Results of a Retrospective FDA Investigational Device Exemption Study for Anterior Vertebral Body Tethering in Adolescent Idiopathic Scoliosis with 3-Year to 10-Year Follow-Up.

Background: Vertebral body tethering (VBT) offers an alternative treatment for patients with idiopathic scoliosis. We present our finalized Food and Drug Administration Investigational Device Exemption (IDE) study results on VBT.

Methods: We retrospectively reviewed patients with Lenke Type IA/B curves who underwent VBT between 2011 and 2015.

Complications of growth-friendly techniques in early onset scoliosis of neurofibromatosis type 1: a case series.

Purpose: Neurofibromatosis type 1 (NF-1) is a genetic disease with many clinical manifestations, including early onset scoliosis (EOS). There has been increasing interest in the use of growing rod constructs in these patients. Our study seeks to understand the complication rates of these procedures in patients with NF-1.

Failure to replace removed growth friendly implants results in deteriorating radiographic outcomes.

Introduction: Management of early onset scoliosis (EOS) patients can require growth-friendly surgery to manage spinal deformity in children too immature for a definitive fusion. There is limited literature on outcomes for patients with failed growing constructs requiring removal of implants (ROI).

Methods: We studied EOS patients from an international registry undergoing removal of growth-friendly implants, comparing early re-implantation (within 12 months of ROI) to observation-only.

Biomarker Longitudinal Idiopathic Scoliosis Study: Predicting Growth in Idiopathic Scoliosis.

Background: Growth has been theorized as one of the main risk factors for idiopathic scoliosis (IS) progression. Determining the amount and timing of growth is surprisingly challenging. Radiographic measures of skeletal maturity do not provide insight into the amount that individuals will grow.

Changing Complication Trends after Anterior Vertebral Body Tethering: 10-Year Experience.

Study Design: Single center retrospective study.

Objective: Identify changes in complication profiles following anterior vertebral body tethering (VBT).

Background: VBT is associated with complications such as overcorrection and breakage.

Predictors of massive transfusion of allogenic blood products during posterior spinal fusion in patients with cerebral palsy.

Purpose: This article aimed to determine modifiable risk factors to prevent massive blood transfusion of blood products (MTBP) during spinal fusion in patients with cerebral palsy.

Methods: Patient data were queried from a prospectively collected multicenter database. Perioperative MTBP was defined as the administration of allogenic blood products equaling at least half (50%) of the patients' preoperative blood volume during the surgical procedure.

How Does the Vertical Expandable Prosthetic Titanium Rib Lengthening Intervals Affect the Clinical Outcome in Early Onset Scoliosis Patients? A Five-Year Follow-Up Study.

Background: Untreated early-onset scoliosis (EOS) is often complicated by decreased thoracic expansion growth and pulmonary complications. Various fusion-less techniques have been developed to address these complications, including growing rods and vertical expandable prosthetic titanium rib (VEPTR) devices. To achieve adequate spinal growth, optimal lengthening timing is required.

Juvenile idiopathic scoliosis treated with anterior vertebral body tethering and disc releases: a case report.

A 10-year-old male with juvenile idiopathic scoliosis underwent an anterior vertebral body tether (VBT) and two disc releases to correct his 72° thoracolumbar curvature. To the best of our knowledge, this procedure has not been previously documented. The patient trialed bracing prior to presenting to our institution, but his curve continued to progress.

Fusion versus Non-fusion Surgery for Pediatric Idiopathic Scoliosis: Preferences of Patients, Caregivers, and Patient-Caregiver Dyads.

Study DesignOriginal research, cross-sectional study.ObjectivesEvaluate preferences of patients, caregivers, and patient-caregiver dyads for non-fusion vs fusion surgery.MethodsA survey-based discrete choice experiment included patients 12-15 years of age with idiopathic scoliosis and their caregivers.

Optimal Selection of Lower Instrumented Vertebra Can Minimize Distal Junctional Kyphosis After Posterior Spinal Fusion for Thoracic Adolescent Idiopathic Scoliosis.

Study Design: Retrospective cohort study of a prospectively collected multicenter database.

Objective: To identify risk factors for developing distal junctional kyphosis (DJK) and elucidate optimal selection of the lowest instrumented vertebra (LIV) utilizing sagittal stable vertebra (SSV) and preoperative distal junctional angle (DJA) to prevent DJK.

Summary Of Background Data: While including the SSV may minimize DJK following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis, relying solely on the SSV criteria can necessitate more extensive fusion.

Incidence and Predictors of Growth Modulation and Overcorrection after Anterior Vertebral Body Tethering.

Study Design: Retrospective review of a prospectively collected single-center adolescent idiopathic scoliosis (AIS) database.

Objective: To evaluate the incidence and predictors of growth modulation and overcorrection after vertebral body tethering (VBT) in AIS.

