Radiographic Results after Vertebral Body Tethering

Abstract

Vertebral body tethering (VBT), otherwise known as fusion-less anterior scoliosis correction (ASC), is a new and increasingly interesting therapeutic option for selected scoliosis patients. The available data on this surgical technique are still limited and guidelines on patient selection or surgical timing are not available. The aim of this study was to conduct a systematic review of the available literature on VBT. The analysis was performed in accordance with the PRISMA Statement. Nine studies with data from 175 patients were available. On average, 7.3 vertebrae were instrumented. Surgical time was 230 min and the estimated blood loss 153 ml. The mean correction on the coronal plane was 52%, and there was no significant change in sagittal parameters. The revision rate was 18.9%. The methodological quality assessment with the Coleman score gave unsatisfactory results, so that available data are not sufficient to propose general indications or guidelines to perform VBT.

What Happens After a Vertebral Body Tether Break? Incidence, Location, and Progression With Five-year Follow-up

“…Importantly, the proportion of thoracic versus lumbar tethers in their study is not specified. We propose that with greater mobility in segments distal to the thoracic curve apex, VBT tethers are more prone to breakage, similar to conclusions drawn by Baroncini et al 4 In addition, level-specific factors, including the degree of tension placed over a given segment as well as the amount of remaining vertebral body growth, likely affect the location of tether breaks.…”

“…2 Spine flexibility and motion are maintained. 2,3 Early studies have demonstrated effective deformity correction-up to 71%-the complication rate was not trivial; 1,[4][5][6][7] the reoperation rate ranges from 3% to 24%. 1,2,5,6 Some reoperations involve the release of the tether secondary to overcorrection.…”

Clinical experience and complications with limited pleural dissection combined with a novel, simplified technique for thoracic Redon-like drain in vertebral body tethering

“…According to the data available in the literature, pulmonary complications after VBT are not uncommon and have been observed in 7–10% of patients [ 1 – 3 , 7 ]. Commonly reported complications in the literature were recurrent pulmonary effusion, chylothorax, atelectasis, pneumonia, and pneumothorax [ 2 ]. In the presented series, the rate of observed pulmonary complications was much lower than the reported rate in the literature, but the kind of observed complications was similar.…”

Bewegungserhaltende operative Korrektur der idiopathischen Adoleszentenskoliose – Evidenz

“…Dazu gehören Korrekturverluste durch Implantatversagen, wie das Reißen der Bandverbindungen "tether breakage", Überkorrekturen im Verlauf und (meist distale) Anschlussdeformitäten im Sinne des "adding on" [10,16,18]. Dies führt zu hohen Revisionsraten von 12%-41%, wobei die Metaanalyse von Shin et al [17] hier auf 14,1% und der systematische Review von Baroncici et al [27] auf 18,9% kommt. Angaben von sekundär additiv erforderlichen klassischen dorsalen Korrekturoperation im Verlauf schwanken zwischen 0°und 13° [15,18,21,22,24,28].…”

“…Die Rate an Komplikationen und Reoperationen ist bei dem AVBT ausgesprochen hoch [17,27]. Sie scheint sich zwar mit der Lernkurve zu verringern [30].…”