April 23, 2024
2 min read
Key takeaways:
- Curve progression greater than 5° occurred in 43% and 50% of patients at 1 year and 2 years, respectively, after vertebral body tether rupture.
- Patients had an overall revision rate of 14% after tether rupture.
Results showed patients who had a vertebral body tether rupture experienced mild general curve progression with a low rate of revision. However, younger patients with larger curves may have an increased chance of undergoing revision.
“We are still trying to refine the indications for vertebral body tethering. Ultimately, having a non-fusion option for the treatment of scoliosis in kids is going to be important,” Tyler A. Tetreault, MD, pediatric orthopedic surgeon in the Jackie and Gene Autry Orthopedic Center at Children’s Hospital Los Angeles, told Healio. “[Vertebral body tethering] is an option that is available, though it might not be the ideal solution that we were optimistic it would be earlier. But this gives us information to continue to refine our techniques and change our practice going forward.”
Patients who had a vertebral body tether rupture experienced mild general curve progression with a low rate of revision; however, younger patients with larger curves may have an increased risk for revision. Image: Adobe Stock
Curve progression
Using the Pediatric Spine Study Group Registry, Tetreault and colleagues from the Pediatric Spine Study Group identified 84 patients with adolescent or juvenile idiopathic scoliosis who underwent vertebral body tethering with 2-years of follow-up and sustained a tether rupture.
“We measured their curve magnitude at 1 year, at 2 years and then after final follow-up after their rupture was identified,” Tetreault said about results presented at the International Meeting on Advanced Spine Techniques. “We also evaluated how many patients underwent revision surgery after their tether broke.”
Tetreault said 43% and 50% of patients had a curve progression greater than 5° at 1 year and 2 years, respectively. At final follow-up, more than two-thirds of patients had a curve greater than 35° and 23% of patients had a curve greater than 45°.
“We found that the main impact of how large the curve got after tether breakage was how quickly after they had the tethering procedure did the tether break,” Tetreault said. “The average time from tethering until the cord broke was 30 months, but there is a small portion of our group that had a breakage within 12 months. They had significantly greater curve progression than those who had a breakage at a later time.”
Revision rate
He added they found a 14% overall revision rate after tether rupture, with six patients undergoing tether revision and six patients undergoing fusion. Patients who were skeletally immature or who had a curve greater than 35° had a greater risk for revision, according to Tetreault.
“We had no patients with a curve less than 35° at the time of rupture that ended up having revision surgery,” Tetreault said. “We found that the time from the [vertebral body tethering] VBT procedure to tether rupture was also associated with undergoing revision surgery, about a three times as great rate for those patients.”
Sources/Disclosures
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Tetreault TA, et al. Paper 41. Presented at: International Meeting on Advanced Spine Techniques; April 10-13, 2024; San Diego.
Disclosures:
Tetreault reports no relevant financial disclosures.
This news is republished from another source.
