Alice Baroncini1,2, Per David Trobisch3, Filippo Migliorini4. 1. Department of Orthopaedics, RWTH Aachen University Clinic, Aachen, Germany. alice.baroncini@artemed.de. 2. Department of Spine Surgery, Eifelklinik St. Brigida, Kammerbruchstr. 8, Simmerath, Germany. alice.baroncini@artemed.de. 3. Department of Spine Surgery, Eifelklinik St. Brigida, Kammerbruchstr. 8, Simmerath, Germany. 4. Department of Orthopaedics, RWTH Aachen University Clinic, Aachen, Germany.
Abstract
STUDY DESIGN: Retrospective study. OBJECTIVES: Vertebral body tethering (VBT) is raising interest for the treatment of adolescent idiopathic scoliosis (AIS), but many scoliosis surgeons have not been trained in anterior surgical approaches. We analyzed data of our first patients to define the learning curve for VBT. VBT has shown encouraging results in the treatment of growing AIS patients, but there is a paucity of data and long-term results are not yet available. To our best knowledge, there is no published data regarding the learning curve for VBT. METHODS: A retrospective analysis was performed, of all consecutive patients who underwent VBT at our Institution. Outcomes of interest were intubation time, surgical duration and estimated blood loss per screw and hospitalization length. For the statistical analysis, we referred to a linear model regression diagnostic and we used the Pearson product-moment correlation (r) for pairwise correlation. The final effect ranked between + 1 and - 1. RESULTS: Data of 90 patients were analyzed, age 14.6 ± 1.8 years. On average, 9.4 ± 2.6 levels were instrumented. Per screw, mean intubation time was 33.1 ± 7.6 min (r = - 0.57; p > 0.0001), mean surgical duration 21.3 ± 5.7 min (r = - 0.55; p > 0.0001), mean estimated blood loss 21.3 ± 18.2 ml (r = - 0.66; p > 0.0001). Mean hospitalization length was 8.3 ± 3.1 days (r = - 0.32; p = 0.002). No intraoperative complications were reported. CONCLUSION: VBT has a rapid learning curve: the estimated blood loss per screw is expected to decrease by 60%, intubation time and surgical duration by over 50%, and hospitalization length by 32% for each treated patient. LEVEL OF EVIDENCE: III.
STUDY DESIGN: Retrospective study. OBJECTIVES: Vertebral body tethering (VBT) is raising interest for the treatment of adolescent idiopathic scoliosis (AIS), but many scoliosis surgeons have not been trained in anterior surgical approaches. We analyzed data of our first patients to define the learning curve for VBT. VBT has shown encouraging results in the treatment of growing AIS patients, but there is a paucity of data and long-term results are not yet available. To our best knowledge, there is no published data regarding the learning curve for VBT. METHODS: A retrospective analysis was performed, of all consecutive patients who underwent VBT at our Institution. Outcomes of interest were intubation time, surgical duration and estimated blood loss per screw and hospitalization length. For the statistical analysis, we referred to a linear model regression diagnostic and we used the Pearson product-moment correlation (r) for pairwise correlation. The final effect ranked between + 1 and - 1. RESULTS: Data of 90 patients were analyzed, age 14.6 ± 1.8 years. On average, 9.4 ± 2.6 levels were instrumented. Per screw, mean intubation time was 33.1 ± 7.6 min (r = - 0.57; p > 0.0001), mean surgical duration 21.3 ± 5.7 min (r = - 0.55; p > 0.0001), mean estimated blood loss 21.3 ± 18.2 ml (r = - 0.66; p > 0.0001). Mean hospitalization length was 8.3 ± 3.1 days (r = - 0.32; p = 0.002). No intraoperative complications were reported. CONCLUSION:VBT has a rapid learning curve: the estimated blood loss per screw is expected to decrease by 60%, intubation time and surgical duration by over 50%, and hospitalization length by 32% for each treated patient. LEVEL OF EVIDENCE: III.
Authors: Amer F Samdani; Ashish Ranade; Daniel M Sciubba; Patrick J Cahill; M Darryl Antonacci; David H Clements; Randal R Betz Journal: Eur Spine J Date: 2009-10-29 Impact factor: 3.134
Authors: Amer F Samdani; Robert J Ames; Jeff S Kimball; Joshua M Pahys; Harsh Grewal; Glenn J Pelletier; Randal R Betz Journal: Spine (Phila Pa 1976) Date: 2014-09-15 Impact factor: 3.468
Authors: Amer F Samdani; Robert J Ames; Jeff S Kimball; Joshua M Pahys; Harsh Grewal; Glenn J Pelletier; Randal R Betz Journal: Eur Spine J Date: 2014-12-16 Impact factor: 3.134
Authors: Baron S Lonner; Yuan Ren; Burt Yaszay; Patrick J Cahill; Suken A Shah; Randal R Betz; Amer F Samdani; Harry L Shufflebarger; Peter O Newton Journal: Spine (Phila Pa 1976) Date: 2018-03-15 Impact factor: 3.468
Authors: Luis Fernando Nicolini; Philipp Kobbe; Jana Seggewiß; Johannes Greven; Marx Ribeiro; Agnes Beckmann; Stephanie Da Paz; Jörg Eschweiler; Andreas Prescher; Bernd Markert; Marcus Stoffel; Frank Hildebrand; Per D Trobisch Journal: Eur Spine J Date: 2021-10-30 Impact factor: 3.134
Authors: Dhruv Shankar; Lily Eaker; Theodor Di Pauli von Treuheim; Jared Tishelman; Zacharia Silk; Baron S Lonner Journal: Spine Deform Date: 2022-03-08
Authors: Alice Baroncini; Per David Trobisch; Pedro Berjano; Claudio Lamartina; Philipp Kobbe; Markus Tingart; Filippo Migliorini Journal: Spine Deform Date: 2021-06-18