Matched comparison of non-fusion surgeries for adolescent idiopathic scoliosis: posterior dynamic distraction device and vertebral body tethering.
Adolescent idiopathic scoliosis
Non-fusion
Posterior dynamic distraction
Vertebral body tether
Journal
Spine deformity
ISSN: 2212-1358
Titre abrégé: Spine Deform
Pays: England
ID NLM: 101603979
Informations de publication
Date de publication:
08 Oct 2024
08 Oct 2024
Historique:
received:
30
06
2024
accepted:
25
09
2024
medline:
8
10
2024
pubmed:
8
10
2024
entrez:
8
10
2024
Statut:
aheadofprint
Résumé
Two non-fusion devices for adolescent idiopathic scoliosis (AIS) received HDE approval for clinical use in 2019: posterior dynamic distraction device (PDDD) and vertebral body tethering system (VBT). Although indications are similar, there is no comparative study of these devices. We hypothesize that curve correction will be comparable, but PDDD will have better perioperative metrics. AIS PDDD patients were prospectively enrolled in this matched multicenter study. Inclusion criteria were Lenke 1 or 5 curves, preoperative curves 35°-60°, correction to ≤30° on bending radiographs, and kyphosis <55°. Patients were matched by age, sex, Risser, curve type and curve magnitude to a single-center cohort of VBT patients. Results were compared at 2 years. 20 PDDD patients were matched to 20 VBT patients. Blood loss was higher in the VBT cohort (88 vs. 36 ml, p < 0.001). Operative time and postoperative length of stay were longer in the VBT cohort, 177 vs. 115 min (p < 0.001) (2.9 vs. 1.2 days, p < 0.001). Postoperative curve measurement and correction at 6 months were better in the PDDD cohort (15° vs. 24°, p < 0.001; 68% vs. 50%, p < 0.001). At 1-year, PDDD patients had improved Cobb angles (14° vs. 21°, p = 0.001). At 2 years, a correction was improved in the PDDD cohort, with a curve measurement of 17° for PDDD and 22° for VBT (p = 0.043). At the latest follow-up, 3 PDDD patients and 1 VBT patient underwent revision surgery. Early results show PDDD demonstrates better index correction, reduced operative time, less blood loss, and shorter length of stay but higher rates of revision compared to a matched cohort of VBT patients at two-year follow-up. Level II, prospective cohort matched comparative study.
Identifiants
pubmed: 39377901
doi: 10.1007/s43390-024-00982-0
pii: 10.1007/s43390-024-00982-0
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.
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