Vertebral body tethering for idiopathic scoliosis: a systematic review and meta-analysis
Purpose Vertebral body tethering (VBT) is a recent procedure to correct and reduce spinal curves in skeletally immature patients with adolescent idiopathic scoliosis (AIS). The purpose of this systematic review and meta-analysis is to determine the expected curve reduction and potential complication...
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| Veröffentlicht in: | Spine deformity 2023-11, Vol.11 (6), p.1297-1307 |
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| creator | Roser, Megan J. Askin, Geoffrey N. Labrom, Robert D. Zahir, Syeda Farah Izatt, Maree Little, J. Paige |
| description | Purpose
Vertebral body tethering (VBT) is a recent procedure to correct and reduce spinal curves in skeletally immature patients with adolescent idiopathic scoliosis (AIS). The purpose of this systematic review and meta-analysis is to determine the expected curve reduction and potential complications for adolescent patients after VBT.
Methods
PubMed, Embase, Google Scholar and Cochrane databases were searched until February 2022. Records were screened against pre-defined inclusion and exclusion criteria. Data sources were prospective and retrospective studies. Demographics, mean differences in Cobb angle, surgical details and complication rates were recorded. Meta-analysis was conducted using a random-effects model.
Results
This systematic review includes 19 studies, and the meta-analysis includes 16 of these. VBT displayed a statistically significant reduction in Cobb angle from pre-operative to final (minimum 2 years) measurements. The initial mean Cobb angle was 47.8° (CI 95% 42.9–52.7°) and decreased to 22.2° (CI 95% 19.9–24.5°). The mean difference is − 25.8° (CI 95% − 28.9–22.7) (
p
|
| doi_str_mv | 10.1007/s43390-023-00723-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10587225</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2854434955</sourcerecordid><originalsourceid>FETCH-LOGICAL-c447t-23ab295da3ff77ad1336f54aec22bb3e2f699ef4683bb28da2d079e72fa4d1c63</originalsourceid><addsrcrecordid>eNp9kc9vFSEQx4mpsU3tP-DBcPSyFgb2lxfTNNqaNPGipjcyuwx9NLvLE3g177-X11df7KUcBgY-8wXmy9g7KT5KIdrzpJXqRSVAVSUtsX_FTgAkVFLV3dFhrW-P2VlK96KMrtOyq9-wY9VqBY3QJ-z2F8VMQ8SJD8Fueaa8ouiXO-5C5N76sMa88iNPY5h8SD594sjTNmWaMZf9SA-e_nBcLJ8pY4ULTtuCvWWvHU6Jzp7mU_bz65cfl9fVzferb5cXN9WodZsrUDhAX1tUzrUtWqlU42qNNAIMgyJwTd-T002nhgE6i2BF21MLDrWVY6NO2ee97nozzGRHWnL5jFlHP2PcmoDePD9Z_MrchQcjRd21AHVR-PCkEMPvDaVsZp9GmiZcKGySga7WWum-3qGwR8cYUorkDvdIYXa2mL0tpthiHm0xfSl6__8LDyX_TCiA2gNpves8RXMfNrH0Mb0k-xf5nprx</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2854434955</pqid></control><display><type>article</type><title>Vertebral body tethering for idiopathic scoliosis: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Roser, Megan J. ; Askin, Geoffrey N. ; Labrom, Robert D. ; Zahir, Syeda Farah ; Izatt, Maree ; Little, J. Paige</creator><creatorcontrib>Roser, Megan J. ; Askin, Geoffrey N. ; Labrom, Robert D. ; Zahir, Syeda Farah ; Izatt, Maree ; Little, J. Paige</creatorcontrib><description>Purpose
Vertebral body tethering (VBT) is a recent procedure to correct and reduce spinal curves in skeletally immature patients with adolescent idiopathic scoliosis (AIS). The purpose of this systematic review and meta-analysis is to determine the expected curve reduction and potential complications for adolescent patients after VBT.
