Measurable Thoracic Motion Remains at 1 Year Following Anterior Vertebral Body Tethering, with Sagittal Motion Greater Than Coronal Motion
Anterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve spinal motion. There is limited information regarding the measurable motion that is maintained over the instrumented levels following thoraci...
Saved in:
| Published in: | Journal of bone and joint surgery. American volume Vol. 103; no. 24; p. 2299 |
|---|---|
| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
15.12.2021
|
| Subjects: | |
| ISSN: | 1535-1386, 1535-1386 |
| Online Access: | Get more information |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Anterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve spinal motion. There is limited information regarding the measurable motion that is maintained over the instrumented levels following thoracic anterior vertebral body tethering surgery in humans. The purpose of the present study was to assess radiographic spinal motion 1 year after anterior vertebral body tethering.
As part of a prospective U.S. Food and Drug Administration investigational device exemption study, 32 patients were treated with thoracic anterior vertebral body tethering. At 1 year postoperatively, patients were evaluated with standing flexion-extension and side-bending radiographs in a microdose biplanar slot scanning imaging system. The angle subtended by the screws at the upper instrumented vertebra (UIV) and lower instrumented vertebra (LIV) was measured on left and right-bending radiographs to evaluate the coronal arc of motion and was compared with preoperative values over the same levels. At 1 year postoperatively, the sagittal Cobb angle was measured over the instrumented levels on flexion and extension radiographs.
Side-bending radiographs revealed that the mean angle subtended by the screws changed from 15° ± 8° on left-bending radiographs to 8° ± 6° on right-bending radiographs. The mean coronal arc of motion on bending was 7° ± 6°, with 20 (62.5%) of 32 patients having a coronal arc of motion of >5°. The mean preoperative coronal arc of motion over the instrumented segments was 30° ± 9°. On flexion-extension lateral radiographs made at 1 year postoperatively, the mean kyphotic angle over the instrumented segments was 33° ± 13° in flexion and 11° ± 14° in extension, for a mean postoperative arc of motion of 21° ± 12° between flexion and extension radiographs.
At 1 year following thoracic anterior vertebral body tethering for the treatment of AIS, the thoracic spine showed a measurable range of coronal and sagittal plane motion over the instrumented levels without evidence of complete autofusion. Motion in the coronal plane decreased by 77% following anterior vertebral body tethering. These findings provide proof of concept that sagittal spinal motion is preserved after thoracic anterior vertebral body tethering, although the functional importance remains to be determined.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
|---|---|
| AbstractList | Anterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve spinal motion. There is limited information regarding the measurable motion that is maintained over the instrumented levels following thoracic anterior vertebral body tethering surgery in humans. The purpose of the present study was to assess radiographic spinal motion 1 year after anterior vertebral body tethering.BACKGROUNDAnterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve spinal motion. There is limited information regarding the measurable motion that is maintained over the instrumented levels following thoracic anterior vertebral body tethering surgery in humans. The purpose of the present study was to assess radiographic spinal motion 1 year after anterior vertebral body tethering.As part of a prospective U.S. Food and Drug Administration investigational device exemption study, 32 patients were treated with thoracic anterior vertebral body tethering. At 1 year postoperatively, patients were evaluated with standing flexion-extension and side-bending radiographs in a microdose biplanar slot scanning imaging system. The angle subtended by the screws at the upper instrumented vertebra (UIV) and lower instrumented vertebra (LIV) was measured on left and right-bending radiographs to evaluate the coronal arc of motion and was compared with preoperative values over the same levels. At 1 year postoperatively, the sagittal Cobb angle was measured over the instrumented levels on