Akademik Veri Yönetim Sistemi
SPINE DEFORMITY, cilt.12, sa.3, ss.651-662, 2024 (ESCI)
PURPOSE: Vertebral body tethering (VBT) is a non-fusion alternative to posterior spinal fusion (PSF). There have been few reports on VBT of two curvatures. We aim to compare the radiographic outcomes between VBT and PSF in patients with double curvatures in which both curves were instrumented. METHODS: 29 AIS patients matched by Lenke, age (+/- 2 years), triradiate cartilage closure status, major Cobb angle (+/- 8 degrees), and T5-T12 kyphosis (+/- 10 degrees). Variables were compared using Wilcoxon rank-sum tests, Student's t tests, and chi-Square. Clinical success was defined as major curve < 35 degrees. RESULTS: Group baseline demographics were similar. Major thoracic (T) curve types had significantly better major (VBT 51.5 +/- 7.9 degrees to 31.6 +/- 12.0 degrees [40%] vs. PSF 54.3 +/- 7.4 degrees to 17.4 +/- 6.5 degrees [68%]; p = 0.0002) and secondary curve correction in the PSF group. 71% of major T VBT patients were clinically successful versus 100% of PSF. Major thoracolumbar (TL) curve types experienced comparable major (VBT 52.3 +/- 7.0 degrees to 18.3 +/- 11.4 degrees (65%) vs. PSF 53.0 +/- 5.2 degrees to 23.8 +/- 10.9 degrees (56%); p = 0.2397) and secondary curve correction. 92% of major TL VBT patients were clinically successful versus 75% in the PSF group. There was no difference in T5-12 kyphosis or lumbar lordosis between groups for any curve type. There were 4 patients (13.8%) with major complications in the VBT group compared to 0 (0%) in the PSF. Conclusion : Patients with double major AIS who underwent VBT with major T curve types had less correction than PSF; however, those with major TL curves experienced similar radiographic outcomes regardless of procedure. Complications were greater for VBT.