STUDY DESIGN: A bovine model was used to evaluate the effects of a multilevel anterolateral flexible tether in a growing spine. OBJECTIVE: To evaluate the radiographic changes in a growing spine with a multilevel anterolateral tether. SUMMARY OF BACKGROUND DATA: Spinal growth modulation has long been considered as a conceptually attractive and elegant possible alternative to arthrodesis in the treatment of idiopathic scoliosis. Although some experimental studies have described spinal growth modulation, few have described a purely mechanical tether. Clinical studies of spinal epiphysiodesis have described inconsistent curve stabilization and/or correction. METHODS: A total of 33 one-month-old male calves underwent a single thoracotomy and placement of vertebral screws at T6-T9. In 11 animals, one screw per level was connected by a 3/16 in. stainless steel cable (single tether). In 11 animals, two screws per level were connected by two cables (double tether). In the remaining 11 animals, single screws in each level were left unconnected (control). After 6 months, the spines were harvested and underwent radiographic analysis. RESULTS: In the control group, there was little change in the coronal and sagittal measurements during the survival period. In the single tether group, there was variable instrumentation fixation and inconsistent creation of coronal deformity, which ranged from 0 degrees to 31 degrees. The double-tether group had more consistent creation of deformity, ranging from 23 degrees to 57 degrees. CONCLUSIONS: Given adequate bony fixation, a flexible lateral spinal tether can affect growth modulation. This technique of growth modulation may serve as a future fusionless method of correction in a growing patient with scoliosis.
STUDY DESIGN: A bovine model was used to evaluate the effects of a multilevel anterolateral flexible tether in a growing spine. OBJECTIVE: To evaluate the radiographic changes in a growing spine with a multilevel anterolateral tether. SUMMARY OF BACKGROUND DATA: Spinal growth modulation has long been considered as a conceptually attractive and elegant possible alternative to arthrodesis in the treatment of idiopathic scoliosis. Although some experimental studies have described spinal growth modulation, few have described a purely mechanical tether. Clinical studies of spinal epiphysiodesis have described inconsistent curve stabilization and/or correction. METHODS: A total of 33 one-month-old male calves underwent a single thoracotomy and placement of vertebral screws at T6-T9. In 11 animals, one screw per level was connected by a 3/16 in. stainless steel cable (single tether). In 11 animals, two screws per level were connected by two cables (double tether). In the remaining 11 animals, single screws in each level were left unconnected (control). After 6 months, the spines were harvested and underwent radiographic analysis. RESULTS: In the control group, there was little change in the coronal and sagittal measurements during the survival period. In the single tether group, there was variable instrumentation fixation and inconsistent creation of coronal deformity, which ranged from 0 degrees to 31 degrees. The double-tether group had more consistent creation of deformity, ranging from 23 degrees to 57 degrees. CONCLUSIONS: Given adequate bony fixation, a flexible lateral spinal tether can affect growth modulation. This technique of growth modulation may serve as a future fusionless method of correction in a growing patient with scoliosis.
Authors: Vidyadhar V Upasani; Christine L Farnsworth; Reid C Chambers; Tracey P Bastrom; Gregory M Williams; Robert L Sah; Koichi Masuda; Peter O Newton Journal: J Bone Joint Surg Am Date: 2011-08-03 Impact factor: 5.284
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Authors: John G Burke; Enzo Vettorato; Gudrun Schöffmann; R Eddie Clutton; Tim S Drew; J N Alastair Gibson Journal: Eur Spine J Date: 2014-10-11 Impact factor: 3.134
Authors: Gene Chi Wai Man; Man Gene Chi Wai; William Wei Jun Wang; Wang William Wei Jun; Annie Po Yee Yim; Yim Annie Po Yee; Jack Ho Wong; Wong Jack Ho; Tzi Bun Ng; Ng Tzi Bun; Tsz Ping Lam; Lam Tsz Ping; Simon Kwong Man Lee; Lee Simon Kwong Man; Bobby Kin Wah Ng; Ng Bobby Kin Wah; Chi Chiu Wang; Wang Chi Chiu; Yong Qiu; Qiu Yong; Chun Yiu Cheng; Cheng Jack Chun Yiu Journal: Int J Mol Sci Date: 2014-09-18 Impact factor: 5.923