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Thread: Tethering looks promising based on early patients

  1. #1
    Join Date
    Jan 2008

    Tethering looks promising based on early patients

    Anterior Vertebral Body Tethering for Idiopathic Scoliosis: Two-Year Results.

    Samdani, Amer F.; Ames, Robert J.; Kimball, Jeff S.; Pahys, Joshua M.; Grewal, Harsh; Pelletier, Glenn J.; Betz, Randal R. Less

    Spine., Post Acceptance: June 11, 2014

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    Study Design. Retrospective review

    Objective. To report the 2-year results of the initial cohort undergoing anterior vertebral body tethering (VBT).

    Summary of Background Data. Anterior VBT is a promising new technique with abundant preclinical studies but very few clinical results. It is a growth modulation technique, which utilizes patients' growth to attain progressive correction of their scoliosis. We report 2-year results of the initial cohort undergoing this procedure.

    Methods. After obtaining IRB approval, we retrospectively reviewed our first 11 consecutive patients who underwent anterior VBT with 2-year follow-up. We collected pertinent preoperative, intraoperative, and most recent clinical and radiographic data. Student's t-test and Fisher's exact test were utilized to compare different time points.

    Results. 11 patients with thoracic IS (8 female) were identified, with a mean age of 12.3 +/- 1.6 years. Preoperatively, all were skeletally immature (Sanders mean = 3.4+/-1.1, Risser mean = 0.6+/-1.1). All underwent tethering of an average of 7.8 +/- 0.9 (range 7-9) levels with the most proximal being T5 and the most distal L2. Preoperative thoracic Cobb angle averaged 44.2+/-9.0[degrees] and corrected to 20.3+/-11.0[degrees] on first erect, with progressive improvement at 2 years (Cobb = 13.5+/-11.6[degrees],% correction = 70%, p-value <0.00002). Similarly, the preoperative lumbar curve of 25.1 +/- 8.7[degrees] demonstrated progressive correction (first erect = 14.9 +/- 4.9[degrees], 2 year = 7.2 +/- 5.1[degrees],% correction = 71%, p-value <0.0002). Thoracic axial rotation as measured by a scoliometer went from 12.4+/-3.3[degrees] preoperatively to 6.9+/-3.4[degrees] at the most recent measurement (p <0.01). No major complications were observed. As anticipated, two patients returned to the operating room at 2 years postoperatively for loosening of the tether to prevent overcorrection.

    Conclusion. Anterior VBT is a promising technique for skeletally immature patients with idiopathic scoliosis. This technique can be performed safely and can result in progressive correction.

    (C) 2014 by Lippincott Williams & Wilkins
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine

    "We are all African."

  2. #2
    Join Date
    Aug 2004
    Yes, it does look very promising after the first 2-3 years. What is also encouraging is that many insurance companies have covered surgeries performed outside of Shriners (by Drs. Betz/Antonacci in NY, Dr. Newton in CA, and others) and some of the docs involved recently went in front of the FDA and feel that the meeting went well and that tethering could be approved in 2-3 years, rather than the 10 years it sometimes takes.

    So apparently you were not the only one who sees promise :-)
    Last edited by mariaf; 06-26-2014 at 11:22 AM.
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

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