flexion and extension radiographs.METHODSAs part of a prospective U.S. Food and Drug Administration investigational device exemption study, 32 patients were treated with thoracic anterior vertebral body tethering. At 1 year postoperatively, patients were evaluated with standing flexion-extension and side-bending radiographs in a microdose biplanar slot scanning imaging system. The angle subtended by the screws at the upper instrumented vertebra (UIV) and lower instrumented vertebra (LIV) was measured on left and right-bending radiographs to evaluate the coronal arc of motion and was compared with preoperative values over the same levels. At 1 year postoperatively, the sagittal Cobb angle was measured over the instrumented levels on flexion and extension radiographs.Side-bending radiographs revealed that the mean angle subtended by the screws changed from 15° ± 8° on left-bending radiographs to 8° ± 6° on right-bending radiographs. The mean coronal arc of motion on bending was 7° ± 6°, with 20 (62.5%) of 32 patients having a coronal arc of motion of >5°. The mean preoperative coronal arc of motion over the instrumented segments was 30° ± 9°. On flexion-extension lateral radiographs made at 1 year postoperatively, the mean kyphotic angle over the instrumented segments was 33° ± 13° in flexion and 11° ± 14° in extension, for a mean postoperative arc of motion of 21° ± 12° between flexion and extension radiographs.RESULTSSide-bending radiographs revealed that the mean angle subtended by the screws changed from 15° ± 8° on left-bending radiographs to 8° ± 6° on right-bending radiographs. The mean coronal arc of motion on bending was 7° ± 6°, with 20 (62.5%) of 32 patients having a coronal arc of motion of >5°. The mean preoperative coronal arc of motion over the instrumented segments was 30° ± 9°. On flexion-extension lateral radiographs made at 1 year postoperatively, the mean kyphotic angle over the instrumented segments was 33° ± 13° in flexion and 11° ± 14° in extension, for a mean postoperative arc of motion of 21° ± 12° between flexion and extension radiographs.At 1 year following thoracic anterior vertebral body tethering for the treatment of AIS, the thoracic spine showed a measurable range of coronal and sagittal plane motion over the instrumented levels without evidence of complete autofusion. Motion in the coronal plane decreased by 77% following anterior vertebral body tethering. These findings provide proof of concept that sagittal spinal motion is preserved after thoracic anterior vertebral body tethering, although the functional importance remains to be determined.CONCLUSIONSAt 1 year following thoracic anterior vertebral body tethering for the treatment of AIS, the thoracic spine showed a measurable range of coronal and sagittal plane motion over the instrumented levels without evidence of complete autofusion. Motion in the coronal plane decreased by 77% following anterior vertebral body tethering. These findings provide proof of concept that sagittal spinal motion is preserved after thoracic anterior vertebral body tethering, although the functional importance remains to be determined.Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.LEVEL OF EVIDENCETherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Anterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve spinal motion. There is limited information regarding the measurable motion that is maintained over the instrumented levels following thoracic anterior vertebral body tethering surgery in humans. The purpose of the present study was to assess radiographic spinal motion 1 year after anterior vertebral body tethering. As part of a prospective U.S. Food and Drug Administration investigational device exemption study, 32 patients were treated with thoracic anterior vertebral body tethering. At 1 year postoperatively, patients were evaluated with standing flexion-extension and side-bending radiographs in a microdose biplanar slot scanning imaging system. The angle subtended by the screws at the upper instrumented vertebra (UIV) and lower instrumented vertebra (LIV) was measured on left and right-bending radiographs to evaluate the coronal arc of motion and was compared with preoperative values over the same levels. At 1 year postoperatively, the sagittal Cobb angle was measured over the instrumented levels on flexion and extension radiographs. Side-bending radiographs revealed that the mean angle subtended by the screws changed from 15° ± 8° on left-bending radiographs