Outcomes of vertebral body tethering in the lumbar spine

Boeyer, Melanie E; Farid, Sophi; Wiesemann, Sebastian; Hoernschemeyer, Daniel G.

doi:10.1007/s43390-023-00662-5

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…The main finding of the present study is that Posterior Vertebral Body Tethering decreases the Cobb angle of the main curve of 70% (from 43.9 • to 13.2 • ) at two years; this is similar to the average correction of the few studies on lumbar Anterior Vertebral Body Tethering: 82% for Pehlivanoglu [16] and 57% for Boeyer [5].…”

Section: Discussionsupporting

confidence: 85%

“…While various treatment options exist to address this condition, one innovative technique has gained increasing attention in recent years: Anterior Vertebral Body Tethering (AVBT). This surgical technique was developed for the treatment of severe scoliosis in adolescents with two main objectives: to avoid fusion and maintain spine flexibility [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…The lumbar spine is the most mobile part of the spine, so to maintain its mobility is essential. But in these cases, surgery is more complex as a mini lumbar approach is needed; this is technically demanding, with potential complications [5,12]. Indeed, it is more difficult to put the screws in the lumbar area through the ilio-psoas muscle between nerves and vessels than in the thoracic spine, and a lot of surgeons are not used to these anterior approaches even though they are very familiar with posterior approaches.…”

Section: Introductionmentioning

confidence: 99%

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Posterior Vertebral Body Tethering: A Preliminary Study of a New Technique to Correct Lenke 5C Lumbar Curves in Adolescent Idiopathic Scoliosis

Metaizeau,

Denis

2024

Children

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Vertebral body tethering has been approved for adolescent scoliosis correction. The usual approach is anterior, which is relatively easy for the thoracic spine, but becomes much more challenging for the lumbar curves, with a higher rate of complications. The purpose of this study was to describe and evaluate the first results of a new posterior vertebral body tethering (PVBT) technique using pedicle screws through a posterolateral Wiltse approach. Twenty-two patients with 5C idiopathic scoliosis (Lenke classification) were included in this retrospective study, with a follow up of 2 years after surgery. The lumbar and thoracic curves were measured pre-operatively (POS), at first standing (FS) and at 2 years (2Y). Complications were also analysed. A significant improvement of 30.7° was observed for lumbar curve magnitude between POS and 2Y. Both the thoracic kyphosis and the lumbar lordosis remained stable. Thirteen complications were noted: three led to posterior arthrodesis, three needed a revision with a good outcome, and the seven others (overcorrections, screw breakage or pull-out) achieved a good result. PVBT seems an effective technique for the management of type 5 C adolescent idiopathic scoliosis. The complication rate seems high but is probably secondary to the learning curve of this new technic as it concerns only the first half of the patients.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Posterior Vertebral Body Tethering: A Preliminary Study of a New Technique to Correct Lenke 5C Lumbar Curves in Adolescent Idiopathic Scoliosis

Metaizeau,

Denis

2024

Children

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“…Over the course of 11 hours, we performed bilateral VBT using a thoracoscopic and/or open retroperitoneal approach as previously described 10 . After extubation, she developed shortness of breath with oxygen saturation levels dropping below 90%.…”

Section: Case Reportmentioning

confidence: 99%

Central Airway Obstruction with Persistent Pulmonary Decline After Vertebral Body Tethering

Boeyer,

Tweedy,

Hoernschemeyer

et al. 2023

JBJS Case Connector

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Case: An 11-year-old girl with pectus excavatum presented with an acute airway obstruction and persistent pulmonary compromise after vertebral body tethering (VBT). The anterior instrumentation was occluding her right basilar bronchus, resulting in hyperinflation. Removal of the instrumentation reversed the hyperinflation. Conclusion: This case illustrates the difficulty of performing VBT in a small patient with severe scoliosis and significant asymmetric pectus excavatum. We recommend using low-profile instrumentation and ensuring the trajectory of the instrumentation is anterior to the rib head and parallel to the articular facets.

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“…Reoperation was required in 16% of patients who underwent vertebral body tethering and 1.3% of patients who underwent posterior spinal fusion, with an additional 1.3% of patients who underwent vertebral body tethering later undergoing conversion to posterior spinal fusion. In a single-institution study of 28 patients who had thoracolumbar scoliosis, vertebral body tethering corrected 57% of the curves successfully at a minimum follow-up of 2 years 57 . Unsuccessful results were due to loss of correction, perioperative complications, surgical revision, or broken tethers.…”

Section: Spinementioning

confidence: 99%

What’s New in Pediatric Orthopaedics

Hardesty

2023

Journal of Bone and Joint Surgery

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InfectionPediatric acute hematogenous osteomyelitis can cause severe illness in children, and a study from New Zealand found that the development of acute (early) complications was more likely to occur if the C-reactive protein (CRP) failed to reduce by 50% at days 4 and 5 after the initiation of treatment 12 . Furthermore, Disclosure: The Disclosure of Potential Conflicts of Interest form is provided with the online version of the article (http://links.lww.com/JBJS/H805).

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Outcomes of vertebral body tethering in the lumbar spine

Cited by 6 publications

References 29 publications

Posterior Vertebral Body Tethering: A Preliminary Study of a New Technique to Correct Lenke 5C Lumbar Curves in Adolescent Idiopathic Scoliosis

Posterior Vertebral Body Tethering: A Preliminary Study of a New Technique to Correct Lenke 5C Lumbar Curves in Adolescent Idiopathic Scoliosis

Central Airway Obstruction with Persistent Pulmonary Decline After Vertebral Body Tethering

What’s New in Pediatric Orthopaedics

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