Ahmet Alanay1, Altug Yucekul1, Kadir Abul2, Gokhan Ergene3, Sahin Senay4, Binnaz Ay5, Barbaros Omer Cebeci6, Pinar Yalinay Dikmen7, Tais Zulemyan8, Yasemin Yavuz9, Caglar Yilgor1. 1. Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey. 2. Department of Orthopedics and Traumatology, Istanbul Basaksehir Pine and Sakura City Training and Research Hospital, Istanbul, Turkey. 3. Department of Operating Room Services, Acibadem Mehmet Ali Aydinlar University Vocational School of Health Sciences, Istanbul, Turkey. 4. Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey. 5. Department of Anesthesiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey. 6. Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey. 7. Department of Neurology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey. 8. Comprehensive Spine Center, Acibadem Maslak Hospital, Istanbul, Turkey. 9. Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey.
Abstract
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To report the follow-up curve behaviors in different Sanders staging groups. SUMMARY OF BACKGROUND DATA: Vertebral body tethering (VBT) is a growth modulation technique that allows gradual spontaneous follow-up curve correction as the patient grows. There is a lack of scientific evidence regarding appropriate patient selection and timing of implantation. METHODS: Patients were grouped into five as: Sanders 1, 2, 3, 4-5, and 6-7. Data were collected preoperatively, at the day before discharge, and at each follow-up. Outcome measures were pulmonary and mechanical complications, readmission, and reoperation rates. Demographic, perioperative, clinical, radiographic, and complication data were compared using Fisher-Freeman-Halton exact tests for categorical variables and Kruskal-Wallis tests for the continuous variables. RESULTS: Thirty-one (29 F, 2 M) consecutive patients with a minimum of 12 months of follow-up were included. The mean age at surgery was 12.1 (10-14). The mean follow-up was 27.1 (12-62) months. The mean preoperative main thoracic curve magnitude was 47° ± 7.6°. For all curves, preoperative and first erect curve magnitudes, bending flexibility, and operative correction percentages were similar between groups (for all comparisons, P > 0.05). The median height gained during follow-up was different between groups (P < 0.001), which was reflected into median curve correction during follow-up. Total curve correction percentage was different between groups (P = 0.009). Four (12.9%) patients had pulmonary and six (19.4%) had mechanical complications. One (3.2%) patient required readmission and two (6.5%) required reoperation. Occurrence of pulmonary complications was similar in Sanders groups (P = 0.804), while mechanical complications and overcorrection was significantly higher in Sanders 2 patients (P = 0.002 and P = 0.018). CONCLUSION: Follow-up curve behavior after VBT is different in patients having different Sanders stages. Sanders 2 patients experienced more overcorrection, thus timing and/or correction should be adjusted, since Sanders 3, 4, and 5 patients displayed a lesser risk of mechanical complications. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To report the follow-up curve behaviors in different Sanders staging groups. SUMMARY OF BACKGROUND DATA: Vertebral body tethering (VBT) is a growth modulation technique that allows gradual spontaneous follow-up curve correction as the patient grows. There is a lack of scientific evidence regarding appropriate patient selection and timing of implantation. METHODS:Patients were grouped into five as: Sanders 1, 2, 3, 4-5, and 6-7. Data were collected preoperatively, at the day before discharge, and at each follow-up. Outcome measures were pulmonary and mechanical complications, readmission, and reoperation rates. Demographic, perioperative, clinical, radiographic, and complication data were compared using Fisher-Freeman-Halton exact tests for categorical variables and Kruskal-Wallis tests for the continuous variables. RESULTS: Thirty-one (29 F, 2 M) consecutive patients with a minimum of 12 months of follow-up were included. The mean age at surgery was 12.1 (10-14). The mean follow-up was 27.1 (12-62) months. The mean preoperative main thoracic curve magnitude was 47° ± 7.6°. For all curves, preoperative and first erect curve magnitudes, bending flexibility, and operative correction percentages were similar between groups (for all comparisons, P > 0.05). The median height gained during follow-up was different between groups (P < 0.001), which was reflected into median curve correction during follow-up. Total curve correction percentage was different between groups (P = 0.009). Four (12.9%) patients had pulmonary and six (19.4%) had mechanical complications. One (3.2%) patient required readmission and two (6.5%) required reoperation. Occurrence of pulmonary complications was similar in Sanders groups (P = 0.804), while mechanical complications and overcorrection was significantly higher in Sanders 2 patients (P = 0.002 and P = 0.018). CONCLUSION: Follow-up curve behavior after VBT is different in patients having different Sanders stages. Sanders 2 patients experienced more overcorrection, thus timing and/or correction should be adjusted, since Sanders 3, 4, and 5 patients displayed a lesser risk of mechanical complications. LEVEL OF EVIDENCE: 3.
Authors: Alice Baroncini; Aurelien Courvoisier; Pedro Berjano; Filippo Migliorini; Jörg Eschweiler; Philipp Kobbe; Frank Hildebrand; Per David Trobisch Journal: Eur Spine J Date: 2021-12-15 Impact factor: 3.134
Authors: James Meyers; Lily Eaker; Jessica Zhang; Theodor di Pauli von Treuheim; Baron Lonner Journal: J Clin Med Date: 2022-06-02 Impact factor: 4.964