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

Adolescent Idiopathic Scoliosis Anterior vertebral tethering Fusion Scoliosis Spine Tether

Journal

Spine deformity
ISSN: 2212-1358
Titre abrégé: Spine Deform
Pays: England
ID NLM: 101603979

Informations de publication

Date de publication:
22 Mar 2024
Historique:
received: 19 09 2023
accepted: 14 02 2024
medline: 22 3 2024
pubmed: 22 3 2024
entrez: 22 3 2024
Statut: aheadofprint

Résumé

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. 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. 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 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.

Identifiants

pubmed: 38517667
doi: 10.1007/s43390-024-00847-6
pii: 10.1007/s43390-024-00847-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Scoliosis Research Society.

Références

Weinstein SL (1989) Adolescent idiopathic scoliosis: prevalence and natural history. Instr Course Lect 38:115–128
pubmed: 2649564
Fong DY et al (2015) A population-based cohort study of 394,401 children followed for 10 years exhibits sustained effectiveness of scoliosis screening. Spine J 15(5):825–833
pubmed: 25615844 doi: 10.1016/j.spinee.2015.01.019
Weinstein SL (2019) The natural history of adolescent idiopathic scoliosis. J Pediatr Orthop 39(Issue 6, Supplement 1 Suppl 1):S44–S46
pubmed: 31169647 doi: 10.1097/BPO.0000000000001350
Weinstein SL et al (2008) Adolescent idiopathic scoliosis. Lancet 371(9623):1527–1537
pubmed: 18456103 doi: 10.1016/S0140-6736(08)60658-3
Mankin HJ, Graham JJ, Schack J (1964) Cardiopulmonary function in mild and moderate idiopathic scoliosis. J Bone Joint Surg Am 46:53–62
pubmed: 14104314 doi: 10.2106/00004623-196446010-00005
Aaro S, Ohlund C (1984) Scoliosis and pulmonary function. Spine 9(2):220–222
pubmed: 6729583 doi: 10.1097/00007632-198403000-00015
Tsiligiannis T, Grivas T (2012) Pulmonary function in children with idiopathic scoliosis. Scoliosis 7(1):7
pubmed: 22445133 pmcid: 3410782 doi: 10.1186/1748-7161-7-7
Van Hooff ML, Te Hennepe N, De Kleuver M (2020) Pulmonary function in patients with spinal deformity: have we been ignorant? Acta Orthop 91(5):503–505
pubmed: 32619109 pmcid: 8023902 doi: 10.1080/17453674.2020.1786267
Calvo-Munoz I, Gomez-Conesa A, Sanchez-Meca J (2013) Prevalence of low back pain in children and adolescents: a meta-analysis. BMC Pediatr 13:14
pubmed: 23351394 pmcid: 3571904 doi: 10.1186/1471-2431-13-14
Dimar JR 2nd, Glassman SD, Carreon LY (2007) Juvenile degenerative disc disease: a report of 76 cases identified by magnetic resonance imaging. Spine J 7(3):332–337
pubmed: 17482117 doi: 10.1016/j.spinee.2006.03.008
Payne WK 3rd et al (1997) Does scoliosis have a psychological impact and does gender make a difference? Spine 22(12):1380–1384
pubmed: 9201842 doi: 10.1097/00007632-199706150-00017
Tones M, Moss N, Polly DW Jr (2006) A review of quality of life and psychosocial issues in scoliosis. Spine 31(26):3027–3038
pubmed: 17173000 doi: 10.1097/01.brs.0000249555.87601.fc
Roberts SB, Tsirikos AI, Subramanian AS (2014) Posterior spinal fusion for adolescent idiopathic thoracolumbar/lumbar scoliosis: clinical outcomes and predictive radiological factors for extension of fusion distal to caudal end vertebra. Bone Joint J 96-B(8):1082–1089
pubmed: 25086125 doi: 10.1302/0301-620X.96B8.33837
Kwan MK et al (2021) Perioperative outcome and complications following single-staged Posterior Spinal Fusion (PSF) using pedicle screw instrumentation in Adolescent Idiopathic Scoliosis (AIS): a review of 1057 cases from a single centre. BMC Musculoskelet Disord 22(1):413
pubmed: 33947368 pmcid: 8097957 doi: 10.1186/s12891-021-04225-5
Wagner SC, Lehman RA, Lenke LG (2015) Surgical management of adolescent idiopathic scoliosis. Semin Spine Surg 27(1):33–38
doi: 10.1053/j.semss.2015.01.008
Lonner BS et al (2018) Evolution of surgery for adolescent idiopathic scoliosis over 20 years: have outcomes improved? Spine 43(6):402–410
pubmed: 28723878 doi: 10.1097/BRS.0000000000002332
Parent S, Shen J (2020) Anterior vertebral body growth-modulation tethering in idiopathic scoliosis: surgical technique. J Am Acad Orthop Surg 28(17):693–699
pubmed: 32618681 doi: 10.5435/JAAOS-D-19-00849
