How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis? A Nonrandomized Clinical Trial
Abstract
BACKGROUND
Recently, there has been an increased interest in alternative surgical options for treating idiopathic scoliosis. For instance, anterior vertebral body tethering (AVBT) is an emerging surgical solution used in lieu of posterior spinal fusion (PSF). This technology has been gaining in popularity because of its potential benefits of preservation of spinal growth, motion, and functional activity. Although prior retrospective studies have indicated the potential efficacy of AVBT in patients with primary thoracic curves, a direct comparison to PSF, the most widely used definitive treatment for pediatric scoliosis, has yet to be conducted. Differences in efficacy, quality of life, and revision risk may exist across the techniques.
QUESTIONS/PURPOSES
We compared AVBT to PSF in terms of (1) the proportion of patients whose main thoracic curve was corrected to < 50° without a return to the operating room for revision within 2 years, (2) residual thoracic and lumbar curve magnitude at 2 years, (3) health-related quality of life (HRQoL) scores, and (4) the frequency of serious complications and healthcare resource utilization.
METHODS
From 2017 to 2022, patients (n = 87) were assessed for eligibility to participate in an FDA-approved investigational device exemption clinical trial for AVBT based on presenting to the clinic with a diagnosis of adolescent idiopathic scoliosis that had entered into surgical range. Based on clinical characteristics and the family's stated goals…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 87 participants or records.
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