Evidence map›Paper›PMID 40836185›Full record

ArticleSpine deformity2026

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.

Matthew A Halanski, Brittney Kokinos, Ellen Leiferman, Minhao Zhou, Yousuf Abubakr, Max Twedt, Cameron Jeffers, David Bennett, Susan Hamman, Jennifer Frank and 3 more

Abstract read
PubMed Full text at PMC Publisher
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.

0numbers the graph read from it
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

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Matthew A HalanskiDivision of Orthopedics and Sports Medicine, Phoenix Children's Hospital, Phoenix, AZ, USA. halanski@arizona.edu.ORCID http://orcid.org/0000-0002-7481-2111
Brittney KokinosDepartments of Orthopedics and Rehabilitation and Animals Sciences, University of Wisconsin-Madison, Madison, WI, USA.
Ellen LeifermanDepartments of Orthopedics and Rehabilitation and Animals Sciences, University of Wisconsin-Madison, Madison, WI, USA.
Minhao ZhouMechanical Engineering, University of California-Berkeley, Berkeley, CA, USA.
Yousuf AbubakrMechanical Engineering, University of California-Berkeley, Berkeley, CA, USA.
Max TwedtOrthopedics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA.
Cameron JeffersDivision of Orthopedics and Sports Medicine, Phoenix Children's Hospital, Phoenix, AZ, USA.
David BennettDivision of Orthopedics and Sports Medicine, Phoenix Children's Hospital, Phoenix, AZ, USA.
Susan HammanDivision of Orthopedics and Sports Medicine, Phoenix Children's Hospital, Phoenix, AZ, USA.
Jennifer FrankDepartments of Orthopedics and Rehabilitation and Animals Sciences, University of Wisconsin-Madison, Madison, WI, USA.
Melanie E BoeyerMissouri Orthopaedic Institute, University of Missouri School of Medicine, Columbia, MO, USA.
Grace D O'ConnellMechanical Engineering, University of California-Berkeley, Berkeley, CA, USA.
Thomas CrenshawDepartments of Orthopedics and Rehabilitation and Animals Sciences, University of Wisconsin-Madison, Madison, WI, USA.

Funding

Improving Spinal Growth Modulation using a Novel Kyphotic Porcine ModelR21AR078528 · NIAMS · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI CRENSHAW, THOMAS D, HALANSKI, MATTHEW A · 2021 to 2022
$403k
NIAMS NIH HHS 1R21AR078528-01A1NIAMS NIH HHS R21 AR078528
6 · The paper itself

Abstract

purposeTo measure the effects of posterior vertebral tethering (pVBT) on disc pressure and the effect of tether tension on growth modulation in the hyperkyphotic swine model, and to use computational modeling to predict growth modulation in scenarios unable to be tested in the animal model.

methodsSwine were divided into non-operative control, single-level apical pVBT, or multi-level posterior pVBT groups. Pulsed fluorochrome labeling was used to measure regional vertebral growth rates, digital radiographs to assess changes in vertebral alignment, and pressure transducers to measure intervertebral disc pressures. Finite element analysis (FEA) was performed to simulate tether-mediated disc space correction.

resultsKyphotic swine had significantly greater angular kyphosis than control swine at 11- and 13-weeks, and deformities increased from 2 to 5 months of age. At 2-weeks post-operative, high-tension single level tethering resulted in significantly greater growth modulation than low-tension (53 ± 43% vs - 1 ± 15%, p = 0.03) or non-operative controls (p = 0.01), however, at 2-4 weeks, growth modulation was normalized between the low and high tensioned cohorts (14 ± 11% vs 10 ± 10%, p = 0.6). The FEA predicted that growth plate stress distributions worsen as the average disc height post-realignment is decreased.

conclusionIncreased tether tension results in more effective early growth modulation in the young flexible spine without increasing disc pressure, however, these tension-related benefits are transitory as growth modulation becomes load-independent with time. Computational modeling predicted that in the less flexible spine, vertebral growth may be arrested rather than modulated.

Indexed as

KyphosisLumbar VertebraeSpineVertebral BodyAnimalsBiomechanical PhenomenaComputer SimulationDisease Models, AnimalFinite Element AnalysisIntervertebral DiscSwineAnimal modelGrowth modulationPhysisPosterior vertebral body tethering (VBT)

Identifiers

PMID40836185
PMCPMC12815995

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.