ArticleSpine deformity2023
Inter-screw index as a novel diagnostic indicator of tether breakage.
Article in Spine deformity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Posterior spinal fusion versus vertebral body tethering for paediatric scoliosis: a meta-analysis of comparative studies.Spine deformity · 2025Pooled it
- Analysis of tether breakages during revision after failed thoracolumbar double-row vertebral body tethering.Spine deformity · 2026Article
- Lumbar, thoracic, and bilateral vertebral body tethering: do surgical outcomes differ?Spine deformity · 2026Article
- Answer to the Letter to the Editor of A. Abudayeh, et al. concerning "Does screw alignment affect tether breakage in vertebral body tethering?" by S. Wan, et al. (Eur Spine J [2025]; doi: 10.1007/s00586-025-09299-6).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Letter to the Editor concerning "Does screw alignment affect tether breakage in vertebral body tethering?" by S. Wan, et al. (Eur Spine J [2025]; doi: 10.1007/s00586-025-09299-6).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Analysis of the risk factors for tether breakage after two-row vertebral body tethering (2RVBT) in adolescent idiopathic scoliosis (AIS).Spine deformity · 2025Article
- Does screw alignment affect tether breakage in vertebral body tethering?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Analysis of the risk factors for tether breakage after two-row vertebral body tethering (2RVBT) in adolescent idiopathic scoliosis (AIS).Spine deformity · 2025Article
- Where does the tether break in vertebral body tethering cases? Clinical insights from revision cases after tether breakage.Spine deformity · 2025Article
- A case series in vertebral body tethering results in improvement in coronal Cobb angle but deterioration in axial rotation: a 3-dimensional analysis.Journal of spine surgery (Hong Kong) · 2024Article
- A comparison of patients receiving vertebral body tethering for adolescent idiopathic scoliosis in the public and private hospital setting.Journal of orthopaedic surgery and research · 2024Article
- A multibody simulation of the spine for objectification of biomechanical quantities after VBT: a proof of concept and description of baseline data.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Inter-screw index as a novel diagnostic indicator of tether breakage.Spine deformity · 2023Article
- Redefining Success and Characterizing Midterm Growth Modulation: Analysis of Radiographic Outcomes in 2 Years Following Vertebral Body Tethering.JB & JS open accessArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTether breakage is the most common complication of Vertebral Body Tethering (VBT) occurring in up to 52% of Adolescent Idiopathic Scoliosis (AIS) patients and risks continued progression and revision. Radiographical diagnosis of tether breakage is commonly defined by a 5° increase in inter-screw angle and associates breakage with loss of correction. However, the sensitivity of this method was 56% only, suggesting that tethers can break without an increase in angulation, which was supported by other studies. To our knowledge, current literature lacks a method merely focusing on the diagnosis of tether breakage radiographically that does not associate the breakages with loss of correction.
methodsThis was a retrospective review of prospectively collected data of AIS patients who underwent VBT. The "inter-screw index" is defined as the percentage increase in inter-screw distance since post-op, with ≥ 13% increase defined as tether breakage as suggested by our mechanical tests. CTs were reviewed to identify the breakages and compared with inter-screw angle and inter-screw index.
results94 segments from 13 CTs were reviewed, and 15 tether breakages were identified. Use of inter-screw index correctly identified 14 breakages (93%), whereas ≥ 5° increase in inter-screw angle only identified 12 breakages (80%).
conclusionUse of inter-screw index is proven to be more sensitive than inter-screw angle in identifying tether breakages. Therefore, we propose the use of inter-screw index to diagnose tether breakages radiographically. Tether breakages were not necessarily accompanied by a loss of segmental correction leading to an increase in inter-screw angle, especially after skeletal maturity. LEVEL OF EVIDENCE: Level 3.
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