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Results of posterior spinal fusion after failed anterior vertebral body tethering – Lumbar Fusion

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This article discusses the outcomes of posterior spinal fusion (PSF) in patients with adolescent idiopathic scoliosis (AIS) who had previously undergone anterior vertebral tethering (AVBT) and experienced tether failure. The study analyzed data from 490 patients who underwent AVBT, with 4.1% of them subsequently undergoing conversion to PSF. The results showed that the AVBT conversion group had a significant increase in estimated blood loss, operative time, fluoroscopy use, and number of levels fused compared to the primary fusion group. However, there were no differences in implant density, blood transfusions, or intraoperative neuromonitoring events. Both groups achieved similar correction in the thoracic and lumbar curves. The study concludes that despite being technically challenging, revision surgery can be safely performed with comparable clinical and radiographic outcomes to primary PSF

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: A subset of patients with AVBT will require conversion to PSF. Although technically more challenging, revision surgery can be safely performed with similar clinical and radiographic outcomes to primary PSF.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine Deform. 2023 Dec 24. doi: 10.1007/s43390-023-00796-6. Online ahead of print.ABSTRACTPURPOSE: In patients with adolescent idiopathic scoliosis (AIS) undergoing anterior vertebral tethering (AVBT), some will subsequently require posterior spinal fusion (PSF). Limited data exist on clinical and radiographic outcomes of fusion after tether failure.METHODS: 490 patients who underwent AVBT were retrospectively analyzed. Twenty patients (4.1%),

Spine Deform. 2023 Dec 24. doi: 10.1007/s43390-023-00796-6. Online ahead of print.

ABSTRACT

PURPOSE: In patients with adolescent idiopathic scoliosis (AIS) undergoing anterior vertebral tethering (AVBT), some will subsequently require posterior spinal fusion (PSF). Limited data exist on clinical and radiographic outcomes of fusion after tether failure.

METHODS: 490 patients who underwent AVBT were retrospectively analyzed. Twenty patients (4.1%) subsequently underwent conversion to PSF. A control group of patients with primary PSF (no previous AVBT) was matched for comparison. Data were compared using paired t-tests and Fisher Exact Tests.

RESULTS: There was a significant increase in estimated blood loss (EBL) (p = 0.002), percent estimated blood volume (%EBV) (p = 0.013), operative time (p = 0.002), and increased amount of fluoroscopy (mGy) (p = 0.04) as well as number of levels fused (p = 0.02) in the AVBT conversion group compared to primary fusion. However, no difference was found in implant density (p = 0.37), blood transfusions (p = 0.11), or intraoperative neuromonitoring events (p > 0.99). Both groups attained similar thoracic and lumbar percent correction (major coronal curve angle) from pre-op to the latest follow-up (thoracic p = 0.507, lumbar p = 0.952).

: A subset of patients with AVBT will require conversion to PSF. Although technically more challenging, revision surgery can be safely performed with similar clinical and radiographic outcomes to primary PSF.

PMID:38142246 | DOI:10.1007/s43390-023-00796-6

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Results of posterior spinal fusion after failed anterior vertebral body tethering

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Spine Deform. 2023 Dec 24. doi: 10.1007/s43390-023-00796-6. Online ahead of print.ABSTRACTPURPOSE: In patients with adolescent idiopathic scoliosis (AIS) undergoing anterior vertebral tethering (AVBT), some will subsequently require posterior spinal fusion (PSF). Limited data exist on clinical and radiographic outcomes of fusion after tether failure.METHODS: 490 patients who underwent AVBT were retrospectively analyzed. Twenty patients (4.1%)

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