Bizzoca D, Piazzolla A, Moretti L, Vicenti G, Moretti B, Solarino G. Anterior vertebral body tethering for idiopathic scoliosis in growing children: A systematic review. World J Orthop 2022; 13(5): 481-493 [PMID: 35633741 DOI: 10.5312/wjo.v13.i5.481]
Corresponding Author of This Article
Giuseppe Solarino, MD, PhD, Associate Professor, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, Bari 70124, Puglia, Italy. giuseppe.solarino@uniba.it
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. May 18, 2022; 13(5): 481-493 Published online May 18, 2022. doi: 10.5312/wjo.v13.i5.481
Anterior vertebral body tethering for idiopathic scoliosis in growing children: A systematic review
Davide Bizzoca, Andrea Piazzolla, Lorenzo Moretti, Giovanni Vicenti, Biagio Moretti, Giuseppe Solarino
Davide Bizzoca, Andrea Piazzolla, UOSD Spinal Deformity Centre, AOU Consorziale Policlinico di Bari, Bari 70124, Italy
Davide Bizzoca, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, Bari 70124, Italy
Lorenzo Moretti, Orthopaedic and Trauma Unit, AUO Consorziale Policlinico di Bari, Bari 70124, Italy
Giovanni Vicenti, Biagio Moretti, Giuseppe Solarino, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”, Bari 70124, Puglia, Italy
Author contributions: Bizzoca D and Piazzolla A performed the research and drafted the manuscript; Solarino G and Moretti B revised the work critically; Moretti L and Vicenti G made substantial contributions to data interpretation, and all the authors approved the version to be published.
Conflict-of-interest statement: The authors declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Solarino, MD, PhD, Associate Professor, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, Bari 70124, Puglia, Italy. giuseppe.solarino@uniba.it
Received: February 21, 2021 Peer-review started: February 21, 2021 First decision: July 28, 2021 Revised: August 1, 2021 Accepted: April 8, 2022 Article in press: April 8, 2022 Published online: May 18, 2022
Abstract
BACKGROUND
The management of idiopathic scoliosis (IS) in skeletally immature patients should aim at three-dimensional deformity correction, without compromising spinal and chest growth. In 2019, the US Food and Drug Administration approved the first instrumentation system for anterior vertebral body tethering (AVBT), under a Humanitarian Device Exception, for skeletally immature patients with curves having a Cobb angle between 35° and 65°.
AIM
To summarize current evidence about the efficacy and safety of AVBT in the management of IS in skeletally immature patients.
METHODS
From January 2014 to January 2021, Ovid Medline, Embase, Cochrane Library, Scopus, Web of Science, Google Scholar and PubMed were searched to identify relevant studies. The methodological quality of the studies was evaluated and relevant data were extracted.
RESULTS
Seven clinical trials recruiting 163 patients were included in the present review. Five studies out of seven were classified as high quality, whereas the remaining two studies were classified as moderate quality. A total of 151 of 163 AVBT procedures were performed in the thoracic spine, and the remaining 12 tethering in the lumbar spine. Only 117 of 163 (71.8%) patients had a nonprogressive curve at skeletal maturity. Twenty-three of 163 (14.11%) patients required unplanned revision surgery within the follow-up period. Conversion to posterior spinal fusion (PSF) was performed in 18 of 163 (11%) patients.
CONCLUSION
AVBT is a promising growth-friendly technique for treatment of IS in growing patients. However, it has moderate success and perioperative complications, revision and conversion to PSF.
Core tip: Although anterior vertebral body tethering is a promising growth-friendly technique for treatment of idiopathic scoliosis in growing patients, it has a moderate success rate and has perioperative complications, revision and conversion to posterior spinal fusion. Future level I studies, with long-term follow-up, are needed to best define the limits and potentials of this emerging surgical technique.
