Anterior vertebral body tethering as a treatment for scoliosis in skeletally immature patients

Published: 28 October 2022
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A relatively new surgical procedure called Anterior Vertebral Body Tethering (AVBT) is used to treat scoliosis in patients with immature skeletons. It is a growth modulation fusionless system that Crowford and Lenke first described in 2010. We present our observations from 25 patients. Improvement in the mean coronal Cobb angle, from mean 57° preoperative to mean 34° postoperative, was 40%. Additionally, we noted that the mean thoracic hypokyphosis improved from 16° to 24° on average after surgery. Complication rates were 16% and surgical revision rates were 12%. All patients who demonstrated improvement in pain, function, and self-image underwent administration of the SRS-24 questionnaire. These data, according to the literature, show that AVBT is a reliable technique that enables scoliosis correction in skeletally immature patients and maintains that correction while utilizing remaining growth potential to achieve further correction, avoiding spinal fusion, and maintaining spine mobility.

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Citations

Stokes IAF. Mechanical effects on skeletal growth. J Musculoskelet Neuronal Interact 2002;2:277-80.
Crawford CR, Lenke LG. Growth modulation by means of anterior tethering resulting in progressive correction of juvenile idiopathic scoliosis: a case report. J Bone Joint Surg Am 2010;92:202–9. DOI: https://doi.org/10.2106/JBJS.H.01728
Rushton P, Nasto L, Parent S, et al. Anterior vertebral body tethering for treatment of idiopathic scoliosis in the skeletally immature. Spine 2021;46:1461-7. DOI: https://doi.org/10.1097/BRS.0000000000004061
Hoernschemeyer DG, Boeyer M, Robertson ME, et al. Anterior vertebral body tethering for adolescent scoliosis with growth remaining: A retrospective review of 2 to 5-year postoperative results. J Bone Joint Surg Am 2020;102:1169-76. DOI: https://doi.org/10.2106/JBJS.19.00980
Newton PO, Kluck DG, Saito W, et al. Bastrom anterior spinal growth tethering for skeletally immature patients with scoliosis: A retrospective look two to four years postoperatively. J Bone Joint Surg Am 2018;100:1691-7. DOI: https://doi.org/10.2106/JBJS.18.00287
Samdani AF, Pahys JM, Ames RJ, et al. Prospective follow-up report on anterior vertebral body tethering for idiopathic scoliosis: Interim results from an FDA IDE study. J Bone Joint Surg Am 2021;103:1611-9. DOI: https://doi.org/10.2106/JBJS.20.01503
Costanzo S, Pansini A, Colombo L, et al. Video-assisted thoracoscopy for vertebral body tethering of juvenile and adolescent idiopathic scoliosis: Tips and tricks of surgical multidisciplinary management. Children (Basel) 2022;9:74. DOI: https://doi.org/10.3390/children9010074

How to Cite

Caretti, V., Andreacchio, A., & Colombo, L. (2022). Anterior vertebral body tethering as a treatment for scoliosis in skeletally immature patients. La Pediatria Medica E Chirurgica, 44(s1). https://doi.org/10.4081/pmc.2022.291

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