Learning curve for vertebral body tethering: analysis on 90 consecutive patients
- PDF / 848,308 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 101 Downloads / 199 Views
CASE SERIES
Learning curve for vertebral body tethering: analysis on 90 consecutive patients Alice Baroncini1,2 · Per David Trobisch2 · Filippo Migliorini1 Received: 24 January 2020 / Accepted: 10 August 2020 © Scoliosis Research Society 2020
Abstract Study design Retrospective study. Objectives Vertebral body tethering (VBT) is raising interest for the treatment of adolescent idiopathic scoliosis (AIS), but many scoliosis surgeons have not been trained in anterior surgical approaches. We analyzed data of our first patients to define the learning curve for VBT. Summary of background data VBT has shown encouraging results in the treatment of growing AIS patients, but there is a paucity of data and long-term results are not yet available. To our best knowledge, there is no published data regarding the learning curve for VBT. Methods A retrospective analysis was performed, of all consecutive patients who underwent VBT at our Institution. Outcomes of interest were intubation time, surgical duration and estimated blood loss per screw and hospitalization length. For the statistical analysis, we referred to a linear model regression diagnostic and we used the Pearson product-moment correlation (r) for pairwise correlation. The final effect ranked between + 1 and − 1. Results Data of 90 patients were analyzed, age 14.6 ± 1.8 years. On average, 9.4 ± 2.6 levels were instrumented. Per screw, mean intubation time was 33.1 ± 7.6 min (r = − 0.57; p > 0.0001), mean surgical duration 21.3 ± 5.7 min (r = − 0.55; p > 0.0001), mean estimated blood loss 21.3 ± 18.2 ml (r = − 0.66; p > 0.0001). Mean hospitalization length was 8.3 ± 3.1 days (r = − 0.32; p = 0.002). No intraoperative complications were reported. Conclusion VBT has a rapid learning curve: the estimated blood loss per screw is expected to decrease by 60%, intubation time and surgical duration by over 50%, and hospitalization length by 32% for each treated patient. Level of evidence III. Keywords Non-fusion anterior scoliosis correction · Vertebral body tethering · Learning curve · Adolescent idiopathic scoliosis · Anterior approach
Introduction Vertebral body tethering (VBT) represents a new, non-fusion option for the treatment of adolescent idiopathic scoliosis (AIS). This technique allows for curve correction while maintaining spine mobility, which is of particular relevance in the lumbar spine. VBT has been investigated with promising results [1–8], but further research is being conducted to * Alice Baroncini [email protected] 1
Department of Orthopaedics, RWTH Aachen University Clinic, Aachen, Germany
Department of Spine Surgery, Eifelklinik St. Brigida, Kammerbruchstr. 8, Simmerath, Germany
2
define the role of VBT in the treatment of AIS and to identify the ideal candidate for this intervention. VBT was developed to employ the Hüter–Volkmann principle to modulate spine growth through a unilateral block of growth plates [9–11]. However, manual full curve correction can also be achieved in patients approaching skeletal maturity (e.g., R
Data Loading...
