Evidence map›Paper›PMID 41236616›Full record

ArticleSpine deformity2026

Does skeletal maturity influence vertebral body tethering outcomes? evaluating the role of risser and sanders stages.

Ria Paradkar, Hans K Nugraha, Kellen L Mulford, Todd A Milbrandt, A Noelle Larson

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Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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3 · Its place in the literature

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3 citing papers in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Ria ParadkarDepartment of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W, Rochester, MN, 55906, USA.
Hans K NugrahaDepartment of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W, Rochester, MN, 55906, USA.
Kellen L MulfordOrthopedic Surgery Artificial Intelligence Laboratory, Mayo Clinic, Rochester, MN, USA.
Todd A MilbrandtDepartment of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W, Rochester, MN, 55906, USA.
A Noelle LarsonDepartment of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W, Rochester, MN, 55906, USA. larson.noelle@mayo.edu.ORCID http://orcid.org/0000-0001-6542-6975

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeVertebral body tethering (VBT) is a scoliosis correction technique that purportedly leverages spinal growth modulation to correct curves over time. Therefore, measures of skeletal maturity such as Risser and Sanders stages are often used in VBT patient selection. VBT in skeletally mature patients is sometimes seen as controversial or less predictable due to their limited remaining growth. This study compares VBT outcomes in Risser 0-2 vs. 3-5 and Sanders 1-4 vs. 5-8 patients.

methodsSingle institution retrospective review of 138 post-VBT patients with minimum 2-year follow-up. Patients were grouped by preop Risser and Sanders stages. Independent t-tests (alpha = 0.05) and Fisher's exact test were used for analysis of outcomes.

resultsNo significant differences were observed in BMI, number of levels instrumented, preop major curve magnitude, preop major curve flexibility, estimated blood loss (EBL), % correction at first erect (FE), % correction at 2-year follow-up, or reoperation rates, complication rates, or cord breakage rates between the skeletally mature and immature patients. Operative time was shorter in Sanders 5-8 patients compared to Sanders 1-4 patients (p = 0.0478). Length of hospital stay was slightly shorter in Risser 3-5 patients (p = 0.0080), with no difference between Sanders groups.

conclusionAt our center, Risser and Sanders stages did not significantly affect most VBT outcomes. Curve correction, reoperation rates, and complication rates were similar, suggesting that VBT can achieve comparable 2-year outcomes across a spectrum of skeletal maturity. However, given the shorter follow-up for the more skeletally mature patients, it remains possible that they may encounter issues such as cord breakage or require reoperation/fusion at rates similar to the less mature patients with longer follow-up. Larger studies are needed to determine the required degree of growth remaining for successful long-term outcomes and explore other factors associated with long-term success following VBT.

Indexed as

ScoliosisSpinal FusionVertebral BodyAdolescentChildFemaleFollow-Up StudiesHumansMaleReoperationRetrospective StudiesTreatment OutcomeAnterior growth modulationRisserSandersSkeletal maturityTether

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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.