Personalization and Active Learning in the Large Introductory Psychology Class

STUDY DESIGN: Retrospective comparative cohort study. OBJECTIVES: To compare the radiographic outcomes, spinal growth, and complication profiles of the traditional active apex correction versus a Hybrid APC technique (convex apical control combined with a concave magnetically controlled growing rod) in early-onset scoliosis (EOS). METHODS: A total of 36 patients (23 Traditional APC, 13 Hybrid APC) with > 2 years were included. Radiographic parameters (major Cobb angle, apical vertebral translation, T1-T12, and T1-L5 lengths) were evaluated preoperatively, early postoperatively, and at final follow-up. Complications and unplanned reoperations were meticulously recorded and compared. The primary outcome was the major Cobb angle at final follow-up. Inter-group comparisons used analysis of covariance and linear mixed-effects models; complications were compared using Fisher's exact test and, because follow-up differed between groups, as events per patient-year. RESULTS: Both groups showed significant correction. Both techniques facilitated significant initial correction and continuous physiological spinal elongation. From immediate post-operative to final follow-up, there was no statistical difference between the traditional and hybrid one. Hybrid group demonstrated better outcomes in curve correction during the postoperative to final follow-up, maintaining the major Cobb angle without progression, although no inter-group radiographic difference reached statistical significance after adjustment. When spinal growth was measured from the early postoperative radiograph, so that the deformity correction was not counted as growth, T1-L5 growth did not differ between the groups (p = 0.378). Complication rates (53.8% vs. 13.0%, p = 0.018) and unplanned reoperations (46.2% vs. 13.0%, p = 0.046) were higher in the Hybrid group; expressed as event rates these were 0.233 versus 0.035 per patient-year (incidence rate ratio 6.69, p = 0.004). CONCLUSIONS: Both Traditional and Hybrid APC are effective fusionless strategies for EOS; however, the small retrospective cohort precludes establishing the superiority of either technique.