Newton PO et al (2018) Anterior spinal growth tethering for skeletally immature patients with scoliosis: a retrospective look two to four years postoperatively. J Bone Joint Surg Am 100(19):1691–1697
pubmed: 30277999 doi: 10.2106/JBJS.18.00287
Samdani AF et al (2014) Anterior vertebral body tethering for idiopathic scoliosis: two-year results. Spine 39(20):1688–1693
pubmed: 24921854 doi: 10.1097/BRS.0000000000000472
Boudissa M et al (2017) Early outcomes of spinal growth tethering for idiopathic scoliosis with a novel device: a prospective study with 2 years of follow-up. Childs Nerv Syst 33(5):813–818
pubmed: 28324184 doi: 10.1007/s00381-017-3367-4
Buchanan R et al (2003) Do you see what I see? Looking at scoliosis surgical outcomes through orthopedists’ eyes. Spine 28(24):2700–2704
pubmed: 14673372 doi: 10.1097/01.BRS.0000103383.81904.5A
Auerbach JD et al (2014) Body image in patients with adolescent idiopathic scoliosis: validation of the body image disturbance questionnaire-scoliosis version. J Bone Joint Surg Am 96(8):e61
pubmed: 24740669 doi: 10.2106/JBJS.L.00867
Suk SI et al (2000) Indications of proximal thoracic curve fusion in thoracic adolescent idiopathic scoliosis: recognition and treatment of double thoracic curve pattern in adolescent idiopathic scoliosis treated with segmental instrumentation. Spine 25(18):2342–2349
pubmed: 10984786 doi: 10.1097/00007632-200009150-00012
Smith PL et al (2006) Parents’ and patients’ perceptions of postoperative appearance in adolescent idiopathic scoliosis. Spine 31(20):2367–2374
pubmed: 16985466 doi: 10.1097/01.brs.0000240204.98960.dd
Terheyden JH et al (2018) Rasterstereography versus radiography for assessing shoulder balance in idiopathic scoliosis: a validation study relative to patients’ self-image. J Back Musculoskelet Rehabil 31(6):1049–1057
pubmed: 29945339 doi: 10.3233/BMR-170867
Lee SY et al (2023) Patients’ perception and satisfaction on neck and shoulder imbalance in adolescent idiopathic scoliosis. Global Spine J 13(3):752–763
pubmed: 33823628 doi: 10.1177/21925682211007795
Ilharreborde B et al (2008) How to determine the upper level of instrumentation in Lenke types 1 and 2 adolescent idiopathic scoliosis: a prospective study of 132 patients. J Pediatr Orthop 28(7):733–739
pubmed: 18812899 doi: 10.1097/BPO.0b013e318185a36b
Trobisch PD et al (2013) Choosing fusion levels in adolescent idiopathic scoliosis. J Am Acad Orthop Surg 21(9):519–528
pubmed: 23996983
Donaldson S et al (2007) Surgical decision making in adolescent idiopathic scoliosis. Spine 32(14):1526–1532
pubmed: 17572623 doi: 10.1097/BRS.0b013e318067dc75
Lonner B et al (2020) The patient generated index and decision regret in adolescent idiopathic scoliosis. Spine Deform 8(6):1231–1238
pubmed: 32588338 doi: 10.1007/s43390-020-00155-9
Miyanji F et al (2021) Shoulder balance in patients with Lenke type 1 and 2 idiopathic scoliosis appears satisfactory at 2 years following anterior vertebral body tethering of the spine. Spine Deform 9(6):1591–1599
pubmed: 34133015 doi: 10.1007/s43390-021-00374-8
Kuklo TR et al (2002) Correlation of radiographic, clinical, and patient assessment of shoulder balance following fusion versus nonfusion of the proximal thoracic curve in adolescent idiopathic scoliosis. Spine 27(18):2013–2020
pubmed: 12634561 doi: 10.1097/00007632-200209150-00009
O’Brien MF et al (2008) Radiographic measurement manual: spinal deformity study group. Medtronic Sofamor Danek USA, Inc., Memphis
Dang NR et al (2005) Intra-observer reproducibility and interobserver reliability of the radiographic parameters in the Spinal Deformity Study Group’s AIS Radiographic Measurement Manual. Spine 30(9):1064–1069
pubmed: 15864160 doi: 10.1097/01.brs.0000160840.51621.6b
Kwan MK et al (2016) Is neck tilt and shoulder imbalance the same phenomenon? A prospective analysis of 89 adolescent idiopathic scoliosis patients (Lenke type 1 and 2). Eur Spine J 25(2):401–408
pubmed: 25962815 doi: 10.1007/s00586-015-4016-9
Kuklo TR et al (2001) Spontaneous proximal thoracic curve correction after isolated fusion of the main thoracic curve in adolescent idiopathic scoliosis. Spine 26(18):1966–1975
