Differential vertebral body growth is maintained after vertebral body tethering surgery for idiopathic scoliosis : 4-year follow-up on 888 peri-apical vertebrae and 592 intervertebral discs
© 2024. The Author(s), under exclusive licence to Scoliosis Research Society..
PURPOSE: To radiographically evaluate if vertebral body tethering (VBT) can maintain differential peri-apical vertebral growth at medium-term follow-up of 4 years.
METHODS: A prospective, international, multicenter database was queried to identify idiopathic scoliosis patients treated with thoracic VBT. Concave vs. convex vertebral body height, vertebral wedging, and disc wedging of the 3 peri-apical vertebrae were measured by two independent observers at 5 timepoints (pre-operative to 4-year follow-up).
RESULTS: 65 skeletally immature patients (60 female, mean 12.8 years old, 21 with open triradiate cartilages) met inclusion criteria. Mean pre-operative maximum scoliosis of 50 ± 8° decreased significantly post-operatively to 27 ± 9° (p < 0.001), which remained stable at 4-year follow-up 30 ± 17° (p = 0.38 vs. post-operative). Mean instrumented scoliosis was 21 ± 14° at 4-year follow-up, which was significantly different than 4-year maximum scoliosis (p < 0.001). Mean pre-operative kyphosis of 30 ± 12° did not significantly change post-operatively (p = 1.0) and remained stable at 4-year follow-up (35 ± 18°; p = 0.05). Mean individual convex vertebral height increased from 17.7 ± 1.9 mm to 19.8 ± 1.5 mm (p < 0.001), while mean individual concave height increased from 14.8 ± 1.9 mm to 17.6 ± 1.6 mm (p < 0.001). Summing the peri-apical heights, the difference in height from pre-operative to 4-year follow-up was greater on the concave (8.3 ± 4.7 mm) than on the convex side (6.2 ± 4.7 mm) (p < 0.001). Mean individual vertebral wedging decreased from 6 ± 2° at pre-operative to 4 ± 2° at 4-year follow-up (p < 0.001). Mean total vertebral and disc wedging started at 29 ± 7° pre-operatively, decreased to 16 ± 6° at post-operative (p < 0.001), then further decreased to 14 ± 8° at 4-year follow-up (p < 0.001). Patients with open triradiate cartilages at the time of surgery had a larger height change over the 4 years compared to those with closed triradiate cartilages (p < 0.001).
CONCLUSION: Patients with idiopathic scoliosis treated with VBT demonstrated differential vertebral growth which was maintained at minimum 4-year follow-up. This effect was more pronounced in patients whose triradiate cartilages were open at the time of surgery.
LEVEL OF EVIDENCE: III.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Spine deformity - (2024) vom: 18. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Photopoulos, Gregory [VerfasserIn] |
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| Links: |
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| Themen: |
AVBT |
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| Anmerkungen: |
Date Revised 18.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s43390-024-00874-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM371240859 |
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| 100 | 1 | |a Photopoulos, Gregory |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Differential vertebral body growth is maintained after vertebral body tethering surgery for idiopathic scoliosis |b 4-year follow-up on 888 peri-apical vertebrae and 592 intervertebral discs |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 18.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Scoliosis Research Society. | ||
| 520 | |a PURPOSE: To radiographically evaluate if vertebral body tethering (VBT) can maintain differential peri-apical vertebral growth at medium-term follow-up of 4 years | ||
| 520 | |a METHODS: A prospective, international, multicenter database was queried to identify idiopathic scoliosis patients treated with thoracic VBT. Concave vs. convex vertebral body height, vertebral wedging, and disc wedging of the 3 peri-apical vertebrae were measured by two independent observers at 5 timepoints (pre-operative to 4-year follow-up) | ||
| 520 | |a RESULTS: 65 skeletally immature patients (60 female, mean 12.8 years old, 21 with open triradiate cartilages) met inclusion criteria. Mean pre-operative maximum scoliosis of 50 ± 8° decreased significantly post-operatively to 27 ± 9° (p < 0.001), which remained stable at 4-year follow-up 30 ± 17° (p = 0.38 vs. post-operative). Mean instrumented scoliosis was 21 ± 14° at 4-year follow-up, which was significantly different than 4-year maximum scoliosis (p < 0.001). Mean pre-operative kyphosis of 30 ± 12° did not significantly change post-operatively (p = 1.0) and remained stable at 4-year follow-up (35 ± 18°; p = 0.05). Mean individual convex vertebral height increased from 17.7 ± 1.9 mm to 19.8 ± 1.5 mm (p < 0.001), while mean individual concave height increased from 14.8 ± 1.9 mm to 17.6 ± 1.6 mm (p < 0.001). Summing the peri-apical heights, the difference in height from pre-operative to 4-year follow-up was greater on the concave (8.3 ± 4.7 mm) than on the convex side (6.2 ± 4.7 mm) (p < 0.001). Mean individual vertebral wedging decreased from 6 ± 2° at pre-operative to 4 ± 2° at 4-year follow-up (p < 0.001). Mean total vertebral and disc wedging started at 29 ± 7° pre-operatively, decreased to 16 ± 6° at post-operative (p < 0.001), then further decreased to 14 ± 8° at 4-year follow-up (p < 0.001). Patients with open triradiate cartilages at the time of surgery had a larger height change over the 4 years compared to those with closed triradiate cartilages (p < 0.001) | ||
| 520 | |a CONCLUSION: Patients with idiopathic scoliosis treated with VBT demonstrated differential vertebral growth which was maintained at minimum 4-year follow-up. This effect was more pronounced in patients whose triradiate cartilages were open at the time of surgery | ||
| 520 | |a LEVEL OF EVIDENCE: III | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a AVBT | |
| 650 | 4 | |a Growth modulation | |
| 650 | 4 | |a Idiopathic scoliosis | |
| 650 | 4 | |a Radiographic | |
| 650 | 4 | |a VBT | |
| 650 | 4 | |a Vertebral body tethering | |
| 700 | 1 | |a Hurry, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Bansal, Ankita |e verfasserin |4 aut | |
| 700 | 1 | |a Miyanji, Firoz |e verfasserin |4 aut | |
| 700 | 1 | |a Parent, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Murphy, Joshua |e verfasserin |4 aut | |
| 700 | 1 | |a El-Hawary, Ron |e verfasserin |4 aut | |
| 700 | 0 | |a Pediatric Spine Study Group |e verfasserin |4 aut | |
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