Evidence map›Paper›PMID 38568378›Full record

ArticleSpine deformity2024

Analysis of three-dimensional spine growth for vertebral body tethering patients at 2 and 5 years post operatively.

Mathieu Boulet, Jennifer Hurry, David Skaggs, Michelle Cameron Welborn, Lindsay Andras, Craig Louer, A Noelle Larson, Firoz Miyanji, Stefan Parent, PSSG and 1 more

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Article in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mathieu BouletDepartment of Orthopaedic Surgery, Orthopaedic Clinic, IWK Health Centre, 5850 University Avenue, PO Box 9700, Halifax, NS, B3K 6R8, Canada.
Jennifer HurryDepartment of Orthopaedic Surgery, Orthopaedic Clinic, IWK Health Centre, 5850 University Avenue, PO Box 9700, Halifax, NS, B3K 6R8, Canada.
David SkaggsCedars Sinai Spine Center, Department of Orthopaedics, Los Angeles, CA, USA.
Michelle Cameron WelbornDepartment of Spine Surgery, Shriners Hospital for Children Portland, Portland, OR, USA.
Lindsay AndrasChildren's Hospital Los Angeles, Children's Orthopaedic Center, Los Angeles, CA, USA.
Craig LouerDepartment of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
A Noelle LarsonDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Firoz MiyanjiDepartment of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada.
Stefan ParentDepartment of Orthopaedic Surgery, CHU Sainte-Justine, Montreal, QC, Canada.
PSSG
Ron El-HawaryDepartment of Orthopaedic Surgery, Orthopaedic Clinic, IWK Health Centre, 5850 University Avenue, PO Box 9700, Halifax, NS, B3K 6R8, Canada. Ron.el-hawary@iwk.nshealth.ca.ORCID 0000-0003-2172-6188

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeScoliosis can be treated with vertebral body tethering (VBT) as a motion-sparing procedure. However, the knowledge of how growth is affected by a tether spanning multiple levels is unclear in the literature. Three-dimensional true spine length (3D-TSL) is a validated assessment technique that accounts for the shape of the spine in both the coronal and sagittal planes. This study aimed to assess if 3D-TSL increases over a five-year period after VBT implantation in thoracic curves for idiopathic scoliosis.

methodsProspectively collected radiographic data from an international pediatric spine registry was analyzed. Complete radiographic data over three visits (post-operative, 2 years, and 5 years) was available for 53 patients who underwent VBT.

resultsThe mean age at instrumentation of this cohort was 12.2 (9-15) years. The average number of vertebrae instrumented was 7.3 (SD 0.7). Maximum Cobb angles were 50° pre-op, which improved to 26° post-op (p < 0.001) and was maintained at 5 years (30°; p = 0.543). Instrumented Cobb angle was 22° at 5 years (p < 0.001 vs 5-year maximum Cobb angle). An accentuation was seen in global kyphosis from 29° pre-operative to 41° at 5 years (p < 0.05). The global spine length (T1-S1 3D-TSL) started at 40.6 cm; measured 42.8 cm at 2 years; and 44.0 cm at the final visit (all p < 0.05). At 5 years, patients reached an average T1-S1 length that is comparable to a normal population at maturity. Immediate mean post-operative instrumented 3D-TSL (top of UIV-top of LIV) was 13.8 cm two-year length was 14.3 cm; and five-year length was 14.6 cm (all p < 0.05). The mean growth of 0.09 cm per instrumented level at 2 years was approximately 50% of normal thoracic growth. Patients who grew more than 0.5 cm at 2 years had a significantly lower BMI (17.0 vs 19.0, p < 0.05) and smaller pre-operative scoliosis (48° vs 53°, p < 0.05). Other subgroup analyses were not significant for age, skeletal maturity, Cobb angles or number of spanned vertebras as contributing factors.

conclusionsThis series demonstrates that 3D-TSL increased significantly over the thoracic instrumented levels after VBT surgery for idiopathic scoliosis. This represented approximately 50% of expected normal thoracic growth over 2 years.

Indexed as

ScoliosisVertebral BodyAdolescentChildFemaleFollow-Up StudiesHumansImaging, Three-DimensionalMalePostoperative PeriodProspective StudiesRadiographySpineThoracic VertebraeTime FactorsTreatment Outcome3D3D-TSLAdolescent idiopathic scoliosis (AIS)Growth modulationSpine growthTrue spine lengthVertebral body tethering (VBT)

Identifiers

PMID38568378

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.