to 8° ± 6° on right-bending radiographs. The mean coronal arc of motion on bending was 7° ± 6°, with 20 (62.5%) of 32 patients having a coronal arc of motion of >5°. The mean preoperative coronal arc of motion over the instrumented segments was 30° ± 9°. On flexion-extension lateral radiographs made at 1 year postoperatively, the mean kyphotic angle over the instrumented segments was 33° ± 13° in flexion and 11° ± 14° in extension, for a mean postoperative arc of motion of 21° ± 12° between flexion and extension radiographs. At 1 year following thoracic anterior vertebral body tethering for the treatment of AIS, the thoracic spine showed a measurable range of coronal and sagittal plane motion over the instrumented levels without evidence of complete autofusion. Motion in the coronal plane decreased by 77% following anterior vertebral body tethering. These findings provide proof of concept that sagittal spinal motion is preserved after thoracic anterior vertebral body tethering, although the functional importance remains to be determined. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
| Author | Mathew, Smitha E Larson, A Noelle Buyuk, Abdul Fettah Milbrandt, Todd A |
| Author_xml | – sequence: 1 givenname: Abdul Fettah orcidid: 0000-0003-0316-5444 surname: Buyuk fullname: Buyuk, Abdul Fettah organization: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota – sequence: 2 givenname: Todd A orcidid: 0000-0001-9950-3668 surname: Milbrandt fullname: Milbrandt, Todd A – sequence: 3 givenname: Smitha E orcidid: 0000-0003-0679-5177 surname: Mathew fullname: Mathew, Smitha E – sequence: 4 givenname: A Noelle orcidid: 0000-0001-6542-6975 surname: Larson fullname: Larson, A Noelle |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34270505$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkM1Lw0AQxRep2A89epU9ejB1s8nm49gWWy0tgq2CpzBJJu1Kult3N5T-C_7VBqzi6Q383rzhTZ90lFZIyLXPhtxn0f18PF8NORsyXwTBGem1Ijw_SKLOv7lL-tZ-MMbCkMUXpBuEPGaCiR75WiLYxkBeI11vtYFCFnSpndSKvuAOpLIUHPXpO4KhU13X-iDVho6UQyO1oW9oHOYGajrW5ZGu0W1boDZ39CDdlq5gI51r6SlzZhDazfYWKDrRRqs_dknOK6gtXp10QF6nD-vJo7d4nj1NRguvCNoqHoZlxTgAj0JMkBeiSkuIWFCF6PMoqFJMRVVikgoWiaLIIQ2qPBaY5Mh4GKd8QG5_cvdGfzZoXbaTtsC6BoW6sRkXgqcJ4yJsrTcna5PvsMz2Ru7AHLPf__Fvll502w |
| CitedBy_id | crossref_primary_10_1097_BPO_0000000000002739 crossref_primary_10_1097_BPO_0000000000002959 crossref_primary_10_3390_children11020157 crossref_primary_10_3390_jcm13072013 crossref_primary_10_1007_s00586_022_07489_0 crossref_primary_10_1007_s43390_022_00578_6 crossref_primary_10_1097_BPO_0000000000002857 crossref_primary_10_1016_j_spinee_2023_09_011 crossref_primary_10_1097_BPO_0000000000003064 crossref_primary_10_3390_jcm11092576 crossref_primary_10_1007_s43390_024_00909_9 crossref_primary_10_1007_s43390_024_00855_6 crossref_primary_10_1007_s00586_021_07009_6 crossref_primary_10_1097_BPO_0000000000002099 crossref_primary_10_1097_BPO_0000000000002172 crossref_primary_10_1002_cnm_70084 crossref_primary_10_1007_s43390_023_00717_7 crossref_primary_10_1007_s43390_023_00662_5 crossref_primary_10_3390_jcm13216330 crossref_primary_10_1080_01616412_2022_2104293 crossref_primary_10_1177_10225536221137753 crossref_primary_10_1007_s00586_022_07321_9 crossref_primary_10_1227_ons_0000000000001212 crossref_primary_10_2106_JBJS_CC_23_00258 crossref_primary_10_1007_s00586_021_07076_9 crossref_primary_10_2106_JBJS_24_00033 crossref_primary_10_1007_s43390_022_00546_0 crossref_primary_10_5435_JAAOS_D_23_00312 crossref_primary_10_1007_s43390_024_01014_7 crossref_primary_10_3389_fped_2023_1133049 crossref_primary_10_3390_jcm13082209 crossref_primary_10_1007_s43390_023_00697_8 crossref_primary_10_1097_BRS_0000000000005072 crossref_primary_10_2106_JBJS_22_00127 crossref_primary_10_1097_CORR_0000000000003373 crossref_primary_10_1097_BSD_0000000000001521 crossref_primary_10_1002_jsp2_70098 crossref_primary_10_2106_JBJS_23_00503 crossref_primary_10_2106_JBJS_CC_24_00394 crossref_primary_10_1097_BSD_0000000000001484 crossref_primary_10_1007_s43390_025_01105_z crossref_primary_10_1007_s43390_025_01123_x crossref_primary_10_1007_s43390_024_00978_w crossref_primary_10_1007_s00586_024_08480_7 crossref_primary_10_1016_j_jor_2023_02_012 crossref_primary_10_1097_BPO_0000000000002202 |
| ContentType | Journal Article |
| Copyright | Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated. |
| Copyright_xml | – notice: Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.2106/JBJS.20.01533 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic MEDLINE |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| EISSN | 1535-1386 |
