Minimum 3-year experience with vertebral body tethering for treating scoliosis: A systematic review and single-arm meta-analysis

Abstract

Purpose Over the past 12 years, vertebral body tethering (VBT) has been gradually promoted for treating scoliosis, but there are few published studies, with only short-term follow-up. This study aimed to systematically review VBT efficacy and safety for treating scoliosis. Methods PubMed, Web of Science, Embase, and the Cochrane Library were searched for studies on VBT treatment of scoliosis published up to November 2021. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in included studies. Data on clinical efficacy, unplanned reoperations, and complications were extracted. The meta-analysis was performed with R 4.1.0. Results Twenty-six studies involving 1045 patients were included in the meta-analysis. The correction rate of major curve immediately post-operation was 46.6% ± 13.8% (16%–69%) and that at final follow-up was 53.2% ± 17.9% (16%–79%). The single-arm meta-analysis results of all included studies showed that VBT was effective in general. The overall clinical success rate was 73.02% (95% confidence interval [CI]: 68.31%–78.05%). The pooled overall unplanned reoperation rate was 8.66% (95% CI: 5.53%–13.31%). The overall incidence rate of complications was 36.8% (95% CI: 23.9%–49.7%). The subgroup analysis based on follow-up time indicated that patients with follow-up time >36 months had increased clinical success rate, unplanned reoperation rate, and incidence rate of complications compared with those with <36 months’ follow-up time. The preliminary results showed that after 36 months of follow-up, only 7.17% (95% CI: 4.81%–10.55%) of patients required posterior spinal fusion (PSF) surgery and nearly 93% of patients avoided spinal fusion surgeries. Conclusions The current evidence from at least 3-year follow-up in different countries indicates that VBT is an effective surgical approach for treating scoliosis, with 73.88% of patients achieving clinical success. Nevertheless, about one in seven patients (15.8%) required unplanned reoperations, but only 7.17% required PSF. About half (52.17%) of the patients experienced complications. Due to the limitation of the study number and quality, our conclusion may be biased and requires verification by further studies with longer follow-up times.

Surgical Treatment of Adolescent Idiopathic Scoliosis with the ApiFix Minimal Invasive Dynamic Correction System—A Preliminary Report of a 24-Month Follow-Up

“…Dynamic systems limit the progression of scoliotic deformity by mechanically restraining the spine during the remaining spinal growth period [18,28]. However, the available data for this regarding long-term success are limited [14,17,29,30]. At present, predominantly, VBT and ApiFix are used as dynamic treatments for AIS [31].…”