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Double-sided vertebral body tethering of double adolescent idiopathic scoliosis curves: radiographic outcomes of the first 13 patients with 2 years of follow-up

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Abstract

Purpose

In skeletally immature patients with adolescent idiopathic scoliosis (AIS), vertebral body tethering (VBT) as a fusionless minimally invasive treatment option has been shown to correct the deformity by growth modulation. This prospective cohort study aimed to present the minimum 2 years’ results of double-sided VBT applied to double curves of 13 skeletally immature patients with AIS.

Methods

Thirteen skeletally immature patients with AIS and double curves were included. All patients were followed up within a brace for at least 6 weeks. A decision to proceed with surgery was established after the detection of curve progression within the brace (> 40° thoracic, > 35° lumbar) with a minimum curve flexibility of 30%.

Results

Patients had an average age of 11.8 years, average follow-up duration of 36.4 months (range 24 to 46), average preoperative main thoracic/thoracolumbar or lumbar curve magnitudes of 48.2°/45.3°. An average of 11.8 levels of tethering was undertaken. Thoracic screws were placed thoracoscopically, while mini-thoracotomy/lumbotomy was added for thoracolumbar levels. Postoperatively, an average first erect thoracic/thoracolumbar major curve magnitudes of 17.3°/14.3° were acquired, while they improved to 9.7°/8.2° at the last follow-up. No neurologic or implant-related complications were acquired.

Conclusion

Double-sided VBT was detected to provide 80% of thoracic (48.2° to 9.7°) and 82% of thoracolumbar–lumbar curve correction (45.3° to 8.2°) as a result of average two years. As being a growth modulating treatment option, double-sided VBT as applied under strict inclusion criteria was shown to be safe and effective for the correction of double curves in skeletally immature patients with AIS, by yielding a gradual, growth-assisted correction of both curves together with the preservation of coronal–sagittal balance without any major complications.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey

    Tuna Pehlivanoglu, Ismail Oltulu, Yigit Erdag, Emre Korkmaz, Ender Sarioglu, Ender Ofluoglu & Mehmet Aydogan

  2. Faculty of Health Sciences, Yeni Yüzyıl University, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26, Cevizlibağ, Zeytinburnu, 34010, İstanbul, Turkey

    Tuna Pehlivanoglu

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  1. Tuna Pehlivanoglu
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  2. Ismail Oltulu
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Correspondence to Tuna Pehlivanoglu.

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Pehlivanoglu, T., Oltulu, I., Erdag, Y. et al. Double-sided vertebral body tethering of double adolescent idiopathic scoliosis curves: radiographic outcomes of the first 13 patients with 2 years of follow-up. Eur Spine J 30, 1896–1904 (2021). https://doi.org/10.1007/s00586-021-06745-z

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