Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;30(12):3442-3449.
doi: 10.1007/s00586-021-06972-4. Epub 2021 Sep 7.

A preliminary assessment of intervertebral disc health and pathoanatomy changes observed two years following anterior vertebral body tethering

Daniel G Hoernschemeyer  1   2   3 , Melanie E Boeyer  4   5 , Nicole M Tweedy  6   4 , John R Worley  4 , Julia R Crim  7
Affiliations

A preliminary assessment of intervertebral disc health and pathoanatomy changes observed two years following anterior vertebral body tethering

Daniel G Hoernschemeyer et al. Eur Spine J. 2021 Dec.

Abstract

Purpose: Vertebral body tethering (VBT) has been reported as a safe and effective non-fusion surgical technique for the treatment of adolescent idiopathic scoliosis, but the postoperative health of the bone and soft tissues of the spine following instrumentation remains unknown. We aimed to evaluate pathoanatomy and degenerative changes of the spine in adolescent idiopathic scoliosis patients both prior to and two years following VBT.

Methods: We prospectively enrolled nine patients who underwent VBT for the treatment of progressive adolescent idiopathic scoliosis. All patients received preoperative and two-year postoperative magnetic resonance imaging of their spine; images were assessed for pathoanatomy (e.g. nucleus pulposus positioning and muscle atrophy) and degenerative changes (e.g. Schmorl nodes, endplate oedema, disc degeneration, and osteoarthritis) at each vertebral level between T1 and S1.

Results: Four patients (44%) exhibited a shift of the nucleus pulposus from an eccentric position at baseline towards midline at three or more levels, most of which were in the tethered region. Tethering did not affect preexisting fatty atrophy of multifidus. No patients exhibited postoperative Schmorl nodes, endplate oedema, or disc degeneration in either the tethered or untethered regions. Four patients (44%) presented with mild facet osteoarthritis in the lower lumbar spine, which did not change postoperatively. One patient developed moderate facet osteoarthritis at L5-S1.

Conclusions: These preliminary data indicate that VBT may not result in significant degenerative changes in either the intervertebral discs or the posterior facets two years following instrumentation.

Keywords: Adjacent segment disease; Disc degeneration; Non-Fusion surgical technique; Pathoanatomy; Scoliosis.

PubMed Disclaimer

References

    1. Nohara A, Kawakami N, Seki K et al (2015) The effects of spinal fusion on lumbar disc degeneration in patients with adolescent idiopathic scoliosis: a minimum 10-year follow-up. Spine Deform 3:462–468 - DOI
    1. Nohara A, Kawakami N, Tsuji T et al (2018) Intervertebral disc degeneration during postoperative follow-up more than 10 years after corrective surgery in idiopathic scoliosis: comparison between patients with and without surgery. Spine 43:255–261 - DOI
    1. Baroncini A, Trobisch PD, Migliorini F (2020) Learning curve for vertebral body tethering: analysis on 90 consecutive patients. Spine Deform 9:141–147 - DOI
    1. Hoernschemeyer D, Boeyer M, Robertson M et al (2020) Anterior vertebral body tethering for adolescent scoliosis with growth remaining: a retrospective review of 2 to 5-year postoperative results. J Bone Jt Surg Am 102:1169–1176 - DOI
    1. Newton P, Kluck D, Saito W et al (2018) Anterior spinal growth tethering for skeletally immature patients with scoliosis: a retrospective look two to four years postoperatively. J Bone Jt Surg Am 100:1691–1697 - DOI

Publication types

MeSH terms

LinkOut - more resources