Tuna Pehlivanoglu1,2, Ismail Oltulu3, Yigit Erdag3, Emre Korkmaz3, Ender Sarioglu3, Ender Ofluoglu3, Mehmet Aydogan3. 1. Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey. dr.tuna@hotmail.com. 2. Faculty of Health Sciences, Yeni Yüzyıl University, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26, Cevizlibağ, Zeytinburnu, 34010, İstanbul, Turkey. dr.tuna@hotmail.com. 3. Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey.
Abstract
PURPOSE: In skeletally immature patients with adolescent idiopathic scoliosis (AIS), vertebral body tethering (VBT) as a fusionless minimally invasive treatment option has been shown to correct the deformity by growth modulation. This prospective cohort study aimed to present the minimum 2 years' results of double-sided VBT applied to double curves of 13 skeletally immature patients with AIS. METHODS: Thirteen skeletally immature patients with AIS and double curves were included. All patients were followed up within a brace for at least 6 weeks. A decision to proceed with surgery was established after the detection of curve progression within the brace (> 40° thoracic, > 35° lumbar) with a minimum curve flexibility of 30%. RESULTS: Patients had an average age of 11.8 years, average follow-up duration of 36.4 months (range 24 to 46), average preoperative main thoracic/thoracolumbar or lumbar curve magnitudes of 48.2°/45.3°. An average of 11.8 levels of tethering was undertaken. Thoracic screws were placed thoracoscopically, while mini-thoracotomy/lumbotomy was added for thoracolumbar levels. Postoperatively, an average first erect thoracic/thoracolumbar major curve magnitudes of 17.3°/14.3° were acquired, while they improved to 9.7°/8.2° at the last follow-up. No neurologic or implant-related complications were acquired. CONCLUSION: Double-sided VBT was detected to provide 80% of thoracic (48.2° to 9.7°) and 82% of thoracolumbar-lumbar curve correction (45.3° to 8.2°) as a result of average two years. As being a growth modulating treatment option, double-sided VBT as applied under strict inclusion criteria was shown to be safe and effective for the correction of double curves in skeletally immature patients with AIS, by yielding a gradual, growth-assisted correction of both curves together with the preservation of coronal-sagittal balance without any major complications.
PURPOSE: In skeletally immature patients with adolescent idiopathic scoliosis (AIS), vertebral body tethering (VBT) as a fusionless minimally invasive treatment option has been shown to correct the deformity by growth modulation. This prospective cohort study aimed to present the minimum 2 years' results of double-sided VBT applied to double curves of 13 skeletally immature patients with AIS. METHODS: Thirteen skeletally immature patients with AIS and double curves were included. All patients were followed up within a brace for at least 6 weeks. A decision to proceed with surgery was established after the detection of curve progression within the brace (> 40° thoracic, > 35° lumbar) with a minimum curve flexibility of 30%. RESULTS:Patients had an average age of 11.8 years, average follow-up duration of 36.4 months (range 24 to 46), average preoperative main thoracic/thoracolumbar or lumbar curve magnitudes of 48.2°/45.3°. An average of 11.8 levels of tethering was undertaken. Thoracic screws were placed thoracoscopically, while mini-thoracotomy/lumbotomy was added for thoracolumbar levels. Postoperatively, an average first erect thoracic/thoracolumbar major curve magnitudes of 17.3°/14.3° were acquired, while they improved to 9.7°/8.2° at the last follow-up. No neurologic or implant-related complications were acquired. CONCLUSION: Double-sided VBT was detected to provide 80% of thoracic (48.2° to 9.7°) and 82% of thoracolumbar-lumbar curve correction (45.3° to 8.2°) as a result of average two years. As being a growth modulating treatment option, double-sided VBT as applied under strict inclusion criteria was shown to be safe and effective for the correction of double curves in skeletally immature patients with AIS, by yielding a gradual, growth-assisted correction of both curves together with the preservation of coronal-sagittal balance without any major complications.
Authors: James O Sanders; Richard H Browne; Sharon J McConnell; Susan A Margraf; Timothy E Cooney; David N Finegold Journal: J Bone Joint Surg Am Date: 2007-01 Impact factor: 5.284
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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