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The preliminary outcomes of vertebral body tethering in treating adolescent idiopathic scoliosis: a systematic review

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Abstract

Purpose

VBT is a novel alternative to spinal fusion surgery to treat skeletally immature AIS and was approved to correct idiopathic scoliosis in August 2019 by US Federal Drug Administration (FDA). To systemically review the preliminary outcomes of vertebral body tethering (VBT) in treating adolescent idiopathic scoliosis.

Methods

The electronic databases PubMed, EMBASE, and Web of Science were queried up to January 2022 for articles regarding VBT. Basic characteristics of patients, changes of radiographic parameters in coronal and sagittal planes, and clinical outcomes of surgical treatment of VBT including complication and revision rates were summarized.

Results

Twenty five studies met the inclusion criteria. Most studies (23/25) included patients with only skeletal immaturity. The average % correction of the main/tethered curve at final follow-up, and % correction of thoracic kyphosis at final follow-up were reported to be 15.6–106.5% and − 31.8 to 20.0%, respectively. The most common complications for VBT were tether breakage (n = 145;21.3%), pulmonary complications (n = 49; 6.9%), and overcorrection (n = 30; 4.2%). The revision rate was 13.1%.

Conclusion

VBT could effectively and safely correct spinal deformity in skeletally immature patients with AIS and preserve the motion and growth of the spine. However, VBT has a relatively high complication and revision rates. Therefore, surgeons should cautiously consider VBT for treating AIS. Future research efforts are needed to lower the complication and revision rates. Whatever, VBT is still in its infancy and may have a promising future as a non-fusion solution for AIS.

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Availability of data and material

The data of this study will be made available on reasonable request.

Code availability

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Funding

Yonggang Fan, Shuangfei Ni, Guofu Pi and Huafeng Zhang declare no funding.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People’s Republic of China

    Huafeng Zhang, Yonggang Fan, Shuangfei Ni & Guofu Pi

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  1. Huafeng Zhang
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  2. Yonggang Fan
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  3. Shuangfei Ni
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  4. Guofu Pi
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Contributions

HZ, YF, SN, GP: made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work. HZ: design of the work; analysis of the data, revised the work. YF: design of the work; analysis of the data, drafted the work. SN: analysis of the data, drafted the work. GP: analysis of the data, revised the work. HZ, YF, SN and GP: approved the version to be published, 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.

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Correspondence to Huafeng Zhang.

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Yonggang Fan, Shuangfei Ni, Guofu Pi and Huafeng Zhang declare that they have no conflict of interest.

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Systematic review. No patient information was accessed for this manuscript. IRB exempt.

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Zhang, H., Fan, Y., Ni, S. et al. The preliminary outcomes of vertebral body tethering in treating adolescent idiopathic scoliosis: a systematic review. Spine Deform 10, 1233–1243 (2022). https://doi.org/10.1007/s43390-022-00546-0

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  • DOI: https://doi.org/10.1007/s43390-022-00546-0

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