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):3570-3576.
doi: 10.1007/s00586-021-07009-6. Epub 2021 Sep 30.

Preliminary outcomes after vertebral body tethering (VBT) for lumbar curves and subanalysis of a 1- versus 2-tether construct

Per David Trobisch  1 , Alice Baroncini  2   3
Affiliations

Preliminary outcomes after vertebral body tethering (VBT) for lumbar curves and subanalysis of a 1- versus 2-tether construct

Per David Trobisch et al. Eur Spine J. 2021 Dec.

Abstract

Introduction: Aim of this study was to analyze the rate of tether breakages after lumbar vertebral body tethering (VBT) and to study the effects and possible benefits of the use of a 2-tether construct. Tether breakage is a known mechanical complication after VBT. However, the literature only refers to thoracic VBT, and no data on the breakage rate or 2-tether construct after lumbar VBT are available.

Materials and methods: Patients who underwent lumbar VBT with lowest instrumented vertebra at L3 or L4 and had a 1-year follow-up were included. Radiologic data were obtained preoperatively, at the 1st standing X-ray and at the 1-year follow-up to study breakage rate, loss of correction and lumbar lordosis in 1- and 2-tether constructs.

Results: Data from 30 patients (mean age 14.7 ± 1.8) were available, 12 with double tether. Double tether did not decrease lumbar lordosis. The breakage rate was 24% in segments instrumented with a single tether and 16% in segments instrumented with a double tether (OR 1.6, p = 0.4). Lumbar loss of correction was 10° ± 6.8° in the entire cohort and 12.1° ± 5.4° in patients with a breakage (p = 0.2). Revision rate was 10%, due to tether breakage and loss of correction.

Conclusion: Breakage rate after lumbar VBT is high, but was improved with the use of a 2-tether construct. Despite tether breakage, loss of correction was limited and the revision rate low. The use of a double tether does not have a kyphotic effect on the lumbar spine.

Keywords: 2-Tether construct; Fusionless anterior scoliosis correction; Lumbar spine; Scoliosis; Vertebral body tethering.

PubMed Disclaimer

References

    1. Alanay A, Yucekul A, Abul K, Ergene G, Senay S, Ay B, Cebeci BO, Dikmen PY, Zulemyan T, Yavuz Y, Yilgor C (2020) Thoracoscopic vertebral body tethering for adolescent idiopathic scoliosis: follow-up curve behavior according to sanders skeletal maturity staging. Spine. https://doi.org/10.1097/BRS.0000000000003643 - DOI - PubMed
    1. Hoernschemeyer DG, Boeyer ME, Robertson ME, Loftis CM, Worley JR, Tweedy NM, Gupta SU, Duren DL, Holzhauser CM, Ramachandran VM (2020) Anterior vertebral body tethering for adolescent scoliosis with growth remaining: a retrospective review of 2 to 5-year postoperative results. J Bone Joint Surg Am 102(13):1169–1176. https://doi.org/10.2106/JBJS.19.00980 - DOI - PubMed
    1. Newton PO, Bartley CE, Bastrom TP, Kluck DG, Saito W, Yaszay B (2020) Anterior spinal growth modulation in skeletally immature patients with idiopathic scoliosis: a comparison with posterior spinal fusion at 2 to 5 years postoperatively. J Bone Joint Surg Am 102(9):769–777. https://doi.org/10.2106/JBJS.19.01176 - DOI - PubMed
    1. Newton PO, Kluck DG, Saito W, Yaszay B, Bartley CE, Bastrom TP (2018) Anterior spinal growth tethering for skeletally immature patients with scoliosis: a retrospective look two to four years postoperatively. J Bone Joint Surg Am 100(19):1691–1697. https://doi.org/10.2106/JBJS.18.00287 - DOI - PubMed
    1. Samdani AF, Ames RJ, Kimball JS, Pahys JM, Grewal H, Pelletier GJ, Betz RR (2014) Anterior vertebral body tethering for idiopathic scoliosis: two-year results. Spine 39(20):1688–1693. https://doi.org/10.1097/BRS.0000000000000472 - DOI - PubMed

LinkOut - more resources