Bilateral vertebral body tethering: identifying key factors associated with successful outcomes.
Eur Spine J
; 33(2): 723-731, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-38180517
ABSTRACT
PURPOSE:
The treatment of operative double major pediatric spinal deformities (e.g., Lenke 3 or 6) with bilateral vertebral body tethering (VBT) can be significantly more challenging when compared to other deformity patterns (e.g., Lenke 1) or treatment with a posterior spinal fusion. We aimed to identify preoperative and perioperative characteristics that were associated with successful postoperative outcomes in patients treated with both a thoracic and thoracolumbar (e.g., bilateral) tether.METHODS:
We retrospectively assessed radiographic and clinical data from patients enrolled in a large multi-center study who had a minimum postoperative follow-up of two years. Standard radiographic parameters were extracted from standing spine and left hand-wrist radiographs at various timepoints. We classified patients based on their preoperative deformity pattern (Primary Thoracic [TP] vs. Primary Thoracolumbar [TLP]) and assessed (1) deformity balance, (2) tilt of the transitional vertebra, and (3) postoperative success.RESULTS:
We analyzed data from thirty-six patients (TP 19 and TLP 17). We observed no relationship between deformity balance at first erect and postoperative success (p = 0.354). Patients with a horizontal transitional vertebra at first erect were significantly (p = 0.001) more likely to exhibit a successful outcome when compared to those who exhibited a tilted transitional vertebra (83% vs. 62%). Patients who had TLP were also more likely to exhibit a successful outcome when compared to patients who exhibited TP (76% vs. 50%).CONCLUSION:
These data indicate that double major deformities can be successfully treated with VBT, particularly for those who exhibit TLP.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Coluna Vertebral
/
Corpo Vertebral
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article