{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:27Z","timestamp":1787755827286,"version":"build-2784847793"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,21]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Growth modulation through anterior vertebral body tethering (AVBT) has emerged as a fusionless option for the treatment of progressive scoliosis. When tethering the main thoracic curve, the compensatory thoracolumbar\/lumbar curve must correct indirectly as a result. The present study evaluated the response of these lumbar curves following AVBT of the main thoracic curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients who underwent thoracic AVBT and who had a minimum follow-up of 2 years were included. Magnitudes of the thoracic and lumbar curves were recorded preoperatively and at the first-erect and 2-year postoperative visits. Lumbar curves were further stratified according to their lumbar modifier (A, B, or C). Analysis of variance (ANOVA) and repeated-measures ANOVA were performed to compare correction rates, and the Pearson coefficient was utilized to determine the correlation between the tethered thoracic curve and uninstrumented lumbar curve magnitudes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 218 patients were included. Thoracic curve correction was 40% at the first-erect visit and 43% at 2 years (p = 0.012). Lumbar correction was 30%, 26%, and 18% at the first-erect visit (p &lt; 0.001 for all compared with preoperatively) and minimally changed at 31%, 26%, and 24% at 2 years for lumbar modifiers A, B, and C, respectively. A total of 118 patients (54%) showed thoracic curve improvement between the first-erect and 2-year visits. In a subgroup analysis, these patients had a correction in lumbar curve magnitude from preoperatively to the first-erect visit of 30%, 22%, and 16% for lumbar modifiers A, B, C, respectively, that increased to 42%, 34%, and 31% at 2 years, with strong correlation to thoracic correction at 2-year follow-up (r = 0.557, p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although there was immediate lumbar correction following AVBT of a main thoracic curve, further improvement following initial correction was only observed among patients with growth modulation of the thoracic curve. Considering all patients, the uninstrumented lumbar curve corrected 30% at 2 years and the instrumented thoracic curve corrected 40%. As indications for AVBT are refined, these data will provide insight into the response of the uninstrumented lumbar curve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.21.01500","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T08:00:31Z","timestamp":1658217631000},"page":"1629-1638","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves"],"prefix":"10.2106","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7418-9561","authenticated-orcid":false,"given":"Anthony A.","family":"Catanzano","sequence":"first","affiliation":[{"name":"Division of Orthopedics & Scoliosis, Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter O.","family":"Newton","sequence":"additional","affiliation":[{"name":"Division of Orthopedics & Scoliosis, Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7624-6977","authenticated-orcid":false,"given":"Tracey P.","family":"Bastrom","sequence":"additional","affiliation":[{"name":"Division of Orthopedics & Scoliosis, Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3893-5429","authenticated-orcid":false,"given":"Carrie E.","family":"Bartley","sequence":"additional","affiliation":[{"name":"Division of Orthopedics & Scoliosis, Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4854-2816","authenticated-orcid":false,"given":"Stefan","family":"Parent","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, CHU Sainte-Justine, Montreal, Quebec, Canada"},{"name":"Department of Surgery, University of Montreal, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3023-3660","authenticated-orcid":false,"given":"Firoz","family":"Miyanji","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, British Columbia Children\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-5754","authenticated-orcid":false,"given":"Daniel G.","family":"Hoernschemeyer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri Health Care, Columbia, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2252-6647","authenticated-orcid":false,"given":"Ahmet","family":"Alanay","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Acibadem University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7158-4432","authenticated-orcid":false,"given":"Laurel","family":"Blakemore","sequence":"additional","affiliation":[{"name":"Division of Pediatric Orthopedics, Pediatric Specialists of Virginia, Fairfax, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8870-8286","authenticated-orcid":false,"given":"Kevin","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nemours Children\u2019s Health, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0819-663X","authenticated-orcid":false,"given":"Baron","family":"Lonner","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mount Sinai Hospital, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9471-3794","authenticated-orcid":false,"given":"Lawrence","family":"Haber","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ochsner Hospital for Children, Ochsner Medical Center, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suken A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Nemours\/Alfred I. 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