Journal of Pediatric Orthopaedics - 2026-04-10 - Journal Article
Minimum 5-Year Clinical and Radiographic Results of Double-Sided Vertebral Body Tethering Applied to Double Adolescent Idiopathic Scoliosis Curves of the First 13 Patients: Important Lessons Learned.
Pehlivanoglu T, Pehlivanoglu BN, Akar A, Erdag Y, Aydogan M
Topics
Key Takeaway
Double-sided VBT in skeletally immature AIS patients with double curves achieved 87% thoracic (48° to 6°) and 91% lumbar (45° to 4°) curve correction at mean 5.4-year follow-up, with 2/13 patients requiring conversion to posterior spinal fusion for overcorrection.
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Summary
This prospective cohort evaluated dsVBT in 13 skeletally immature AIS patients (mean age 11.8, Risser 0, Sanders 3) with flexible double curves >40° thoracic and >35° lumbar after failed bracing. At mean 5.4-year follow-up, thoracic curves corrected from 48° to 6° and lumbar from 45° to 4°, with mean SRS-22 improving from 2.9 to 4.9. Two patients (15%) required conversion to instrumented posterior spinal fusion after year 5 due to overcorrection; no other complications were reported.
Key Limitation
The sample size of 13 patients is insufficient to define reliable complication rates, identify predictors of overcorrection, or generalize inclusion criteria, making all reported percentages statistically unstable.
Original Abstract
BACKGROUND
Double-sided VBT (dsVBT) (bilateral application to thoracic and lumbar major curves) was reported to provide successful thoracic and thoracolumbar curve corrections in skeletally immature adolescent idiopathic scoliosis (AIS) patients when applied under strict inclusion criteria in the short term. The present prospective cohort study aimed to present at least 5 years' results from the same study population to question the reliability of dsVBT in terms of correctional efficacy, growth modulation, and long-term functional outcomes.
METHODS
Thirteen consecutive skeletally immature (mean: Risser: 0, Sanders: 3) AIS patients [average age: 11.8 (11 to 14)] with flexible (≥30%) double curves and a history of failed bracing for at least 6 months, were included. After the detection of curve progression within the brace (>40° thoracic, >35° lumbar), a decision to proceed with dsVBT was established.
RESULTS
An average age, follow-up (FU) duration, and preoperative main thoracic and lumbar major curves' magnitudes of 11.8 years-5.4 years-48° and 45° were noted. Average 11.3 levels were tethered. An average first erect thoracic and lumbar major curves' magnitudes of 17° and 14° were improved to 6° and 4° at last FU. A mean thoracic kyphosis and lumbar lordosis of 27° and 51° were acquired at the last FU. Mean total SRS-22 scores were improved from 2.9 to 4.9. Two patients underwent instrumented posterior spinal fusion after the fifth year because of overcorrection. No other complication was acquired.
CONCLUSIONS
At the end of 5 to 7 years, dsVBT provided 87% of thoracic (48° to 6°) and 91% of lumbar (45° to 4°) gradual and sustained major curve corrections owed to growth modulation together with significantly improved SRS-22 scores and preservation of coronal-sagittal balance underlining the safety and efficacy, if applied to skeletally immature AIS patients with double curves under strict inclusion criteria.
LEVEL OF EVIDENCE
Level IV.