September 02, 2021
1 min read
Lonner BS, et al. Paper 366. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. Aug. 31-Sept. 3, 2021; San Diego.
Lonner reports being a consultant for and receiving royalties from Zimmer Biomet Spine and DePuy Synthes Spine.
SAN DIEGO — Results showed vertebral body tethering for treatment of adolescent idiopathic scoliosis may have outcomes comparable to that of posterior spinal fusion.
Baron S. Lonner, MD, and colleagues compared patients with adolescent idiopathic scoliosis who underwent vertebral body tethering with patients who underwent posterior spinal fusion. The groups were matched for curve type, age and kyphosis. Lonner noted he performed all operations.
“We had 25 matched pairs and we looked at radiographic outcomes, complication rates and operative statistics, like blood loss and operative time, and we assessed patient-reported outcomes with the Scoliosis Research Society Questionnaire,” Lonner, chief of minimally invasive scoliosis surgery at Mount Sinai Hospital in New York and professor of orthopedic surgery at Icahn School of Medicine, told Healio Orthopedics about research presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
Patients in both groups had similar age and major (largest) curvature prior to surgery, according to Lonner. He added the groups also had similar corrections of the major structural curvature, as well as the secondary compensatory curvature. Although the groups had similar rotational correction, Lonner noted the spinal fusion group had slightly improved correction for thoracolumbar curves compared with the vertebral body tethering group.
“So, [there was] slightly more rotational correction for fusion,” Lonner said. “Although clinically similar, [the correction was] statistically slightly greater for the fusion patients.”
Complication rates included one infection and one screw requiring revision surgery in the fusion group compared with three patients with cord breakage in the vertebral body tether group, Lonner noted. Despite the cord breakages, Lonner said reoperation was not required. He added the two groups had no significant differences in patient-reported outcomes in the Scoliosis Research Society Questionnaire. However, Lonner said patients who underwent vertebral body tethering had one-fifth less blood loss compared with patients who underwent spinal fusion.
“We still have a lot of work to do in studying outcomes and finding the sweet spot, the best indications and the best timing for performing [vertebral body tethering] VBT, but I think it will have an increasingly prominent role in the treatment of the adolescent patient with scoliosis and will allow patients to have at least partial preservation of motion and flexibility,” Lonner said.