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Factors Predictive of Outcomes in Vertebral Body Stapling for Idiopathic Scoliosis

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Abstract

Study Design

Retrospective review.

Objectives

To identify factors associated with successful outcomes in patients treated with vertebral body stapling (VBS) for idiopathic scoliosis.

Summary of Background Data

The standard of care for moderate scoliosis (20°–45°) consists of observation and bracing with the goal of halting curve progression. Although several recent studies have confirmed the efficacy of bracing in altering the natural history of scoliosis, bracing is not universally effective. Recent studies have demonstrated that VBS is a safe and viable treatment for some young patients with scoliosis at risk for progression. The identification of factors associated with successful outcomes in VBS for idiopathic scoliosis would better define the population likely to benefit from VBS.

Methods

We retrospectively reviewed all patients from a single institution treated with VBS who met previously defined inclusion criteria. Successful treatment was defined as avoidance of a fusion and a final Cobb angle no more than 10° greater than the pretreatment Cobb angle.

Results

We identified 63 patients who met inclusion criteria. The patients underwent VBS at a mean age of 10.78 years and had a mean follow-up of 3.62 years (minimum 2 years). The mean pre-op Cobb angle for stapled thoracic curves was 29.5°. Seventy-four percent of the patients who had VBS of the thoracic curve have avoided progression and/or fusion, and the mean Cobb angle at most recent follow-up was 21.8°. The mean preoperative Cobb angle for lumbar curves was 31.1°. Eighty-two percent of the patients who had VBS of the lumbar curve have avoided progression and/or fusion, and their mean Cobb angle at follow-up was 21.6°.

Conclusion

VBS is effective at preventing progression and fusion for moderate idiopathic scoliosis in immature patients. The complication rates are low.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Children’s Hospital of Philadelphia, 34th Street & 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Patrick J. Cahill MD

  2. Department of Orthopaedic Surgery, Lewis Katz School of Medicine at Temple University, 3500 N Broad St, Philadelphia, PA, 19140, USA

    Michael Auriemma MD & John P. Gaughan PhD

  3. Department of Neurological Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA

    Elias Dakwar MD

  4. Shriners Hospitals for Children, 3551 N Broad St, Philadelphia, PA, 19140, USA

    Amer F. Samdani MD & Joshua M. Pahys MD

  5. Institute for Spine & Scoliosis, 3100 Princeton Pike, Lawrenceville, NJ, 08648, USA

    Randal R. Betz MD

Authors
  1. Patrick J. Cahill MD
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  2. Michael Auriemma MD
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  3. Elias Dakwar MD
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  4. John P. Gaughan PhD
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  5. Amer F. Samdani MD
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  6. Joshua M. Pahys MD
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  7. Randal R. Betz MD
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Corresponding author

Correspondence to Patrick J. Cahill MD.

Additional information

Author disclosures

PJC (other from AAOS, POSNA, SRS, JBJS-A, and Spine Deformity, outside the submitted work); MA (none); ED (none); JPG (none); AFS (personal fees from DePuy Synthes Spine, Ethicon, Globus Medical, Misonix, Stryker, and Zimmer Biomet, outside the submitted work); JMP (personal fees from DePuy Synthes Spine and Globus Medical, outside the submitted work); RRB (personal fees from DePuy Synthes Spine, Globus Medical, Medtronic, and Zimmer Biomet; personal fees and other from Abyrx, Apifix, and SpineGuard; other from Advanced Vertebral Solutions, MiMedx, Orthobond, and Medovex, outside the submitted work).

The device(s)/drug(s) that is/are the subject of this manuscript is/are not FDA-approved for this indication and is/are not commercially available in the United States.

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Cahill, P.J., Auriemma, M., Dakwar, E. et al. Factors Predictive of Outcomes in Vertebral Body Stapling for Idiopathic Scoliosis. Spine Deform 6, 28–37 (2018). https://doi.org/10.1016/j.jspd.2017.03.004

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  • DOI: https://doi.org/10.1016/j.jspd.2017.03.004

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