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Early-term outcome of apical fusion with vertebral body tethering for thoracolumbar curves in adolescent idiopathic scoliosis: a preliminary study

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Abstract

Introduction

Vertebral body tethering (VBT) has become an alternative option for select patients with idiopathic scoliosis. However, studies have shown a high number of tether breakages, specifically after thoracolumbar (TL) VBT, that can have a negative impact on the outcome, when the breakage occurs within the first year after surgery. In order to overcome this problem, we have started to apply an apical fusion (AF) in combination with TL VBT for select patients. This study aims to analyze the outcome after AF plus VBT.

Methods

This is a retrospective single surgeon’s data analysis. All patients were included who have had TL VBT after January 2022 and a follow-up of 12 months. Patients were grouped based on whether they only had VBT or VBT + AF.

Results

Twenty-five patients were analyzed (15 VBT, 10 VBT + AF). Both groups showed a significant curve correction for thoracic and TL curves. Minor loss of correction was observed in both groups. A significant difference was seen regarding early tether breakages, which were found in 60% of VBT patients and 10% of VBT + AF patients.

Conclusion

The preliminary data shows a significant reduction of early tether breakages when TL VBT is applied in combination with AF.

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Funding

No funding was received/required for this study.

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Authors and Affiliations

  1. Department of Spine Surgery, Eifelklinik St. Brigida, Simmerath, Germany

    Per D. Trobisch, Stephanie Da Paz & Mahmoud Alkharsawi

  2. Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea

    Hong-Jin Kim & Dong-Gune Chang

  3. Dutch Scoliosis Center, University Medical Center Utrecht, Utrecht, Zeist, The Netherlands

    Rene Castelein

Authors
  1. Per D. Trobisch
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  2. Hong-Jin Kim
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  3. Stephanie Da Paz
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  4. Mahmoud Alkharsawi
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  5. Rene Castelein
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  6. Dong-Gune Chang
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Contributions

PDT provided lead investigator, study design, data analysis, draft of manuscript, manuscript revision, and final approval (includes revision). HJK presented data analysis, draft of manuscript, manuscript revision, and final approval (includes revision). SDP performed data acquisition, data analysis, manuscript revision, and final approval (includes revision). MA analyzed data acquisition, data analysis, manuscript revision, and final approval (includes revision). RC contributed data analysis, manuscript revision, and final approval (includes revision). DGC carried out data analysis, draft of manuscript, manuscript revision, and final approval (includes revision). All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Per D. Trobisch.

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Conflict of interest

PDT: Globus Medical (Consultant, Paid Lectures), Stryker Spine (Consultant), Triaspine (Paid Lectures), Spineguard (Paid Lectures). SDP: Globus Medical (Paid Lectures). RC: Stryker Spine Research Grant, Co-owner Cresco Spine (Spring Distraction System), Co-owner Dutch Scoliosis Center, InSpine Netherlands Research Grant, Fondation Yves Cotrel Research Grants, Nuvasive Research Grant, J&J Congress bureau, AO Foundation Research Grant, Eurospine Research Grant, Surgical Advisory Board MRI Guidance, Medical Advisory Board Telefield Medicine. HJK, MA, DGC: nothing to disclose.

Ethical approval

This retrospective review was approved by the local ethics committee.

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Trobisch, P.D., Kim, HJ., Da Paz, S. et al. Early-term outcome of apical fusion with vertebral body tethering for thoracolumbar curves in adolescent idiopathic scoliosis: a preliminary study. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08242-5

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  • DOI: https://doi.org/10.1007/s00586-024-08242-5

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