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Minerva Orthopedics 2021 June;72(3):322-7

DOI: 10.23736/S2784-8469.20.04041-2


lingua: Inglese

Vertebral body tethering as a treatment for adolescent scoliosis: one-year experience

Luca F. COLOMBO 1, Valentina CARETTI 1, Claudio VELLA 1, Andrea PANSINI 1, Flavia ALBERGHINA 2, Federico CANAVESE 3, Antonio ANDREACCHIO 1

1 Department of Pediatric Orthopedic Surgery, Buzzi Children’s Hospital, Milan, Italy; 2 Department of Pediatric Orthopedic Surgery, Regina Margherita Children’s Hospital, Turin, Italy; 3 Department of Pediatric Orthopedic Surgery, Jeanne de Flandre Hospital, Lille University Center, Lille, France

BACKGROUND: Vertebral body tethering (VBT) is a relatively recent technique for treatment of idiopathic scoliosis during adolescence. The advantages of the procedure include the possibility to obtain partial correction during surgery and complete correction guiding the residual growth, so that skeletal fusion can be avoided. The goal of this study was to report radiographic and clinical outcomes for patients with adolescent scoliosis treated with VBT.
METHODS: All patients with adolescent scoliosis who underwent surgical treatment between December 2018 and March 2020 were reviewed. Indications for the procedure were: Lenke type 1A/B curves, right convex, mainly thoracic deformities. The severity of the deformity was assessed according to the Cobb angle on standard X-rays. Residual growth potential was scored according to Risser and Sanders stage. Scoliosis Research Society 24 Patient Questionnaire was administrated.
RESULTS: Ten patients underwent VBT. Mean age at the time of surgery was 12 years. Mean Cobb angle value before the surgery was 56° on standard X-rays with 25% mean correction in side-bending and 40% mean correction on wedge X-rays. All patients were in Risser stage 0 or 1, and Sanders stage between 2 and 5. In all patients, SRS 24 questionnaire after surgery showed improvement in self-image, but the difference was not significant.
CONCLUSIONS: Our results suggest that VBT is a valid choice for treatment of adolescent with idiopathic scoliosis who cannot benefit from bracing. However, future prospective and randomized trials on a larger number of patients are needed to confirm our findings and define the long-term outcomes of the technique.

KEY WORDS: Scoliosis; Growth; Therapeutics

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