Continued vertebral body growth in patients with juvenile idiopathic scoliosis following vertebral body stapling

Murray, Erin P.; Tung, Robert; Sherman, Ashley; Schwend, Richard M.

doi:10.1007/s43390-019-00019-x

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…During VBT, a tensioned cable connected to vertebral implants on the convex side partially corrects the deformity intra-operatively and in theory modulates remaining growth post-operatively [7,8,[20][21][22][23][24]. Growth modulation of VBT relies on the Hueter-Volkmann law, which states that compression on the convex side of vertebra following VBT slows growth, but clinical evidence of this principle is limited following VBT surgery [24,25].…”

Section: Discussionmentioning

confidence: 99%

Concave and convex growth do not differ over tethered vertebral segments, even with open tri-radiate cartilage

et al. 2023

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Purpose To assess the following hypotheses related to vertebral body tethering (VBT): 1. VBT is associated with asymmetric (concave > convex) increases in height over the instrumented vertebra. 2. The instrumented Cobb angle improves following VBT surgery with growth. Methods This is a retrospective case series of pediatric patients from a multicenter scoliosis registry treated with VBT between 2013 to 2021. Inclusion criteria: patients with standing radiographs at < 4 months and ≥ 2 years after surgery. Distances between the superior endplate of the UIV and the inferior endplate of the LIV were measured at the concave corner, mid-point, and convex corner of the endplates. The UIV-LIV angle was recorded. Subgroup analyses included comparing different Risser scores and tri-radiate cartilage (TRC) closed versus open using student t-tests. Results 83 patients met inclusion criteria (92% female; age at time of surgery 12.5 ± 1.4 years) with mean follow-up time of 3.8 ± 1.4 years. Risser scores at surgery were: 0 (n = 33), 1 (n = 12), 2 (n = 10), 3 (n = 11), 4 (n = 12), and 5 (n = 5). Of the 33 Risser 0 patients, 17 had an open TRC, 16 had a closed TRC. The UIV-LIV distance at concave, middle, and convex points significantly increased from immediate post-op to final-follow-up for Risser 0 patients, but not for Risser 1–5 patients. Increases in UIV-LIV distance were not significantly different between concave, middle, and convex points for all groups. There was no significant improvement or worsening in UIV-LIV angle for any group. Conclusion At a mean of 3.8 years following VBT, 33 Risser 0 patients demonstrated significant growth in the instrumented segment, though there was no difference between concave or convex growth, even for patients with open TRC.

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Section: Discussionmentioning

confidence: 99%

Concave and convex growth do not differ over tethered vertebral segments, even with open tri-radiate cartilage

et al. 2023

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“…The specified indications are almost identical to the indications for PDDC, AIS curves from 45°-60° demonstrating curve flexibility to 35° on lateral bending views. On the other hand, Murray et al [15] reported that VBS failed to differentially influence vertebral body growth.…”

Section: Discussionmentioning

confidence: 99%

Vertebral growth modulation by posterior dynamic deformity correction device in skeletally immature patients with moderate adolescent idiopathic scoliosis

et al. 2020

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Study design Retrospective, comparative, multicenter. Introduction Growth modulating spinal implants are used in the management of scoliosis such as anterior vertebral body tethering. A motion-sparing posterior device (PDDC) was recently approved for the treatment of moderate AIS. The purpose of this study was to determine if the PDDC can modulate growth in skeletally immature patients with AIS. Methods From a database of patients treated with the PDDC over 4 years, we identified those who had a minimum of 2 years follow-up. Pre-operative and post-operative Cobb angles and coronal plane wedging of the apical vertebra were evaluated on standing full length radiographs. Independent sample t test and one-way ANOVA with post-hoc Tukey HSD analysis was used to compare three groups in varying skeletal maturity: Risser 0–1, Risser 2–3, and Risser 4–5. Results 45 patients (14.2-years old, 11–17) were evaluated with a mean pre-op curve of 46° (35°-66°). The average preoperative major curve magnitude, of either Lenke 1 or 5 curve type, was similar among the three groups 47.6°, 46° and 41.5°. Deformity correction was similar in the three groups, with reduction to 26.4°, 20.4° and 26.2°, respectively, at final follow-up [p < 0.05]. Pre-op wedging 7.4° (3.8°–15°) was reduced after surgery to 5.7° (1°–15°) (p < 0.05). Of those patients, Risser 0–1 (n = 16) had preoperative wedging of 9.5° (6°–14.5°) that was reduced to 5.4° (1°–8°) postoperatively (p < 0.05); Risser 2–3 (n = 15) had pre-op 7.7° (4°–15°) vs. post-op 7.0° (3°–15°); Risser 4–5 (n = 14) had pre-op 4.8° (3.8°–6.5°) vs. post-op 4.7° (3.7°–6.5°). Delta Wedging in Risser 0–1 stage was significantly different than for Risser 2–3 and for Risser 4–5. Conclusion The posterior dynamic deformity correction device was able to modulate vertebral body wedging in skeletally immature patients with AIS. This was most evident in patients who were Risser 0–1. In contrast, curve correction was similar among the three groups. This finding lends support to the device’s ability to modulate growth.

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Prediction of post-operative adding-on or compensatory lumbar curve correction after anterior vertebral body tethering

et al. 2022

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Continued vertebral body growth in patients with juvenile idiopathic scoliosis following vertebral body stapling

Cited by 5 publications

References 18 publications

Concave and convex growth do not differ over tethered vertebral segments, even with open tri-radiate cartilage

Concave and convex growth do not differ over tethered vertebral segments, even with open tri-radiate cartilage

Vertebral growth modulation by posterior dynamic deformity correction device in skeletally immature patients with moderate adolescent idiopathic scoliosis

Prediction of post-operative adding-on or compensatory lumbar curve correction after anterior vertebral body tethering

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