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Anterior vertebral body tethering for immature adolescent idiopathic scoliosis: one-year results on the first 32 patients

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Abstract

Purpose

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.

Methods

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.

Results

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 42.8° ± 8.0° which corrected to 21.0° ± 8.5° on first erect and 17.9° ± 11.4° at most recent. The pre-operative lumbar curve of 25.2° ± 7.3° demonstrated progressive correction (first erect = 18.0° ± 7.1°, 1 year = 12.6° ± 9.4°, p < 0.00001). Thoracic axial rotation measured 13.4° pre-operatively and 7.4° at the most recent measurement (p < 0.00001). One patient experienced prolonged atelectasis which required a bronchoscopy; otherwise, no major complications were observed.

Conclusions

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.

Level of evidence

IV.

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Conflict of interest

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Authors and Affiliations

  1. Shriners Hospitals for Children-Philadelphia, 3551 North Broad Street, 19140, Philadelphia, PA, USA

    Amer F. Samdani, Robert J. Ames, Jeff S. Kimball & Joshua M. Pahys

  2. Temple University School of Medicine, Philadelphia, PA, USA

    Robert J. Ames

  3. Cooper Medical School at Rowan University and Cooper University Health Care, Camden, NJ, USA

    Harsh Grewal

  4. Nemours/AI duPont Hospital for Children, Wilmington, DE, USA

    Glenn J. Pelletier

  5. Institute for Spine and Scoliosis, Lawrenceville, NJ, USA

    Randal R. Betz

Authors
  1. Amer F. Samdani
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  2. Robert J. Ames
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  3. Jeff S. Kimball
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  4. Joshua M. Pahys
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  5. Harsh Grewal
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  6. Glenn J. Pelletier
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  7. Randal R. Betz
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Corresponding author

Correspondence to Amer F. Samdani.

Additional information

IRB statement: IRB approval for the study was obtained from Temple University School of Medicine.

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Samdani, A.F., Ames, R.J., Kimball, J.S. et al. Anterior vertebral body tethering for immature adolescent idiopathic scoliosis: one-year results on the first 32 patients. Eur Spine J 24, 1533–1539 (2015). https://doi.org/10.1007/s00586-014-3706-z

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  • DOI: https://doi.org/10.1007/s00586-014-3706-z

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