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Anterior vertebral body tethering shows clinically comparable shoulder balance outcomes to posterior spinal fusion.

Authors :
Meyers J
Eaker L
Samdani A
Miyanji F
Herrera M
Wilczek A
Alanay A
Yilgor C
Hoernschemeyer D
Shah S
Newton P
Lonner B
Source :
Spine deformity [Spine Deform] 2024 Jul; Vol. 12 (4), pp. 1033-1042. Date of Electronic Publication: 2024 Mar 22.
Publication Year :
2024

Abstract

Purpose: Posterior spinal fusion (PSF) is the current gold standard in surgical treatment for adolescent idiopathic scoliosis. Vertebral body tethering (VBT) is a fusionless alternative. Shoulder balance is an important metric for outcomes and patient satisfaction. Here we compare shoulder balance outcomes between PSF and VBT.<br />Methods: In this retrospective review, the pre-operative and post-operative absolute radiographic shoulder height (|RSH|) of 45 PSF patients were compared to 46 VBT patients. Mean values were compared and then collapsed into discrete groups (|RSH| GROUP) and compared. Patients were propensity score matched. Regression models based on pretest-posttest designs were used to compare procedure type on post-operative outcomes.<br />Results: Pre-operatively there were no differences in |RSH| between PSF and VBT, however, at latest post-operative follow-up PSF maintained a larger |RSH| imbalance compared to VBT (0.91 cm vs 0.63 cm, p = 0.021). In an ANCOVA regression, PSF was associated with a larger |RSH| imbalance compared to VBT, F(1, 88) = 5.76, p = 0.019. An ordinal logistic regression found that the odds ratio of being in a worse |RSH| GROUP for PSF vs VBT is 2.788 (95% CI = 1.099 to 7.075), a statistically significant effect χ <superscript>2</superscript> (1) = 4.658, p = 0.031. Results were similar in subgroup analyses of Lenke 1 and Lenke 2 patients, though to less statistical significance.<br />Conclusion: While PSF was found to be associated with worse |RSH| outcomes, the actual numbers (2-3 mm) are unlikely to be clinically meaningful. Thus, in this analysis, VBT can be said to show comparable shoulder balance outcomes to PSF.<br /> (© 2024. The Author(s), under exclusive licence to Scoliosis Research Society.)

Details

Language :
English
ISSN :
2212-1358
Volume :
12
Issue :
4
Database :
MEDLINE
Journal :
Spine deformity
Publication Type :
Academic Journal
Accession number :
38517667
Full Text :
https://doi.org/10.1007/s43390-024-00847-6