Comparison of clinical and functional outcomes of vertebral body tethering to posterior spinal fusion in patients with adolescent idiopathic scoliosis and evaluation of quality of life: preliminary results.

Abstract

This preliminary study was aimed to present the results of the comparison of clinical and functional outcomes of vertebral body tethering (VBT) and posterior spinal fusion (PSF) for the first time in the literature. 21 thoracolumbar (T5-L3) VBT patients (VBT group); and 22 age-gender-fusion level and minimum follow-up duration matched thoracolumbar (T3-L3) PSF patients (PSF group) were enrolled. Average FU duration of group 1 and 2 were 37.1/37.8months (p = 0.33). Patients clinical data together with SRS-22 scores and SF-36 scores were compared. A retrospective, comparative study was undertaken. VBT group was detected to have superior lumbar range of motion; superior anterior-lateral lumbar bending flexibility; superior flexor and extensor endurances of trunk, and superior average motor strength of trunk muscles with high statistical significance. VBT group was also detected to have superior scores regarding life quality, including better average total SRS-22 and better average SF-36 MCS/PCS scores with also high statistical significance. This study for the first time in the literature concluded, that in skeletally immature patients with AIS, VBT as a result of the utilization of growth modulation was able to yield significantly superior lumbar range of motion, lumbar anterior and lateral flexibility, trunk flexor-extensor endurance and trunk motor strength as compared to patients who underwent fusion. By yielding significantly superior SRS-22 and SF-36 scores, VBT was detected to provide better life quality and patient satisfaction than fusion. This study concluded hereby, that by applying VBT, spinal motion could be preserved and complications of fusion could be avoided.