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Cyclically controlled vertebral body tethering for scoliosis: an in vivo verification in a pig model of the pressure exerted on vertebral end plates

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Abstract

Study design

Experimental in vivo study of the pressure exerted on the spine of a pig by a new cyclic anterior vertebral body tethering (AVBT) prototype.

Objectives

To evaluate the relationship between the tether tension and the pressures transmitted onto the vertebral end plates by a cyclic AVBT prototype.

Summary of background data

AVBT is a recent surgical technique for the treatment of pediatric scoliosis that compresses the convex side of the spine with a sustained tension, to modulate the growth to progressively correct the deformity over time. Previous studies demonstrated that cyclic compression has similar growth modulation capacity but with less detrimental effects on the integrity of the discs and growth plates.

Methods

A 3-month-old healthy Duroc pig was anesthetized and a lateral thoracotomy was performed. The T7–T10 segment was instrumented and compressed during 50 s with the load oscillating (0.2 Hz) from + 30 to − 30% of the following mean tensions: 29, 35, 40, 44, and 49 N. The pressure exerted on T9 superior vertebral end plate was monitored during the cyclic loading. Three repetitions of each test were performed.

Results

The resulting mean pressure exerted on the vertebral end plate was linearly correlated with the mean tether tension (r2 = 0.86). Each cycle translated in a hysteresis profile of the measured pressure and tension, with amplitudes varying between ± 11.5 and ± 29.9%.

Conclusions

This experimental study documented the relationship between the tether tension and the pressure. This study confirmed the feasibility of cyclic AVBT principle to transfer varying pressures on the vertebral end plates, which is intended to control vertebral growth, while keeping the spine flexibility and preserving the health of soft tissues such as the intervertebral discs and the growth plate but remained to be further verified.

Level of evidence

Level IV.

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Acknowledgements

The authors acknowledge the help of Caroline Bouchard’s team from Sacré-Coeur Hospital, as well as Laure Boyer and Roxanne Dube-Cyr, for their help before and during the experimental testing. This project was funded by the Natural Sciences and Engineering Research Council of Canada (Industrial Research Chair program with Medtronic of Canada) (Grant number PCIPJ-346145).

Funding

Pr Aubin Grant: Natural Sciences and Engineering Research Council of Canada (Industrial Research Chair program with Medtronic of Canada) (Grant number PCIPJ-346145).

Author information

Authors and Affiliations

  1. Polytechnique Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada

    Viviane Lalande, Isabelle Villemure, Manuel Vonthron & Carl-Éric Aubin

  2. CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada

    Viviane Lalande, Isabelle Villemure, Stefan Parent & Carl-Éric Aubin

  3. Université de Montréal, 2900, Boul. Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada

    Stefan Parent & Carl-Éric Aubin

Authors
  1. Viviane Lalande
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  2. Isabelle Villemure
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  3. Manuel Vonthron
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  4. Stefan Parent
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  5. Carl-Éric Aubin
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Corresponding author

Correspondence to Carl-Éric Aubin.

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Conflict of interest

VL (Grants from Natural Sciences and Engineering Research Council of Canada [NSERC], during the conduct of the study), IV (Grants from NSERC, during the conduct of the study; in addition, IV has a patent “CE Aubin, S Parent, I Villemure, S Amini, M Driscoll, F Moldovan, Dynamic Fusionless Device for the Correction of Adolescent Idiopathic Scoliosis [WO2014127464 A1, Aug 28, 2014]” issued), MV (none), SP (Grants from NSERC, during the conduct of the study; personal fees from EOS-imaging, Spinologics, K2M, Medtronic, and DePuy Synthes Spine; other from Academic Research Chair in Spine Deformities of the CHU Sainte-Justine (DePuy); Grants from DePuy Synthes Spine, Canadian Institutes of Health Research, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society; grants from Medtronic, EOS imaging, Canadian Foundation for Innovation, Setting Scoliosis Straight Foundation, NSERC, Fonds de recherche Québec–Santé, and Orthopaedic Research and Education Foundation; other from DePuy Synthes and Medtronic, outside the submitted work; in addition, SP has a patent “CE Aubin, S Parent, I Villemure, S Amini, M Driscoll, F Moldovan, Dynamic Fusionless Device for the Correction of Adolescent Idiopathic Scoliosis [WO2014127464 A1, Aug 28, 2014]” issued), CÉA (Grants from Natural Sciences and Engineering Research Counsil of Canada (NSERC), during the conduct of the study; grants from Medtronic, outside the submitted work; in addition, CÉA has a patent “CE Aubin, S Parent, I Villemure, S Amini, M Driscoll, F Moldovan, Dynamic Fusionless Device for the Correction of Adolescent Idiopathic Scoliosis [WO2014127464 A1, Aug 28, 2014]” issued).

Ethical approval

Approved by the “comité d’éthique de l’expérimentation animale” (CÉEA) from the Centre de recherche de l’hôpital du Sacré-Cœur de Montréal (no. PARS01).

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Lalande, V., Villemure, I., Vonthron, M. et al. Cyclically controlled vertebral body tethering for scoliosis: an in vivo verification in a pig model of the pressure exerted on vertebral end plates. Spine Deform 8, 39–44 (2020). https://doi.org/10.1007/s43390-019-00021-3

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  • DOI: https://doi.org/10.1007/s43390-019-00021-3

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