Anterior Vertebral Body Tethering for Idiopathic Scoliosis
| Autor: | Harsh Grewal, Joshua M. Pahys, Randal R. Betz, Amer F. Samdani, Jeff S. Kimball, Robert J. Ames, Glenn J. Pelletier |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Adolescent Radiography Idiopathic scoliosis Scoliosis Thoracic Vertebrae symbols.namesake medicine Humans Orthopedic Procedures Orthopedics and Sports Medicine Child Fisher's exact test Retrospective Studies Lumbar Vertebrae Cobb angle business.industry Retrospective cohort study Institutional review board medicine.disease Treatment Outcome Cohort symbols Female Neurology (clinical) business Nuclear medicine Follow-Up Studies |
| Zdroj: | Spine. 39:1688-1693 |
| ISSN: | 0362-2436 |
| Popis: | Retrospective review.To report the 2-year results of the initial cohort undergoing anterior vertebral body tethering (VBT).Anterior VBT is a promising new technique with abundant preclinical studies but very few clinical results. It is a growth modulation technique, which utilizes patients' growth to attain progressive correction of their scoliosis. We report 2-year results of the initial cohort undergoing this procedure.After obtaining institutional review board approval, we retrospectively reviewed our first 11 consecutive patients who underwent anterior VBT with 2-year follow-up. We collected pertinent preoperative, intraoperative, and most recent clinical and radiographical data. Student t test and Fisher exact test were utilized to compare different time points.Eleven patients with thoracic idiopathic scoliosis (8 females) were identified, with a mean age of 12.3 ± 1.6 years. Preoperatively, all were skeletally immature (Sanders mean = 3.4 ± 1.1; Risser mean = 0.6 ± 1.1). All underwent tethering of an average of 7.8 ± 0.9 (range: 7-9) levels, with the most proximal being T5 and the most distal L2. Preoperative thoracic Cobb angle averaged 44.2 ± 9.0° and corrected to 20.3 ± 11.0° on first erect, with progressive improvement at 2 years (Cobb angle = 13.5 ± 11.6°, % correction = 70%; P0.00002). Similarly, the preoperative lumbar curve of 25.1 ± 8.7° demonstrated progressive correction (first erect = 14.9 ± 4.9°, 2 yr = 7.2 ± 5.1°, % correction = 71%; P0.0002). Thoracic axial rotation as measured by a scoliometer went from 12.4 ± 3.3° preoperatively to 6.9 ± 3.4° at the most recent measurement (P0.01). No major complications were observed. As anticipated, 2 patients returned to the operating room at 2 years postoperatively for loosening of the tether to prevent overcorrection.Anterior VBT is a promising technique for skeletally immature patients with idiopathic scoliosis. This technique can be performed safely and can result in progressive correction.4. |
| Databáze: | OpenAIRE |
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