Background: Little data exists regarding which AIS patients will exhibit growth modulation and/or overcorrection after VBT compared to those whose curve correction will remain unchanged (no modulation).

Outcomes of Single-Sided Thoracic vs. Bilateral Thoracic and Lumbar Anterior Vertebral Body Tethering in Lenke 1 Curves with Lumbar C Modifier.

Study Design: Retrospective review of a prospectively collected single-center adolescent idiopathic scoliosis (AIS) database.

Objective: To evaluate the outcomes of single-sided thoracic anterior vertebral body tethering (VBT) versus bilateral thoracic/thoracolumbar VBT for the treatment of Lenke 1C type curves, as well as the outcomes of Lenke 1A/B curves compared to 1C curves.

Background: Lenke 1C curves can be successfully treated with selective thoracic fusion alone.

Outcomes and complications of vertebral body tethering by patient gender.

Purpose: Non-fusion surgical options for pediatric scoliosis management such as vertebral body tethering (VBT) offer an alternative to spinal fusion. With this study, we aim to evaluate the postoperative outcomes in boys versus girls who have undergone VBT. Our hypothesis is that girls and boys will have similar outcomes by 2-year follow-up.

Reoperation Rate After Posterior Spinal Fusion Varies Significantly by Lenke Type.

Background: Lenke curve types can vary in their response to treatment. We explored potential differences in reoperation rates, causes, and risk factors among patients with different Lenke types who underwent posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS).

Methods: We studied a multicenter database of patients with AIS who underwent index PSF at ≤21 years of age and had a minimum 2-year follow-up.

Should the C7-T1 Junction Be Feared? The Effect of a T1 Upper Instrumented Vertebra on Development of Proximal Junctional Kyphosis.

Purpose: Proximal junctional kyphosis is an infrequent complication in AIS; however, equipoise remains on the effects of ending a fusion proximally at the C7-T1 junction on the future development of PJK. The purpose of this study was to determine the rate of PJK in patients with AIS who had a UIV of T1 vs those with a UIV of T2 at 5 years of follow-up.

Methods: A query was performed of a prospective, multi-center AIS database of patients who received a PSF with at least 5 years of follow-up.

Compensatory thoracic curve correction in lumbar anterior vertebral body tether (VBT) versus lumbar posterior spinal fusion (PSF).

Purpose: Anterior vertebral body tethering (VBT) is a non-fusion surgical option for skeletally immature patients with idiopathic scoliosis. Prior studies demonstrated compensatory correction of the thoracic curve after lumbar posterior spinal fusion (PSF); however, no studies have examined thoracic curve correction after lumbar VBT.

Methods: Patients with Lenke 5 + 6 lumbar scoliosis who underwent VBT and at least 2 years' follow-up were compared to matched lumbar PSF patients.

Incidence of Parental Requests to Discontinue Growth-Friendly Surgical Lengthening for Early Onset Scoliosis.

Background: The STOP questionnaire was developed to document reasons for discontinuation of growth-friendly (GF) treatment in early onset scoliosis (EOS). This study investigated the incidence of parental request (PR) on the STOP questionnaire and compared clinical information and Early Onset Scoliosis 24-Item Questionnaire (EOSQ-24) scores of PR patients with those whose parents did not request discontinuation (non-parent request [NPR]).

Materials And Methods: An international pediatric spine registry was queried for EOS patients with STOP questionnaires completed by their surgeon.

Osteotomies at the Time of Graduation Surgery: How Much Do We Get From Them?

Study Design: Retrospective, multicenter.

Objective: Determine if posterior column osteotomies (PCO) at time of conversion from growth friendly instrumentation (GFI) to definitive fusion in early onset scoliosis (EOS) graduates impacts outcomes.

Summary Of Background Data: Increasing spinal rigidity following treatment of EOS with GFI can limit curve correction at time of conversion to definitive spinal fusion.

Proximal foundation anchor variations and their correlation with unplanned return to the operating room (UPROR) in children with EOS treated with magnetically controlled growing rods (MCGR).

Introduction: The evolution of MCGR technique has led to modifications in the configuration of the proximal construct to decrease the incidence of implant-related complications (IRC) and revision surgeries. However, there is no data characterizing the performance of the most used configurations reducing the risk of complications.

Methods: 487 patients were identified from an international multicenter EOS database.

Learning Curve Associated With Thoracoscopic Anterior Vertebral Body Tether and Double Anterior Vertebral Body Tether for Idiopathic Scoliosis: Analysis of Three Independent Surgeons.

Background And Objectives: Anterior vertebral body tether (VBT) is a fusionless approach to treat idiopathic scoliosis, and surgeons are beginning to implement the technique into current practice. This study aims to evaluate the learning curve for single and double VBT.

Methods: A retrospective review of 3 surgeons' first 40 single and 20 double VBT was performed.