Methods
PubMed, Embase, Google Scholar and Cochrane databases were searched until February 2022. Records were screened against pre-defined inclusion and exclusion criteria. Data sources were prospective and retrospective studies. Demographics, mean differences in Cobb angle, surgical details and complication rates were recorded. Meta-analysis was conducted using a random-effects model.
Results
This systematic review includes 19 studies, and the meta-analysis includes 16 of these. VBT displayed a statistically significant reduction in Cobb angle from pre-operative to final (minimum 2 years) measurements. The initial mean Cobb angle was 47.8° (CI 95% 42.9–52.7°) and decreased to 22.2° (CI 95% 19.9–24.5°). The mean difference is − 25.8° (CI 95% − 28.9–22.7) (
p
< 0.01). The overall complication rate was 23% (CI 95% 14.4–31.6%), the most common complication was tether breakage 21.9% (CI 95% 10.6–33.1%). The spinal fusion rate was 7.2% (CI 95% 2.3–12.1%).
Conclusion
VBT results in a significant reduction of AIS at 2 years of follow-up. Overall complication rate was relatively high although the consequences of the complications are unknown. Further research is required to explore the reasons behind the complication rate and determine the optimal timing for the procedure. VBT remains a promising new procedure that is effective at reducing scoliotic curves and preventing spinal fusion in the majority of patients.
Level of evidence
Systematic review of Therapeutic Studies with evidence level II–IV.</description><identifier>ISSN: 2212-134X</identifier><identifier>ISSN: 2212-1358</identifier><identifier>EISSN: 2212-1358</identifier><identifier>DOI: 10.1007/s43390-023-00723-9</identifier><identifier>PMID: 37432604</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adolescent ; Humans ; Medicine ; Medicine & Public Health ; Orthopedic Procedures - adverse effects ; Orthopedic Procedures - methods ; Orthopedics ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Review ; Review Article ; Scoliosis - surgery ; Treatment Outcome ; Vertebral Body - surgery</subject><ispartof>Spine deformity, 2023-11, Vol.11 (6), p.1297-1307</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-23ab295da3ff77ad1336f54aec22bb3e2f699ef4683bb28da2d079e72fa4d1c63</citedby><cites>FETCH-LOGICAL-c447t-23ab295da3ff77ad1336f54aec22bb3e2f699ef4683bb28da2d079e72fa4d1c63</cites><orcidid>0000-0003-0601-1475 ; 0000-0002-2074-6999 ; 0000-0001-8377-5343 ; 0000-0002-1734-0082 ; 0000-0002-4926-3077 ; 0000-0003-2543-8538</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s43390-023-00723-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s43390-023-00723-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37432604$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roser, Megan J.</creatorcontrib><creatorcontrib>Askin, Geoffrey N.</creatorcontrib><creatorcontrib>Labrom, Robert D.</creatorcontrib><creatorcontrib>Zahir, Syeda Farah</creatorcontrib><creatorcontrib>Izatt, Maree</creatorcontrib><creatorcontrib>Little, J. Paige</creatorcontrib><title>Vertebral body tethering for idiopathic scoliosis: a systematic review and meta-analysis</title><title>Spine deformity</title><addtitle>Spine Deform</addtitle><addtitle>Spine Deform</addtitle><description>Purpose
Vertebral body tethering (VBT) is a recent procedure to correct and reduce spinal curves in skeletally immature patients with adolescent idiopathic scoliosis (AIS). The purpose of this systematic review and meta-analysis is to determine the expected curve reduction and potential complications for adolescent patients after VBT.
Methods
PubMed, Embase, Google Scholar and Cochrane databases were searched until February 2022. Records were screened against pre-defined inclusion and exclusion criteria. Data sources were prospective and retrospective studies. Demographics, mean differences in Cobb angle, surgical details and complication rates were recorded. Meta-analysis was conducted using a random-effects model.
