학술논문
Bilateral vertebral body tethering: identifying key factors associated with successful outcomes.
Document Type
Article
Author
Hoernschemeyer, Daniel G.; Elliott, Patrick; Lonner, Baron S.; Eaker, Lily; Harms Study Group; Buckland, Aaron; Alanay, Ahmet; Samdani, Amer; Jain, Amit; Larson, A. Noelle; Lonner, Baron; Roye, Benjamin; Cho, Bob; Yaszay, Burt; Yilgor, Caglar; Reilly, Chris; Hoernschmeyer, Dan; Hedequist, Daniel; Sucato, Daniel; Clements, David
Source
Subject
*SKELETAL maturity
*SPINE abnormalities
*SPINAL fusion
*ADOLESCENT idiopathic scoliosis
*TREATMENT effectiveness
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Language
ISSN
0940-6719
Abstract
Purpose: The treatment of operative double major pediatric spinal deformities (e.g., Lenke 3 or 6) with bilateral vertebral body tethering (VBT) can be significantly more challenging when compared to other deformity patterns (e.g., Lenke 1) or treatment with a posterior spinal fusion. We aimed to identify preoperative and perioperative characteristics that were associated with successful postoperative outcomes in patients treated with both a thoracic and thoracolumbar (e.g., bilateral) tether. Methods: We retrospectively assessed radiographic and clinical data from patients enrolled in a large multi-center study who had a minimum postoperative follow-up of two years. Standard radiographic parameters were extracted from standing spine and left hand-wrist radiographs at various timepoints. We classified patients based on their preoperative deformity pattern (Primary Thoracic [TP] vs. Primary Thoracolumbar [TLP]) and assessed: (1) deformity balance, (2) tilt of the transitional vertebra, and (3) postoperative success. Results: We analyzed data from thirty-six patients (TP: 19 and TLP: 17). We observed no relationship between deformity balance at first erect and postoperative success (p = 0.354). Patients with a horizontal transitional vertebra at first erect were significantly (p = 0.001) more likely to exhibit a successful outcome when compared to those who exhibited a tilted transitional vertebra (83% vs. 62%). Patients who had TLP were also more likely to exhibit a successful outcome when compared to patients who exhibited TP (76% vs. 50%). Conclusion: These data indicate that double major deformities can be successfully treated with VBT, particularly for those who exhibit TLP. [ABSTRACT FROM AUTHOR]