VERTEBRAL PEDICULAR TETHERING - GROWTH MODULATION TECHNIQUE FOR IDIOPATHIC SCOLIOSIS
ABSTRACT Objectives: This study aimed to evaluate Vertebral Pedicular Tethering (VPT) as a less invasive alternative to traditional spinal fusion in Adolescent Idiopathic Scoliosis (AIS), focusing on thoracolumbar and lumbar curves (Lenke 5C and 6C) in growing patients. The objective was to correct...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Coluna (SBC)
2025-02-01
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| Series: | Coluna/Columna |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512025000100200&lng=en&tlng=en |
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| Summary: | ABSTRACT Objectives: This study aimed to evaluate Vertebral Pedicular Tethering (VPT) as a less invasive alternative to traditional spinal fusion in Adolescent Idiopathic Scoliosis (AIS), focusing on thoracolumbar and lumbar curves (Lenke 5C and 6C) in growing patients. The objective was to correct scoliosis without fusion, preserving spinal mobility and growth. Methods: A series of six female adolescents underwent VPT, three of whom had over six months of follow-up. The procedure applied posterior compression on the convex side of the scoliotic curve, utilizing the Hueter-Volkman principle to modulate growth and correct deformity. Outcomes were evaluated in the coronal, sagittal, and rotational planes using radiographic measurements and clinical assessments. Results: The main Cobb angle improved by an average of 67.5% (34.8°) over six months, with spinal length increasing by an average of 7 mm. Vertebral rotation also improved, with a reduction from Nash-Moe grade +3 to +1. However, one patient experienced over-correction, requiring tether release. Sagittal plane analysis showed increased kyphosis in the proximal segment and improved lordosis in the thoracolumbar region without hyperlordosis. Conclusions: VPT demonstrated promising results in correcting spinal deformities while preserving mobility and growth in selected AIS patients (Sanders stages 3-5). The technique offers a viable alternative to fusion, particularly in thoracolumbar curves. However, the procedure’s timing is crucial to avoid over-correction or insufficient growth modulation. Further research with longer follow-ups and larger cohorts is needed to refine patient selection and improve outcomes. Level of Evidence IV; Case Series. |
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| ISSN: | 2177-014X |