Journal article
Anterior vertebral body tethering for immature adolescent idiopathic scoliosis: one-year results on the first 32 patients
European spine journal, v 24(7), pp 1533-1539
01 Jul 2015
PMID: 25510515
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
This retrospective chart review evaluates the clinical and radiographic outcomes of anterior vertebral body tethering (VBT) at 1-year follow-up. Anterior VBT offers a fusionless treatment option for skeletally immature patients with adolescent idiopathic scoliosis. It is a growth-modulation technique, which utilizes patients' growth to attain progressive scoliosis correction. Numerous animal models support its promise; however, clinical data remain sparse.
Clinical and radiographic data were retrospectively analyzed. We reviewed 32 patients who underwent thoracic VBT with a minimum one-year follow-up. Pertinent clinical and radiographic data were collected. ANOVA, Student's t test and Fisher's exact test were utilized to compare different time points.
32 patients with thoracic idiopathic scoliosis (72 % female) with a minimum one-year follow-up were identified; mean age at surgery was 12 years. All patients were considered skeletally immature pre-operatively; mean Risser score 0.42, mean Sanders score 3.2. Patients underwent tethering of an average of 7.7 levels (range 7-11). Median blood loss was 100 cc. The mean pre-operative thoracic curve magnitude was 42.8A degrees A A +/- A 8.0A degrees which corrected to 21.0A degrees A A +/- A 8.5A degrees on first erect and 17.9A degrees A A +/- A 11.4A degrees at most recent. The pre-operative lumbar curve of 25.2A degrees A A +/- A 7.3A degrees demonstrated progressive correction (first erect = 18.0A degrees A A +/- A 7.1A degrees, 1 year = 12.6A degrees A A +/- A 9.4A degrees, p < 0.00001). Thoracic axial rotation measured 13.4A degrees pre-operatively and 7.4A degrees at the most recent measurement (p < 0.00001). One patient experienced prolonged atelectasis which required a bronchoscopy; otherwise, no major complications were observed.
Our early results indicate that anterior VBT is a safe and potentially effective treatment option for skeletally immature patients with idiopathic scoliosis. These patients experienced an improvement of their scoliosis with minimal major complications. However, longer term follow-up of this cohort will reveal the true benefits of this promising technique.
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Details
- Title
- Anterior vertebral body tethering for immature adolescent idiopathic scoliosis: one-year results on the first 32 patients
- Creators
- Amer F. Samdani - Shriners Hospitals for Children - PhiladelphiaRobert J. Ames - Shriners Hospitals for Children - PhiladelphiaJeff S. Kimball - Shriners Hospitals for Children - PhiladelphiaJoshua M. Pahys - Shriners Hospitals for Children - PhiladelphiaHarsh Grewal - Rowan UniversityGlenn J. Pelletier - Dupont HospitalRandal R. Betz - The Spine Institute
- Publication Details
- European spine journal, v 24(7), pp 1533-1539
- Publisher
- Springer Nature
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Surgery
- Web of Science ID
- WOS:000356875500024
- Scopus ID
- 2-s2.0-84933180182
- Other Identifier
- 991021931099104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Orthopedics