Abstract：
OBJECTIVE: VBT is a novel alternative to spinal fusion surgery to treat skeletally immature AIS and was approved to correct idiopathic scoliosis in August 2019 by US Federal Drug Administration (FDA). To systemically review the preliminary outcomes of vertebral body tethering (VBT) in treating adolescent idiopathic scoliosis.
METHODS: The electronic databases PubMed, EMBASE, and Web of Science were queried up to January 2022 for articles regarding VBT. Basic characteristics of patients, changes of radiographic parameters in coronal and sagittal planes, and clinical outcomes of surgical treatment of VBT including complication and revision rates were summarized.
RESULTS: Twenty five studies met the inclusion criteria. Most studies (23/25) included patients with only skeletal immaturity. The average % correction of the main/tethered curve at final follow-up, and % correction of thoracic kyphosis at final follow-up were reported to be 15.6-106.5% and - 31.8 to 20.0%, respectively. The most common complications for VBT were tether breakage (n = 145;21.3%), pulmonary complications (n = 49; 6.9%), and overcorrection (n = 30; 4.2%). The revision rate was 13.1%.
CONCLUSIONS: VBT could effectively and safely correct spinal deformity in skeletally immature patients with AIS and preserve the motion and growth of the spine. However, VBT has a relatively high complication and revision rates. Therefore, surgeons should cautiously consider VBT for treating AIS. Future research efforts are needed to lower the complication and revision rates. Whatever, VBT is still in its infancy and may have a promising future as a non-fusion solution for AIS.
METHODS: The electronic databases PubMed, EMBASE, and Web of Science were queried up to January 2022 for articles regarding VBT. Basic characteristics of patients, changes of radiographic parameters in coronal and sagittal planes, and clinical outcomes of surgical treatment of VBT including complication and revision rates were summarized.
RESULTS: Twenty five studies met the inclusion criteria. Most studies (23/25) included patients with only skeletal immaturity. The average % correction of the main/tethered curve at final follow-up, and % correction of thoracic kyphosis at final follow-up were reported to be 15.6-106.5% and - 31.8 to 20.0%, respectively. The most common complications for VBT were tether breakage (n = 145;21.3%), pulmonary complications (n = 49; 6.9%), and overcorrection (n = 30; 4.2%). The revision rate was 13.1%.
CONCLUSIONS: VBT could effectively and safely correct spinal deformity in skeletally immature patients with AIS and preserve the motion and growth of the spine. However, VBT has a relatively high complication and revision rates. Therefore, surgeons should cautiously consider VBT for treating AIS. Future research efforts are needed to lower the complication and revision rates. Whatever, VBT is still in its infancy and may have a promising future as a non-fusion solution for AIS.
摘要：
目的：VBT是脊柱融合手术的一种新型替代方法，可治疗骨骼未成熟的AIS，并于2019年8月被美国联邦药物管理局（FDA）批准用于矫正特发性脊柱侧凸。系统评价椎体束缚（VBT）治疗青少年特发性脊柱侧凸的初步疗效。
方法：电子数据库PubMed，EMBASE,和WebofScience在2022年1月之前被查询有关VBT的文章。患者的基本特征，冠状面和矢状面的射线照相参数的变化，总结VBT手术治疗的临床结果，包括并发症和翻修率。
结果：25项研究符合纳入标准。大多数研究（23/25）仅包括骨骼不成熟的患者。最终随访时主/系留曲线的平均修正百分比，最终随访时胸椎后凸的矫正百分比为15.6-106.5％和-31.8至20.0％，分别。VBT最常见的并发症是系绳断裂(n=145;21.3%)。肺部并发症（n=49;6.9％），和过度校正（n=30；4.2%）。修订率为13.1%。
结论：VBT可以有效和安全地纠正骨骼未成熟的AIS患者的脊柱畸形，并保持脊柱的运动和生长。然而,VBT具有相对较高的并发症和翻修率。因此,外科医生应谨慎考虑VBT治疗AIS。未来的研究工作需要降低并发症和翻修率。不管怎样,VBT仍处于起步阶段，作为AIS的非融合解决方案可能具有广阔的前景。
方法：电子数据库PubMed，EMBASE,和WebofScience在2022年1月之前被查询有关VBT的文章。患者的基本特征，冠状面和矢状面的射线照相参数的变化，总结VBT手术治疗的临床结果，包括并发症和翻修率。
结果：25项研究符合纳入标准。大多数研究（23/25）仅包括骨骼不成熟的患者。最终随访时主/系留曲线的平均修正百分比，最终随访时胸椎后凸的矫正百分比为15.6-106.5％和-31.8至20.0％，分别。VBT最常见的并发症是系绳断裂(n=145;21.3%)。肺部并发症（n=49;6.9％），和过度校正（n=30；4.2%）。修订率为13.1%。
结论：VBT可以有效和安全地纠正骨骼未成熟的AIS患者的脊柱畸形，并保持脊柱的运动和生长。然而,VBT具有相对较高的并发症和翻修率。因此,外科医生应谨慎考虑VBT治疗AIS。未来的研究工作需要降低并发症和翻修率。不管怎样,VBT仍处于起步阶段，作为AIS的非融合解决方案可能具有广阔的前景。