Results
This systematic review includes 19 studies, and the meta-analysis includes 16 of these. VBT displayed a statistically significant reduction in Cobb angle from pre-operative to final (minimum 2 years) measurements. The initial mean Cobb angle was 47.8° (CI 95% 42.9–52.7°) and decreased to 22.2° (CI 95% 19.9–24.5°). The mean difference is − 25.8° (CI 95% − 28.9–22.7) (
p
< 0.01). The overall complication rate was 23% (CI 95% 14.4–31.6%), the most common complication was tether breakage 21.9% (CI 95% 10.6–33.1%). The spinal fusion rate was 7.2% (CI 95% 2.3–12.1%).
Conclusion
VBT results in a significant reduction of AIS at 2 years of follow-up. Overall complication rate was relatively high although the consequences of the complications are unknown. Further research is required to explore the reasons behind the complication rate and determine the optimal timing for the procedure. VBT remains a promising new procedure that is effective at reducing scoliotic curves and preventing spinal fusion in the majority of patients.
Level of evidence
Systematic review of Therapeutic Studies with evidence level II–IV.</description><subject>Adolescent</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedic Procedures - adverse effects</subject><subject>Orthopedic Procedures - methods</subject><subject>Orthopedics</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Review</subject><subject>Review Article</subject><subject>Scoliosis - surgery</subject><subject>Treatment Outcome</subject><subject>Vertebral Body - surgery</subject><issn>2212-134X</issn><issn>2212-1358</issn><issn>2212-1358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kc9vFSEQx4mpsU3tP-DBcPSyFgb2lxfTNNqaNPGipjcyuwx9NLvLE3g177-X11df7KUcBgY-8wXmy9g7KT5KIdrzpJXqRSVAVSUtsX_FTgAkVFLV3dFhrW-P2VlK96KMrtOyq9-wY9VqBY3QJ-z2F8VMQ8SJD8Fueaa8ouiXO-5C5N76sMa88iNPY5h8SD594sjTNmWaMZf9SA-e_nBcLJ8pY4ULTtuCvWWvHU6Jzp7mU_bz65cfl9fVzferb5cXN9WodZsrUDhAX1tUzrUtWqlU42qNNAIMgyJwTd-T002nhgE6i2BF21MLDrWVY6NO2ee97nozzGRHWnL5jFlHP2PcmoDePD9Z_MrchQcjRd21AHVR-PCkEMPvDaVsZp9GmiZcKGySga7WWum-3qGwR8cYUorkDvdIYXa2mL0tpthiHm0xfSl6__8LDyX_TCiA2gNpves8RXMfNrH0Mb0k-xf5nprx</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Roser, Megan J.</creator><creator>Askin, Geoffrey N.</creator><creator>Labrom, Robert D.</creator><creator>Zahir, Syeda Farah</creator><creator>Izatt, Maree</creator><creator>Little, J. Paige</creator><general>Springer International Publishing</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0601-1475</orcidid><orcidid>https://orcid.org/0000-0002-2074-6999</orcidid><orcidid>https://orcid.org/0000-0001-8377-5343</orcidid><orcidid>https://orcid.org/0000-0002-1734-0082</orcidid><orcidid>https://orcid.org/0000-0002-4926-3077</orcidid><orcidid>https://orcid.org/0000-0003-2543-8538</orcidid></search><sort><creationdate>20231101</creationdate><title>Vertebral body tethering for idiopathic scoliosis: a systematic review and meta-analysis</title><author>Roser, Megan J. ; Askin, Geoffrey N. ; Labrom, Robert D. ; Zahir, Syeda Farah ; Izatt, Maree ; Little, J. Paige</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-23ab295da3ff77ad1336f54aec22bb3e2f699ef4683bb28da2d079e72fa4d1c63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedic Procedures - adverse effects</topic><topic>Orthopedic Procedures - methods</topic><topic>Orthopedics</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Review</topic><topic>Review Article</topic><topic>Scoliosis - surgery</topic><topic>Treatment Outcome</topic><topic>Vertebral Body - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roser, Megan J.</creatorcontrib><creatorcontrib>Askin, Geoffrey N.</creatorcontrib><creatorcontrib>Labrom, Robert D.