ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Clinical outcomes and complications of the posterior dynamic distraction device in adolescent idiopathic scoliosis: a systematic review and meta-analysis.
Review in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
7 authors.
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Abstract
purposeThe posterior dynamic distraction device (PDDD) is a fusionless implant for adolescent idiopathic scoliosis (AIS). We aimed to quantify pooled major-curve Cobb correction, complication, revision, and infection rates after primary PDDD implantation for Lenke 1 or 5 curves, and to place these outcomes in context alongside posterior spinal fusion (PSF) and vertebral body tethering (VBT).
methodsFollowing PRISMA guidance (PROSPERO: CRD420251074442), PubMed, Embase, Scopus, and Web of Science were searched to May 2025. Random-effects meta-analyses were performed for Cobb correction, complications, and revisions, with leave-one-out sensitivity analyses.
resultsFive studies (148 unique patients; mean age 13.1-16.0 years) met the inclusion criteria. Pooled mean Cobb correction was 22.8° (95% CI: 14.2-31.4°), approximately 51% of the preoperative magnitude; however, heterogeneity was extreme (I²=98%; prediction interval - 14.5° to 60.1°), and this pooled figure should not be interpreted as a reliable estimate of expected correction. The pooled complication rate was 24% (95% CI: 12-40%, I²=76%) and revision rate was 30% (95% CI: 19-45%, I²=64%), rising to 35% when elective exchanges for device outgrowth were included, with mechanical failures predominating. Primary surgical site infection occurred in 6% (95% CI: 3-12%, I²=0%). Risk of bias was moderate to serious across all studies.
conclusionPDDD provides moderate short-term curve correction, but approximately one in four patients experiences a complication and nearly one in three requires reoperation at short-term follow-up. Reported perioperative advantages derive from only two to three uncontrolled cohorts. PDDD does not yet match PSF for reliability or percentage correction, nor VBT for reoperation rates. Pending larger comparative studies with long-term follow-up, PDDD should be considered investigational and patients counselled accordingly.
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