P62. Outcomes of combined thoracic anterior and lumbar posterior tethering versus posterior spinal fusion

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<h3>BACKGROUND CONTEXT</h3> In the treatment of skeletally immature idiopathic scoliosis, outcomes for combined Thoracic Anterior and Lumbar Posterior Tethering (TALPT) and posterior spinal fusion and instrumentation (PSF) have never been compared. <h3>PURPOSE</h3> The purpose of this study is to compare the outcomes of TALPT with PSF in skeletally immature patients with idiopathic scoliosis. <h3>STUDY DESIGN/SETTING</h3> Retrospective Cohort Study. <h3>PATIENT SAMPLE</h3> Skeletally immature patients with curves of at least 40 degrees with at least two-year follow-up who underwent TALPT or PSF from 2014-2018 were included. <h3>OUTCOME MEASURES</h3> The primary outcome is revision. Secondary outcomes include procedure duration, estimated blood loss (EBL), length of stay (LOS), total postoperative opioid morphine equivalent (OME), foley duration, days to solid food, direct cost and 30-day readmission. <h3>METHODS</h3> In this IRB-approved retrospective cohort study, TALPT and PSF were compared with respect to primary and secondary outcome measures. TALPT patients underwent a single-stage open anterior tethering for the thoracic curve and unilateral posterior tethering on the convexity of the lumbar curve. <h3>RESULTS</h3> Of 104 enrolled patients, 6 (5.8%) underwent TALPT while 98 (94.2%) underwent PSF. There was no significant difference in revision rate between TALPT and PSF (33% vs 11%, p=0.26). TALPT patients had significantly longer ICU length of stay in hours (18.7±18 vs 4.6±19.1, p<0.01), higher direct cost in USD ($68,365±$17,863 vs $50,277±$13,905, p<0.01), and increased postoperative day 0 inpatient OME use (36.2±21.9 vs 12±19, p<0.01). There was no no significant difference in case length, EBL, LOS, foley duration, days to solid food and 30-day readmission (p>0.05). <h3>CONCLUSIONS</h3> Skeletally immature idiopathic scoliosis patients who undergo TALPT have equivalent two-year revision rates to PSF patients However, TALPT had significantly increased ICU stay, inpatient OME use on postoperative day 0 and direct cost. <h3>FDA DEVICE/DRUG STATUS</h3> Zimmer Spinal Tether (Not approved for this indication)