</creatorcontrib><creatorcontrib>Zahir, Syeda Farah</creatorcontrib><creatorcontrib>Izatt, Maree</creatorcontrib><creatorcontrib>Little, J. Paige</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Spine deformity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roser, Megan J.</au><au>Askin, Geoffrey N.</au><au>Labrom, Robert D.</au><au>Zahir, Syeda Farah</au><au>Izatt, Maree</au><au>Little, J. Paige</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vertebral body tethering for idiopathic scoliosis: a systematic review and meta-analysis</atitle><jtitle>Spine deformity</jtitle><stitle>Spine Deform</stitle><addtitle>Spine Deform</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>11</volume><issue>6</issue><spage>1297</spage><epage>1307</epage><pages>1297-1307</pages><issn>2212-134X</issn><issn>2212-1358</issn><eissn>2212-1358</eissn><abstract>Purpose
Vertebral body tethering (VBT) is a recent procedure to correct and reduce spinal curves in skeletally immature patients with adolescent idiopathic scoliosis (AIS). The purpose of this systematic review and meta-analysis is to determine the expected curve reduction and potential complications for adolescent patients after VBT.
Methods
PubMed, Embase, Google Scholar and Cochrane databases were searched until February 2022. Records were screened against pre-defined inclusion and exclusion criteria. Data sources were prospective and retrospective studies. Demographics, mean differences in Cobb angle, surgical details and complication rates were recorded. Meta-analysis was conducted using a random-effects model.
Results
This systematic review includes 19 studies, and the meta-analysis includes 16 of these. VBT displayed a statistically significant reduction in Cobb angle from pre-operative to final (minimum 2 years) measurements. The initial mean Cobb angle was 47.8° (CI 95% 42.9–52.7°) and decreased to 22.2° (CI 95% 19.9–24.5°). The mean difference is − 25.8° (CI 95% − 28.9–22.7) (
p
< 0.01). The overall complication rate was 23% (CI 95% 14.4–31.6%), the most common complication was tether breakage 21.9% (CI 95% 10.6–33.1%). The spinal fusion rate was 7.2% (CI 95% 2.3–12.1%).
Conclusion
VBT results in a significant reduction of AIS at 2 years of follow-up. Overall complication rate was relatively high although the consequences of the complications are unknown. Further research is required to explore the reasons behind the complication rate and determine the optimal timing for the procedure. VBT remains a promising new procedure that is effective at reducing scoliotic curves and preventing spinal fusion in the majority of patients.
Level of evidence
Systematic review of Therapeutic Studies with evidence level II–IV.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37432604</pmid><doi>10.1007/s43390-023-00723-9</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-0601-1475</orcidid><orcidid>https://orcid.org/0000-0002-2074-6999</orcidid><orcidid>https://orcid.org/0000-0001-8377-5343</orcidid><orcidid>https://orcid.org/0000-0002-1734-0082</orcidid><orcidid>https://orcid.org/0000-0002-4926-3077</orcidid><orcidid>https://orcid.org/0000-0003-2543-8538</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2212-134X |
| ispartof | Spine deformity, 2023-11, Vol.11 (6), p.1297-1307 |
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| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adolescent Humans Medicine Medicine & Public Health Orthopedic Procedures - adverse effects Orthopedic Procedures - methods Orthopedics Postoperative Complications - epidemiology Postoperative Complications - etiology Review Review Article Scoliosis - surgery Treatment Outcome Vertebral Body - surgery |
| title | Vertebral body tethering for idiopathic scoliosis: a systematic review and meta-analysis |
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