Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves.

Publication ,  Journal Article
Catanzano, AA; Newton, PO; Bastrom, TP; Bartley, CE; Parent, S; Miyanji, F; Hoernschemeyer, DG; Alanay, A; Blakemore, L; Neal, K; Lonner, B ...
Published in: J Bone Joint Surg Am
September 21, 2022

BACKGROUND: Growth modulation through anterior vertebral body tethering (AVBT) has emerged as a fusionless option for the treatment of progressive scoliosis. When tethering the main thoracic curve, the compensatory thoracolumbar/lumbar curve must correct indirectly as a result. The present study evaluated the response of these lumbar curves following AVBT of the main thoracic curves. METHODS: Patients who underwent thoracic AVBT and who had a minimum follow-up of 2 years were included. Magnitudes of the thoracic and lumbar curves were recorded preoperatively and at the first-erect and 2-year postoperative visits. Lumbar curves were further stratified according to their lumbar modifier (A, B, or C). Analysis of variance (ANOVA) and repeated-measures ANOVA were performed to compare correction rates, and the Pearson coefficient was utilized to determine the correlation between the tethered thoracic curve and uninstrumented lumbar curve magnitudes. RESULTS: A total of 218 patients were included. Thoracic curve correction was 40% at the first-erect visit and 43% at 2 years (p = 0.012). Lumbar correction was 30%, 26%, and 18% at the first-erect visit (p < 0.001 for all compared with preoperatively) and minimally changed at 31%, 26%, and 24% at 2 years for lumbar modifiers A, B, and C, respectively. A total of 118 patients (54%) showed thoracic curve improvement between the first-erect and 2-year visits. In a subgroup analysis, these patients had a correction in lumbar curve magnitude from preoperatively to the first-erect visit of 30%, 22%, and 16% for lumbar modifiers A, B, C, respectively, that increased to 42%, 34%, and 31% at 2 years, with strong correlation to thoracic correction at 2-year follow-up (r = 0.557, p < 0.001). CONCLUSIONS: Although there was immediate lumbar correction following AVBT of a main thoracic curve, further improvement following initial correction was only observed among patients with growth modulation of the thoracic curve. Considering all patients, the uninstrumented lumbar curve corrected 30% at 2 years and the instrumented thoracic curve corrected 40%. As indications for AVBT are refined, these data will provide insight into the response of the uninstrumented lumbar curve. LEVEL OF EVIDENCE: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Bone Joint Surg Am

DOI

EISSN

1535-1386

Publication Date

September 21, 2022

Volume

104

Issue

18

Start / End Page

1629 / 1638

Location

United States

Related Subject Headings

  • Vertebral Body
  • Treatment Outcome
  • Thoracic Vertebrae
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Radiography
  • Orthopedics
  • Lumbar Vertebrae
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Catanzano, A. A., Newton, P. O., Bastrom, T. P., Bartley, C. E., Parent, S., Miyanji, F., … on behalf of the Harms Non-Fusion Study Group Investigators, . (2022). Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves. J Bone Joint Surg Am, 104(18), 1629–1638. https://doi.org/10.2106/JBJS.21.01500
Catanzano, Anthony A., Peter O. Newton, Tracey P. Bastrom, Carrie E. Bartley, Stefan Parent, Firoz Miyanji, Daniel G. Hoernschemeyer, et al. “Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves.J Bone Joint Surg Am 104, no. 18 (September 21, 2022): 1629–38. https://doi.org/10.2106/JBJS.21.01500.
Catanzano AA, Newton PO, Bastrom TP, Bartley CE, Parent S, Miyanji F, et al. Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves. J Bone Joint Surg Am. 2022 Sep 21;104(18):1629–38.
Catanzano, Anthony A., et al. “Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves.J Bone Joint Surg Am, vol. 104, no. 18, Sept. 2022, pp. 1629–38. Pubmed, doi:10.2106/JBJS.21.01500.
Catanzano AA, Newton PO, Bastrom TP, Bartley CE, Parent S, Miyanji F, Hoernschemeyer DG, Alanay A, Blakemore L, Neal K, Lonner B, Haber L, Shah SA, Yaszay B, on behalf of the Harms Non-Fusion Study Group Investigators. Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves. J Bone Joint Surg Am. 2022 Sep 21;104(18):1629–1638.

Published In

J Bone Joint Surg Am

DOI

EISSN

1535-1386

Publication Date

September 21, 2022

Volume

104

Issue

18

Start / End Page

1629 / 1638

Location

United States

Related Subject Headings

  • Vertebral Body
  • Treatment Outcome
  • Thoracic Vertebrae
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Radiography
  • Orthopedics
  • Lumbar Vertebrae
  • Humans