pubmed: 11547194 doi: 10.1097/00007632-200109150-00006
Lee CS et al (2011) Changes of upper thoracic curve and shoulder balance in thoracic adolescent idiopathic scoliosis treated by anterior selective thoracic fusion using VATS. J Spinal Disord Tech 24(7):462–468
pubmed: 21164363 doi: 10.1097/BSD.0b013e318204d553
Han X et al (2016) Clavicle chest cage angle difference: is it a radiographic and clinical predictor of postoperative shoulder imbalance in Lenke I adolescent idiopathic scoliosis? Spine (Phila Pa 1976) 41(17):1346–1354
pubmed: 26909841 doi: 10.1097/BRS.0000000000001521
Wei Chan CY et al (2020) An analysis of preoperative shoulder and neck balance and surgical outcome in 111 adolescent idiopathic scoliosis patients with two subtypes of Lenke 1 curves. J Neurosurg Spine 34(1):37–44
pubmed: 32858516
Dimitrov DM, Rumrill PD Jr (2003) Pretest-posttest designs and measurement of change. Work 20(2):159–165
pubmed: 12671209
Mathew SE et al (2022) Vertebral body tethering compared to posterior spinal fusion for skeletally immature adolescent idiopathic scoliosis patients: preliminary results from a matched case-control study. Spine Deform 10(5):1123–1131
pubmed: 35610543 doi: 10.1007/s43390-022-00519-3
Siu JW et al (2023) Perioperative outcomes of open anterior vertebral body tethering and instrumented posterior spinal fusion for skeletally immature patients with idiopathic scoliosis. J Pediatr Orthop 43(3):143–150
pubmed: 36746139 doi: 10.1097/BPO.0000000000002320
Newton PO et al (2022) Anterior vertebral body tethering compared with posterior spinal fusion for major thoracic curves: a retrospective comparison by the Harms Study Group. J Bone Joint Surg Am 104(24):2170–2177
pubmed: 37010479 doi: 10.2106/JBJS.22.00127
Tang X et al (2016) The spontaneous development of cosmetic shoulder balance and shorter segment fusion in adolescent idiopathic scoliosis with Lenke I curve: a consecutive study followed up for 2 to 5 years. Spine (Phila Pa 1976) 41(12):1028–1035
pubmed: 27294809 doi: 10.1097/BRS.0000000000001442
Gotfryd AO et al (2017) Predictors for postoperative shoulder balance in Lenke 1 adolescent idiopathic scoliosis: a prospective cohort study. Spine Deform 5(1):66–71
pubmed: 28038696 doi: 10.1016/j.jspd.2016.09.046
Lee CK et al (1993) Analysis of the upper thoracic curve in surgically treated idiopathic scoliosis. A new concept of the double thoracic curve pattern. Spine (Phila Pa 1976) 18(12):1599–1608
pubmed: 8235838 doi: 10.1097/00007632-199309000-00006
Brooks JT et al (2018) In search of the ever-elusive postoperative shoulder balance: is the T2 UIV the key? Spine Deform 6(6):707–711
pubmed: 30348348 doi: 10.1016/j.jspd.2018.03.010
Rose PS, Lenke LG (2007) Classification of operative adolescent idiopathic scoliosis: treatment guidelines. Orthop Clin North Am 38(4):521–529
pubmed: 17945131 doi: 10.1016/j.ocl.2007.06.001
Bjerke BT et al (2015) Do current recommendations for upper instrumented vertebra predict shoulder imbalance? An attempted validation of level selection for adolescent idiopathic scoliosis. HSS J 11(3):216–222
pubmed: 26981056 pmcid: 4773683 doi: 10.1007/s11420-015-9451-y
King HA et al (1983) The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am 65(9):1302–1313
pubmed: 6654943 doi: 10.2106/00004623-198365090-00012
Baroncini A et al (2021) Return to sport and daily life activities after vertebral body tethering for AIS: analysis of the sport activity questionnaire. Eur Spine J 30(7):1998–2006
pubmed: 33638722 doi: 10.1007/s00586-021-06768-6
Gajaseni P et al (2022) Achieving shoulder balance using medial and lateral radiological measures in adolescent idiopathic scoliosis. Iowa Orthop J 42(1):47–51
pubmed: 35821947 pmcid: 9210422
Qiu XS et al (2009) Discrepancy between radiographic shoulder balance and cosmetic shoulder balance in adolescent idiopathic scoliosis patients with double thoracic curve. Eur Spine J 18(1):45–51
pubmed: 19043746 doi: 10.1007/s00586-008-0833-4
Sharma S et al (2016) How well do radiologic assessments of truncal and shoulder balance correlate with cosmetic assessment indices in Lenke 1C adolescent idiopathic scoliosis? Clin Spine Surg 29(8):341–351
pubmed: 25374382 doi: 10.1097/BSD.0000000000000134