| ExternalDocumentID | 34270505 |
| Genre | Clinical Trial Journal Article |
| GroupedDBID | .XZ 08P 0R~ 123 29K 34G 36B 39C 4.4 53G 5RE 5RS 6NX 8F7 AAAAV AAAXR AAFTM AAGIX AAHPQ AAIQE AAMOA AAQKA AASCR AAWTL AAXQO ABASU ABDIG ABJNI ABPMR ABVCZ ABXVJ ABZZY ACEWG ACGFS ACGOD ACIJW ACILI ACIWK ACLDA ACNWC ACPRK ACXJB ACZKN ADGGA ADHPY AFBFQ AFCHL AFDTB AFMFG AFRAH AFUWQ AHMBA AHOMT AHQNM AIJEX AINUH AJCLO AJIOK AJNWD AJZMW AKCTQ AKULP ALKUP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AOQMC BOWHD BQLVK BYPQX C45 CGR CS3 CUY CVF D-I DIWNM E3Z EBS ECM EEVPB EIF EJD ERAAH F5P FCALG GNXGY GQDEL HLJTE IKREB IKYAY JG8 K-O L7B M5~ NPM O9- OCB OGEVE OHH OPUJH OVD OVDNE OVIDH OVLEI OXXIT PZZ RLZ SJN TEORI TSPGW VVN W1K WH7 YCJ YOC ZY1 ~H1 ~ZZ 7X8 ABPXF ACBKD ADKSD ADSXY RIG |
| ID | FETCH-LOGICAL-c3386-e4df02aa264e8e2c5f9da603f4e1263f9e95fde895065ccba93fb75e8be024792 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 47 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=00004623-202112150-00006&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1535-1386 |
| IngestDate | Sun Nov 09 10:54:07 EST 2025 Thu Apr 03 07:07:59 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 24 |
| Language | English |
| License | Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c3386-e4df02aa264e8e2c5f9da603f4e1263f9e95fde895065ccba93fb75e8be024792 |
| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
| ORCID | 0000-0001-9950-3668 0000-0003-0316-5444 0000-0003-0679-5177 0000-0001-6542-6975 |
| PMID | 34270505 |
| PQID | 2552980254 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2552980254 pubmed_primary_34270505 |
| PublicationCentury | 2000 |
| PublicationDate | 2021-12-15 20211215 |
| PublicationDateYYYYMMDD | 2021-12-15 |
| PublicationDate_xml | – month: 12 year: 2021 text: 2021-12-15 day: 15 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Journal of bone and joint surgery. American volume |
| PublicationTitleAlternate | J Bone Joint Surg Am |
| PublicationYear | 2021 |
| SSID | ssj0004407 |
| Score | 2.554384 |
| Snippet | Anterior vertebral body tethering is an alternative to fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) that is purported to preserve... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 2299 |
| SubjectTerms | Adolescent Bone Screws Child Feasibility Studies Female Humans Male Orthopedic Procedures - instrumentation Orthopedic Procedures - methods Postoperative Period Prospective Studies Range of Motion, Articular Scoliosis - physiopathology Scoliosis - surgery Thoracic Vertebrae - diagnostic imaging Thoracic Vertebrae - physiology Thoracic Vertebrae - surgery Treatment Outcome Vertebral Body - surgery |
| Title | Measurable Thoracic Motion Remains at 1 Year Following Anterior Vertebral Body Tethering, with Sagittal Motion Greater Than Coronal Motion |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/34270505 https://www.proquest.com/docview/2552980254 |
| Volume | 103 |
| WOSCitedRecordID | wos00004623-202112150-00006&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LT9tAEF7x6IELFFEg0KJF4lgTe9fr9Z4qQI1QRCLUhCg9Rev1OFhqbUgCiL_QX90Z26FcKiFx8cXyQzPf7nwzszPD2EmGWlZgQy-m8t8wMdKzWiXo8ygIYt9ZqIb2ja50vx-Px-a6CbjNm2OVyz2x2qjT0lGMvI3UV5iYare_3d17NDWKsqvNCI1Vti6RyhCq9fhVt_CwKpfGRa2o115U99hEJydqd8-7A_QOT33iO_9nl5WV6Wy99_8-ss2GX_KzGhDbbAWKHfanV0UCqUqKD29R6S53vFfN7-E_4LfNizm3Cx7wn4h73kFolE9o0vgZST0vZ3wEswVlmH_x8zJ95kOoywanXznFcfnATvMFsvjlO6u4A8zwW7bgF9Qj4eXeJ3bT-T68uPSaIQyeQ-818iBMM19Yi8QJYhBOZSa1kS-zEAIRycyAUVkKsVFIZpxLrJFZguqPE0Dzr43YZWtFWcA-46FIAxlAYpWgZKeOjXZagkyiNPW1li12vBTtBEFOmQtbQPkwn_wTbovt1fqZ3NXdOCYyFJrG8R284elDtiHoTEogvEB9ZusZLnH4wj64x0U-nx1V6MFr_7r3F1bEz90 |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Measurable+Thoracic+Motion+Remains+at+1+Year+Following+Anterior+Vertebral+Body+Tethering%2C+with+Sagittal+Motion+Greater+Than+Coronal+Motion&rft.jtitle=Journal+of+bone+and+joint+surgery.+American+volume&rft.au=Buyuk%2C+Abdul+Fettah&rft.au=Milbrandt%2C+Todd+A&rft.au=Mathew%2C+Smitha+E&rft.au=Larson%2C+A+Noelle&rft.date=2021-12-15&rft.eissn=1535-1386&rft.volume=103&rft.issue=24&rft.spage=2299&rft_id=info:doi/10.2106%2FJBJS.20.01533&rft_id=info%3Apmid%2F34270505&rft_id=info%3Apmid%2F34270505&rft.externalDocID=34270505 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1535-1386&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1535-1386&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1535-1386&client=summon |