Bilateral vertebral body tethering: identifying key factors associated with successful outcomes.

Autor: Hoernschemeyer, Daniel G., Elliott, Patrick, Lonner, Baron S., Eaker, Lily, Harms Study Group, Buckland, Aaron, Alanay, Ahmet, Samdani, Amer, Jain, Amit, Larson, A. Noelle, Lonner, Baron, Roye, Benjamin, Cho, Bob, Yaszay, Burt, Yilgor, Caglar, Reilly, Chris, Hoernschmeyer, Dan, Hedequist, Daniel, Sucato, Daniel, Clements, David
Předmět:
Zdroj: European Spine Journal; Feb2024, Vol. 33 Issue 2, p723-731, 9p
Abstrakt: Purpose: The treatment of operative double major pediatric spinal deformities (e.g., Lenke 3 or 6) with bilateral vertebral body tethering (VBT) can be significantly more challenging when compared to other deformity patterns (e.g., Lenke 1) or treatment with a posterior spinal fusion. We aimed to identify preoperative and perioperative characteristics that were associated with successful postoperative outcomes in patients treated with both a thoracic and thoracolumbar (e.g., bilateral) tether. Methods: We retrospectively assessed radiographic and clinical data from patients enrolled in a large multi-center study who had a minimum postoperative follow-up of two years. Standard radiographic parameters were extracted from standing spine and left hand-wrist radiographs at various timepoints. We classified patients based on their preoperative deformity pattern (Primary Thoracic [TP] vs. Primary Thoracolumbar [TLP]) and assessed: (1) deformity balance, (2) tilt of the transitional vertebra, and (3) postoperative success. Results: We analyzed data from thirty-six patients (TP: 19 and TLP: 17). We observed no relationship between deformity balance at first erect and postoperative success (p = 0.354). Patients with a horizontal transitional vertebra at first erect were significantly (p = 0.001) more likely to exhibit a successful outcome when compared to those who exhibited a tilted transitional vertebra (83% vs. 62%). Patients who had TLP were also more likely to exhibit a successful outcome when compared to patients who exhibited TP (76% vs. 50%). Conclusion: These data indicate that double major deformities can be successfully treated with VBT, particularly for those who exhibit TLP. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
Externí odkaz: