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. 2022 Jul;10(4):791-797.
doi: 10.1007/s43390-022-00471-2. Epub 2022 Jan 22.

When successful, anterior vertebral body tethering (VBT) induces differential segmental growth of vertebrae: an in vivo study of 51 patients and 764 vertebrae

Tyler C McDonald  1 , Suken A Shah  2 , John B Hargiss  3 , Jeffrey Varghese  1 , Melanie E Boeyer  4 , Michael Pompliano  1 , Kevin Neal  5 , Baron S Lonner  6 , A Noelle Larson  3 , Burt Yaszay  7 , Peter O Newton  7 , Daniel G Hoernschemeyer  4 ; Harms Nonfusion Study Group
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When successful, anterior vertebral body tethering (VBT) induces differential segmental growth of vertebrae: an in vivo study of 51 patients and 764 vertebrae

Tyler C McDonald et al. Spine Deform. 2022 Jul.

Abstract

Purpose: This study aimed to determine (1) does vertebral body tethering (VBT) produce differential growth modulation in individual vertebrae in patients with idiopathic scoliosis, (2) does VBT change disc shape, and (3) does VBT affect total spine length?

Methods: Patients with idiopathic scoliosis treated with VBT of the main thoracic curve and minimum 2-year follow-up were included. Vertebrae and discs were categorized as uninstrumented proximal thoracic, instrumented main thoracic, or uninstrumented thoracolumbar-lumbar. The left- and right-sided heights of each vertebra and disc were measured on subsequent radiographs to assess for differential growth. T1-T12 thoracic and T1-S1 thoracolumbar growth velocities were compared with standardized reference data.

Results: Fifty-one patients (764 vertebrae and 807 discs) were analyzed. The average major curve magnitude improved from 46° ± 11° to 17° ± 11° at 2-year follow-up. Differential growth was observed in MT vertebrae, in which the left/concave side grew 2.0 ± 2.2 mm compared with 1.5 ± 2.3 mm on the right/convex (tethered) side (p < 0.001). Differential height changes were observed for all discs, but were most pronounced in instrumented MT discs, in which the right/convex sides decreased by an average of 1.2 mm each, compared with no significant height change on the left/concave side. Total spinal growth velocities were not significantly different from standard reference data.

Conclusion: Vertebral body tethering limits convex spinal growth as designed while permitting concave growth. Curve correction results from differential vertebral growth and decreased convex disc height. Overall spinal growth continues at the expected rate.

Level of evidence: Level IV case series.

Keywords: Adolescent idiopathic scoliosis (AIS); Anterior vertebral body tethering (AVBT); Differential growth; Growth modulation.

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References

    1. Braun JT, Ogilvie JW, Akyuz E et al (2006) Creation of an experimental idiopathic-type scoliosis in an immature goat model using a flexible posterior asymmetric tether. Spine 31:1410–1414. https://doi.org/10.1097/01.brs.0000219869.01599.6b - DOI - PubMed
    1. Newton PO, Fricka KB, Lee SS et al (2002) Asymmetrical flexible tethering of spine growth in an immature bovine model. Spine 27:689–693. https://doi.org/10.1097/00007632-200204010-00004 - DOI - PubMed
    1. Newton PO, Farnsworth CL, Faro FD et al (2008) Spinal growth modulation with an anterolateral flexible tether in an immature bovine model: disc health and motion preservation. Spine 33:724–733. https://doi.org/10.1097/BRS.0b013e31816950a0 - DOI - PubMed
    1. Crawford CH 3rd, Lenke LG (2010) Growth modulation by means of anterior tethering resulting in progressive correction of juvenile idiopathic scoliosis: a case report. J Bone Jt Surg Am 92:202–209. https://doi.org/10.2106/JBJS.H.01728 - DOI
    1. Baker CE, Kiebzak GM, Neal KM (2021) Anterior vertebral body tethering shows mixed results at 2-year follow-up. Spine Deform 9:481–489. https://doi.org/10.1007/s43390-020-00226-x - DOI - PubMed

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