Vertebral body tethering shows clinical success as treatment for
scoliosis
Study finds more than 90% of patients avoided mobility-limiting spinal
fusion procedure

Date:
August 27, 2020
Source:
University of Missouri-Columbia
Summary:
Scoliosis is the most common spinal deformity affecting pediatric
patients. A posterior spinal fusion (PSF) is the gold standard
treatment for patients with curves exceeding 45 degrees, but
the procedure's drawbacks include the loss of spinal mobility,
persistent pain and adjacent segment disc disease. However, a new
retrospective study shows an alternative to PSF called vertebral
body tethering (VBT) yields promising results with fewer long-term
consequences for a specific group of scoliosis patients.



FULL STORY ========================================================================== Scoliosis is the most common spinal deformity affecting pediatric
patients. A posterior spinal fusion (PSF) is the gold standard treatment
for patients with curves exceeding 45 degrees, but the procedure's
drawbacks include the loss of spinal mobility, persistent pain and
adjacent segment disc disease. However, a new retrospective study from
the University of Missouri School of Medicine and MU Health Care shows
an alternative to PSF called vertebral body tethering (VBT) yields
promising results with fewer long-term consequences for a specific group
of scoliosis patients.


==========================================================================
VBT is an alternative to PSF for scoliosis patients who still have
growth remaining and flexibility of their spine. Screws are attached
in a minimally invasive fashion to the thoracic or lumbar vertebra in
the curved area of the spine. A polyethylene cord connects the screws
and tension straightens the spine, correcting the scoliosis. MU Health
Care is one of only a handful of medical centers in the U.S. offering
the procedure. Pediatric orthopaedic surgeon Dan Hoernschemeyer, MD,
is the principal investigator for the study and has performed more than
85 VBT surgeries on patients from around the country.

"If the child's spine has more than 45 degrees of scoliosis and still has
some growth remaining, VBT is a way to correct the scoliosis, preserve
motion and modulate normal growth instead of fusing it," Hoernschemeyer
said. "Our study examined the radiographic and clinical outcomes of
idiopathic scoliosis patients with various curve patterns treated with
VBT." Hoernschemeyer and his team conducted a retrospective review of
29 consecutive patients with 2-5 year follow-ups. Successful outcomes
were defined by a curve of less than 30 degrees in patients who reached skeletally maturity and had not receive a PSF. At the latest follow-up,
27 patients reached skeletal maturity and 74% achieved clinical success.

"Despite our patient population being slightly more mature at the time
of surgery than when compared to previous studies, we found a higher
success rate and a lower revision rate," Hoernschemeyer said. "Our
overall revision rate was 21% and a PSF was avoided in 93% of patients, indicating that VBT may be a reliable treatment option for adolescent scoliosis." The most common complication that led to revision involved
tether breakage.

Fourteen patients experienced a broken tether, and half required either
a revision surgery or PSF.

"While the exact role of VBT in the management of adolescent scoliosis continues to be defined, the data from this study supports the fact that
this surgical procedure should be considered as a treatment option for
children with scoliosis and an alternative to fusion," Hoernschemeyer
said.


========================================================================== Story Source: Materials provided by University_of_Missouri-Columbia. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Daniel G. Hoernschemeyer, Melanie E. Boeyer, Madeline E. Robertson,
Christopher M. Loftis, John R. Worley, Nicole M. Tweedy, Sumit
U. Gupta, Dana L. Duren, Christina M. Holzhauser, Venkataraman
M. Ramachandran.

Anterior Vertebral Body Tethering for Adolescent Scoliosis with
Growth Remaining. Journal of Bone and Joint Surgery, 2020; Publish
Ahead of Print DOI: 10.2106/JBJS.19.00980 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200827122119.htm

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