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
Comparative Study
. 2024 May;12(3):651-662.
doi: 10.1007/s43390-023-00803-w. Epub 2024 Jan 29.

Double major curvature treated with vertebral body tethering of both curves: how do outcomes compare to posterior spinal fusion?

Baron Lonner  1 , Lily Eaker  2 , Daniel Hoernschemeyer  3 , Jessica Zhang  2 , Ashley Wilczek  2 , Patrick Elliot  3 , Melanie E Boeyer  3 , Nicholas D Fletcher  4 , Ahmet Alanay  5 , Caglar Yilgor  5 , Peter Newton  6 , Firoz Miyanji  7 ; Harms Study Group
Affiliations
Comparative Study

Double major curvature treated with vertebral body tethering of both curves: how do outcomes compare to posterior spinal fusion?

Baron Lonner et al. Spine Deform. 2024 May.

Abstract

Purpose: Vertebral body tethering (VBT) is a non-fusion alternative to posterior spinal fusion (PSF). There have been few reports on VBT of two curvatures. We aim to compare the radiographic outcomes between VBT and PSF in patients with double curvatures in which both curves were instrumented.

Methods: 29 AIS patients matched by Lenke, age (± 2 years), triradiate cartilage closure status, major Cobb angle (± 8°), and T5-T12 kyphosis (± 10°). Variables were compared using Wilcoxon rank-sum tests, Student's t tests, and chi-Square. Clinical success was defined as major curve < 35°.

Results: Group baseline demographics were similar. Major thoracic (T) curve types had significantly better major (VBT 51.5 ± 7.9° to 31.6 ± 12.0° [40%] vs. PSF 54.3 ± 7.4° to 17.4 ± 6.5° [68%]; p = 0.0002) and secondary curve correction in the PSF group. 71% of major T VBT patients were clinically successful versus 100% of PSF. Major thoracolumbar (TL) curve types experienced comparable major (VBT 52.3 ± 7.0° to 18.3 ± 11.4° (65%) vs. PSF 53.0 ± 5.2° to 23.8 ± 10.9° (56%); p = 0.2397) and secondary curve correction. 92% of major TL VBT patients were clinically successful versus 75% in the PSF group. There was no difference in T5-12 kyphosis or lumbar lordosis between groups for any curve type. There were 4 patients (13.8%) with major complications in the VBT group compared to 0 (0%) in the PSF.

Conclusion: Patients with double major AIS who underwent VBT with major T curve types had less correction than PSF; however, those with major TL curves experienced similar radiographic outcomes regardless of procedure. Complications were greater for VBT.

Keywords: Adolescent idiopathic scoliosis; Double curve; Posterior spinal fusion; Vertebral body tethering.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Cheng JC, Castelein RM, Chu WC, Danielsson AJ, Dobbs MB, Grivas TB, Gurnett CA, Luk KD, Moreau A, Newton PO, Stokes IA, Weinstein SL, Burwell RG (2015) Adolescent idiopathic scoliosis. Nat Rev Dis Primers 1:1–21. https://doi.org/10.1038/nrdp.2015.30 - DOI
    1. McDonald TC, Shah SA, Hargiss JB, Varghese J, Boeyer ME, Pompliano M, Neal K, Lonner BS, Larson AN, Yaszay B, Newton PO, Hoernschemeyer DG (2022) When successful, anterior vertebral body tethering (VBT) induces differential segmental growth of vertebrae: an in vivo study of 51 patients and 764 vertebrae. Spine Deform. https://doi.org/10.1007/s43390-022-00471-2 - DOI - PubMed
    1. Auerbach JD, Lonner BS, Errico TJ, Freeman A, Goerke D, Beaubien BP (2012) Quantification of intradiscal pressures below thoracolumbar spinal fusion constructs: is there evidence to support “saving a level?” Spine 37:359–366. https://doi.org/10.1097/BRS.0b013e31821e1106 - DOI - PubMed
    1. Lonner BS, Ren Y, Upasani VV, Marks MM, Newton PO, Samdani AF, Chen K, Shufflebarger HL, Shah SA, Lefton DR, Nasser H, Dabrowski CT, Betz RR (2018) Disc degeneration in unfused caudal motion segments ten years following surgery for adolescent idiopathic scoliosis. Spine Deform 6:684–690. https://doi.org/10.1016/j.jspd.2018.03.013 - DOI - PubMed
    1. Ohashi M, Bastrom TP, Marks MC, Bartley CE, Newton PO (2020) The benefits of sparing lumbar motion segments in spinal fusion for adolescent idiopathic scoliosis are evident at 10 years postoperatively. Spine 45:755–763. https://doi.org/10.1097/BRS.0000000000003373 - DOI - PubMed

Publication types

LinkOut - more resources