"https:\/\/doi.org\/10.1007\/s43390-025-01247-0","relation":{},"ISSN":["2212-134X","2212-1358"],"issn-type":[{"value":"2212-134X","type":"print"},{"value":"2212-1358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]},"assertion":[{"value":"6 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"MAH has received research support (not related to this manuscript) from Orthopediatrics.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the University of Wisconsin Institutional Animal Care and Use Committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}