Curve progression after vertebral body tether rupture may be mild with low revision rate

April 23, 2024

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Important points:

  • Curvature progression of >5° occurred in 43% and 50% of patients 1 and 2 years after vertebral tether rupture, respectively.
  • The overall revision rate for patients after tether rupture was 14%.

Results showed that patients with vertebral body tether tears had lower revision rates and milder overall curve progression. However, younger patients with larger curves are more likely to undergo revision surgery.

“We are still working to further refine the indications for vertebral tethering. Ultimately, it will be important to have non-fusion options for the treatment of scoliosis in children.” Dr. Tyler A. Tetrault, Pediatric orthopedic surgeons at the Jackie and Gene Autry Orthopedic Center at Children’s Hospital Los Angeles told Helio. “[Vertebral body tethering] Although an option available, this may not be the ideal solution we were optimistic we could achieve earlier. However, it gives us information to continue to hone our skills and change our practice going forward. ”



Idiopathic scoliosis in adolescence
Patients with vertebral body tether tears had lower revision rates and milder overall curve progression. However, younger patients with larger curves may be at increased risk of revision. Image: Adobe Stock

progression of the curve

Tetreault et al. of the Pediatric Spine Research Group used the Pediatric Spine Research Group registry to study 84 adolescent or juvenile idiopathic scoliosis patients who underwent vertebral body tethering and had tether tears over a 2-year follow-up. has been identified.

“We measured the magnitude of the spinal curvature at one year, two years, and at a final follow-up after the tear was identified,” Tetreault said of the results, which were presented at the International Conference on Advanced Spine Technology. Stated. “We also evaluated the number of patients who underwent reoperation after the tether broke.”

Tetreault said 43% and 50% of patients had curve progression of >5° at 1 and 2 years, respectively. At final follow-up, more than two-thirds of patients had a curvature greater than 35°, and 23% of patients had a curvature greater than 45°.

“We found that how quickly the tether is severed after the tether procedure has a major effect on how large the curve becomes after the tether is severed,” Tetreault said. “The average time from tethering to the cord breaking was 30 months, but some in our group had it broken within 12 months. , it showed a fairly large curve progression.”

Revision rate

He added that the overall revision rate after tether rupture was 14%, with six patients undergoing tether revision and six patients undergoing fusion. Tetreault said patients who were skeletally immature or had a curvature greater than 35 degrees were at higher risk for revision.

“None of the patients who had a curvature at rupture of less than 35 degrees ultimately underwent reoperation,” Tetreault said. “we, [vertebral body tethering] VBT procedures to hold tears together were also associated with undergoing reoperation, about three times as likely in these patients. ”

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