Anterior vertebral body tethering : a single center cohort with 5+ years of follow-up
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Introduction: Vertebral Body Tethering (VBT) is a new surgical technique for the treatment of Adolescent Idiopathic Scoliosis where limited data for mid-to long-term outcomes exists. We aimed to fill this critical gap by evaluating outcomes in a cohort of patients with 4-7 years of post-operative follow-up. Methods: We performed a retrospective review of clinical and radiologic data from our first thirty-one consecutive patients treated with VBT, all of whom had at least four years of follow-up (mean: 5.7±0.7 yrs.). We assessed various parameters related to deformity correction, suspected broken tethers, and surgical revisions at all available timepoints. A successful postoperative outcome was defined by a residual deformity of ≤ 30° at latest follow-up without conversion to Posterior Spinal Fusion (PSF). Results: Of the patients who met the inclusion criteria, two were lost to follow-up, seven required revisions, sixteen exhibited at least one suspected broken tether, and two were converted to a PSF. Only two broken tethers were identified more than four years postoperatively (mean: 2.68 years). The average main thoracic and thoracolumbar deformities were 22° and 23° at latest follow-up. A successful postoperative outcome was observed in 64% of patients despite an average increase of 4° in main thoracic and 8° in thoracolumbar deformities. Conclusion: Although some deformity correction was lost, we remain optimistic regarding outcomes as 93% of patients avoided PSF and only two new suspected broken tethers were identified beyond four years. Additional long-term follow-up data will be required to continue to elucidate the efficacy of VBT.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License.