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Lumbar Vertebral Body Tethering: Single Center Outcomes and Reoperations in a Consecutive Series of 106 Patients – Lumbar Fusion

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The article presents the findings of a retrospective cohort study that aimed to assess the outcomes and reoperation rates in patients with adolescent idiopathic scoliosis (AIS) who underwent lumbar anterior vertebral body tethering (AVBT). The study found that vertebral body tethering is a viable treatment option for skeletally immature patients with idiopathic scoliosis, with 84% of patients having a curve of less than 35° at the latest follow-up. However, the study also highlighted an 18.9% reoperation rate, with overcorrection and broken tethers being common reasons for reoperations. This report is considered the largest to date for lumbar AVBT, emphasizing the importance of balancing the benefits of motion preservation with the risk of reoperations

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised day surgery spinal centre on Harley Street UK

Published article

S: Vertebral body tethering is a viable treatment option for skeletally immature patients with idiopathic scoliosis. This report is the largest to date for lumbar AVBT, highlighting that 84% of patients harbored a curve < 35° at the latest follow-up but with an 18.9% reoperation rate. Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine (Phila Pa 1976). 2024 Feb 20. doi: 10.1097/BRS.0000000000004967. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: To evaluate the outcomes and reoperation rates in patients with adolescent idiopathic scoliosis (AIS) undergoing lumbar anterior vertebral body tethering (AVBT).SUMMARY OF BACKGROUND DATA: Anterior vertebral body tethering (AVBT) is a viable option in growing children. The benefit,

Spine (Phila Pa 1976). 2024 Feb 20. doi: 10.1097/BRS.0000000000004967. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: To evaluate the outcomes and reoperation rates in patients with adolescent idiopathic scoliosis (AIS) undergoing lumbar anterior vertebral body tethering (AVBT).

SUMMARY OF BACKGROUND DATA: Anterior vertebral body tethering (AVBT) is a viable option in growing children. The benefit of motion preservation must be balanced by a higher reoperation rate. A paucity of reports has addressed lumbar AVBT.

METHODS: A single-center retrospective study was conducted to identify all patients who underwent lumbar AVBT (lowest instrumented vertebra L3 or L4) with a minimum 2 years of follow-up. Clinical and radiographic parameters, including complications and reoperations, were also collected. Statistical analysis was performed using Student’s t-test for qualitative variables.

RESULTS: From a dataset of 551 patients, we identified 106 patients (89% female) who underwent a lumbar AVBT (33 lumbar only, 73 bilateral thoracic/lumbar) with mean follow-up of 4.1±1.6 years at which point 85% (90/106) had reached skeletal maturity. Preoperatively, these patients were skeletally immature (age: 12.8±1.3 y, Sanders: 3.3±0.8, R=0.6±0.9) with a lumbar coronal curve angle of 49.6°±11.2 which corrected to 19.9°±11.2 (P <0.0001) at most recent follow-up. At the latest follow-up, 76.4% (81/106) of the patients harbored a coronal curve angle of < 30°. Twenty patients (18.9%) underwent 23 reoperations, with overcorrection being the most common (10/23, 43%). Broken tethers led to reoperation in 3 instances (3/23, 13%). Six patients in the cohort needed a posterior spinal fusion (6/106, 5.4%).

S: Vertebral body tethering is a viable treatment option for skeletally immature patients with idiopathic scoliosis. This report is the largest to date for lumbar AVBT, highlighting that 84% of patients harbored a curve < 35° at the latest follow-up but with an 18.9% reoperation rate.

LEVEL OF EVIDENCE: 3.

PMID:38375615 | DOI:10.1097/BRS.0000000000004967

The London Spine Unit : most specialised day surgery spinal centre on Harley Street UK

Read the original publication:

Lumbar Vertebral Body Tethering: Single Center Outcomes and Reoperations in a Consecutive Series of 106 Patients

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Spine (Phila Pa 1976). 2024 Feb 20. doi: 10.1097/BRS.0000000000004967. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: To evaluate the outcomes and reoperation rates in patients with adolescent idiopathic scoliosis (AIS) undergoing lumbar anterior vertebral body tethering (AVBT).SUMMARY OF BACKGROUND DATA: Anterior vertebral body tethering (AVBT) is a viable option in growing children. The benefit
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