Auteurs

James Meyers (J)

Department of Orthopaedics, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 5 E 98th St., 4th Floor, New York, NY, 10029, USA.

Lily Eaker (L)

Department of Orthopaedics, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 5 E 98th St., 4th Floor, New York, NY, 10029, USA.

Amer Samdani (A)

Department of Neurosurgery, Shriners Hospital-Philadelphia, Philadelphia, PA, USA.

Firoz Miyanji (F)

Department of Orthopedics, British Columbia Children's Hospital, Vancouver, BC, Canada.

Michael Herrera (M)

Department of Orthopaedics, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 5 E 98th St., 4th Floor, New York, NY, 10029, USA.

Ashley Wilczek (A)

Department of Orthopaedics, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 5 E 98th St., 4th Floor, New York, NY, 10029, USA.

Ahmet Alanay (A)

Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.

Caglar Yilgor (C)

Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.

Daniel Hoernschemeyer (D)

Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.

Suken Shah (S)

Department of Orthopaedics, Nemours Children's Hospital, Wilmington, DE, USA.

Peter Newton (P)

Department of Orthopaedics, Rady Children's Hospital, San Diego, CA, USA.

Baron Lonner (B)

Department of Orthopaedics, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 5 E 98th St., 4th Floor, New York, NY, 10029, USA. baron.lonner@mountsinai.org.

Classifications MeSH