{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T21:18:19Z","timestamp":1788297499316,"version":"build-2803163510"},"reference-count":35,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective Cohort Study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Mid-term Anterior Vertebral Body Tethering (AVBT) results demonstrate an acceptable degree of clinical success, yet the revision rate remains notably higher than fusion. Fulcrum-bending radiographs have previously been shown to more reliably predict radiological outcomes in Adolescent Idiopathic Scoliosis (AIS) as compared to supine-lateral bending radiographs. This study aims to discern how Fulcrum Flexibility Rate (FFR) correlates with Correction Rate (CR) and establish whether this can reliably predict residual deformity following AVBT surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A review of 38 consecutive AIS patients undergoing thoracic AVBT between 2015 \u2013 2020 was performed. Preoperative (standing and fulcrum-bending) and postoperative (first-erect) radiographs were evaluated for curve magnitude using the Cobb-method. The FFR, CR and Fulcrum Bending Correction Index (FBCI) were calculated. Patients were also percentile-ranked according to their FFR and dichotomized into flexible and rigid cohorts for comparison. Student t-test, Pearson correlation and linear stepwise regression was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>AVBT resulted in a significant improvement in the major Cobb angle (Preoperative: 50.9\u00b17.5\u00b0 vs Postoperative: 19.9\u00b19.4\u00b0; P &lt; .0001) with a mean FBCI of 98.0%. Bivariate correlation revealed a moderate relationship between fulcrum-bending and first-erect Cobb angle (r = .5306, P = .0006). Linear regression demonstrated a predictive relationship between fulcrum-bending and first-erect Cobb using the equation \u2018Postoperative Cobb = 7.5 + .65(Fulcrum-bending Cobb).\u2019<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This is the first study to demonstrate the ability of fulcrum-bending radiographs to predict early radiographic outcomes following AVBT, \u2018timepoint-zero\u2019 for the growth modulation process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682221100444","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T03:32:25Z","timestamp":1651721545000},"page":"219-224","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Reducing Uncertainty in Anterior Vertebral Body Tethering: Predicting Postoperative Curvature With Fulcrum Bending Radiographs"],"prefix":"10.1177","volume":"14","author":[{"given":"Zacharia Matthew","family":"Silk","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Leeds General Infirmary, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared C.","family":"Tishelman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Eaker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-200X","authenticated-orcid":false,"given":"Baron","family":"Lonner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, 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