DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS

J. Bernard; T. Bishop; J. Herzog; S. Haleem; B. Ajayi; D. Lui

doi:10.1302/1358-992X.2022.11.032

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General Orthopaedics

DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS

The British Indian Orthopaedic Society (BIOS) Annual Scientific Meeting, Mansfield, England, 7–8 July 2022.

J. Bernard
T. Bishop
J. Herzog
S. Haleem
B. Ajayi
D. Lui

DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS

Bernard J, Bishop T, Herzog J, Haleem S, Ajayi B, Lui D. DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS. Orthop Procs. 2022;104-B(SUPP_11):32-32. doi:10.1302/1358-992X.2022.11.032

Bernard, J., et al. “DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_11, 2022, pp. 32-32., https://doi.org/10.1302/1358-992X.2022.11.032

Bernard, J., Bishop, T., Herzog, J., Haleem, S., Ajayi, B., & Lui, D. (2022). DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS. Orthopaedic Proceedings, 104-B(SUPP_11), 32-32. https://doi.org/10.1302/1358-992X.2022.11.032

Bernard, J., Bishop, T., Herzog, J., Haleem, S., Ajayi, B. and Lui, D. (2022) “DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS.” Orthopaedic Proceedings, 104-B(SUPP_11), pp. 32-32. Available at: https://doi.org/10.1302/1358-992X.2022.11.032

Bernard, J., T. Bishop, J. Herzog, S. Haleem, B. Ajayi, and D. Lui. “DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS.” Orthopaedic Proceedings 104-B, no. SUPP_11 (2022): 32-32. https://doi.org/10.1302/1358-992X.2022.11.032

Bernard J, Bishop T, Herzog J, Haleem S, Ajayi B, Lui D. DUAL MODALITY OF VERTEBRAL BODY TETHERING: ANTERIOR SCOLIOSIS CORRECTION VERSUS GROWTH MODULATION WITH MEAN FOLLOW-UP OF FIVE YEARS. Orthop Procs. 2022 Nov 1;104-B(SUPP_11):32-32. https://doi.org/10.1302/1358-992X.2022.11.032

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Abstract

Aims

Vertebral body tethering (VBT) is a non-fusion technique to correct scoliosis allowing correction of scoliosis through growth modulation (GM) by tethering the convex side to allow concave unrestricted growth similar to the hemiepiphysiodesis concept. The other modality is anterior scoliosis correction (ASC) where the tether is able to perform most of the correction immediately where limited growth is expected.

Methods

A retrospective analysis of 20 patients (M:F=19:1 – 9–17 years) between January 2014 to December 2016 with a mean five-year follow-up (4 to 7).

Results

There were ten patients in each group with a total of 23 curves operated upon. VBT-GM mean age −12.5 years (9 to 14), mean Risser of 0.63 (0 to 2) and VBT-ASC was 14.9 years (13 to 17) and mean Risser of 3.66 (3 to 5). Mean preoperative VBT-GM Cobb was 47.4° (40°–58°) compared to VBT-ASC 56.5° (40°–79°). Postoperative VBT-GM Cobb was 20.3° and VBT-ASC was 11.2°. The early postoperative correction rate was 54.3% versus 81% whereas Fulcrum Bending Correction Index (FBCI) was 93.1% vs 146.6%. Latest Cobb angle at mean five years' follow-up was 19.4° (VBT-GM) and 16.5° (VBT-ASC). Overall, 5% of patients required fusion.

Conclusion

We show a high success rate (95%) in helping children avoid fusion at five years post-surgery. VBT is a safe technique for scoliosis correction in the skeletally immature patient. This is the first report at five years showing two possible options of VBT depending on the skeletal maturity of the patient: GM and ASC.