Abstract：
Over the past 12 years, vertebral body tethering (VBT) has been gradually promoted for treating scoliosis, but there are few published studies, with only short-term follow-up. This study aimed to systematically review VBT efficacy and safety for treating scoliosis.
PubMed, Web of Science, Embase, and the Cochrane Library were searched for studies on VBT treatment of scoliosis published up to November 2021. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in included studies. Data on clinical efficacy, unplanned reoperations, and complications were extracted. The meta-analysis was performed with R 4.1.0.
Twenty-six studies involving 1045 patients were included in the meta-analysis. The correction rate of major curve immediately post-operation was 46.6% ± 13.8% (16%-69%) and that at final follow-up was 53.2% ± 17.9% (16%-79%). The single-arm meta-analysis results of all included studies showed that VBT was effective in general. The overall clinical success rate was 73.02% (95% confidence interval [CI]: 68.31%-78.05%). The pooled overall unplanned reoperation rate was 8.66% (95% CI: 5.53%-13.31%). The overall incidence rate of complications was 36.8% (95% CI: 23.9%-49.7%). The subgroup analysis based on follow-up time indicated that patients with follow-up time >36 months had increased clinical success rate, unplanned reoperation rate, and incidence rate of complications compared with those with <36 months\' follow-up time. The preliminary results showed that after 36 months of follow-up, only 7.17% (95% CI: 4.81%-10.55%) of patients required posterior spinal fusion (PSF) surgery and nearly 93% of patients avoided spinal fusion surgeries.
The current evidence from at least 3-year follow-up in different countries indicates that VBT is an effective surgical approach for treating scoliosis, with 73.88% of patients achieving clinical success. Nevertheless, about one in seven patients (15.8%) required unplanned reoperations, but only 7.17% required PSF. About half (52.17%) of the patients experienced complications. Due to the limitation of the study number and quality, our conclusion may be biased and requires verification by further studies with longer follow-up times.
PubMed, Web of Science, Embase, and the Cochrane Library were searched for studies on VBT treatment of scoliosis published up to November 2021. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in included studies. Data on clinical efficacy, unplanned reoperations, and complications were extracted. The meta-analysis was performed with R 4.1.0.
Twenty-six studies involving 1045 patients were included in the meta-analysis. The correction rate of major curve immediately post-operation was 46.6% ± 13.8% (16%-69%) and that at final follow-up was 53.2% ± 17.9% (16%-79%). The single-arm meta-analysis results of all included studies showed that VBT was effective in general. The overall clinical success rate was 73.02% (95% confidence interval [CI]: 68.31%-78.05%). The pooled overall unplanned reoperation rate was 8.66% (95% CI: 5.53%-13.31%). The overall incidence rate of complications was 36.8% (95% CI: 23.9%-49.7%). The subgroup analysis based on follow-up time indicated that patients with follow-up time >36 months had increased clinical success rate, unplanned reoperation rate, and incidence rate of complications compared with those with <36 months\' follow-up time. The preliminary results showed that after 36 months of follow-up, only 7.17% (95% CI: 4.81%-10.55%) of patients required posterior spinal fusion (PSF) surgery and nearly 93% of patients avoided spinal fusion surgeries.
The current evidence from at least 3-year follow-up in different countries indicates that VBT is an effective surgical approach for treating scoliosis, with 73.88% of patients achieving clinical success. Nevertheless, about one in seven patients (15.8%) required unplanned reoperations, but only 7.17% required PSF. About half (52.17%) of the patients experienced complications. Due to the limitation of the study number and quality, our conclusion may be biased and requires verification by further studies with longer follow-up times.
摘要：
在过去的12年里,椎体栓系（VBT）治疗脊柱侧凸已逐步推广，但是很少有发表的研究，只有短期随访。本研究旨在系统评价VBT治疗脊柱侧凸的疗效和安全性。
PubMed,WebofScience,Embase,并在Cochrane图书馆搜索了截至2021年11月发表的关于VBT治疗脊柱侧凸的研究。两名研究人员独立筛选了文献，提取的数据，并评估纳入研究的偏倚风险。临床疗效数据，计划外的再操作,并提取了并发症。使用R4.1.0进行荟萃分析。
在荟萃分析中纳入了26项涉及1045名患者的研究。术后即刻主曲线修正率为46.6%±13.8%(16%-69%),末次随访时修正率为53.2%±17.9%(16%-79%)。所有纳入研究的单臂荟萃分析结果显示，VBT总体有效。总体临床成功率为73.02%(95%置信区间[CI]:68.31%-78.05%)。合并总计划外再手术率为8.66%(95%CI:5.53%-13.31%)。并发症的总发生率为36.8%(95%CI:23.9%-49.7%)。根据随访时间进行亚组分析,随访时间>36个月的患者临床成功率提高,计划外再操作率,与随访时间<36个月的患者相比，并发症的发生率。初步结果显示,经过36个月的随访,只有7.17%(95%CI:4.81%-10.55%)的患者需要后路脊柱融合术(PSF),近93%的患者避免了脊柱融合术.
目前来自不同国家至少3年随访的证据表明，VBT是治疗脊柱侧凸的有效手术方法。73.88%的患者取得临床成功。然而，大约七分之一的患者(15.8%)需要计划外的再次手术，但只有7.17%需要PSF。约一半（52.17%）的患者出现并发症。由于研究数量和质量的限制,我们的结论可能存在偏差,需要通过随访时间较长的进一步研究进行验证.
PubMed,WebofScience,Embase,并在Cochrane图书馆搜索了截至2021年11月发表的关于VBT治疗脊柱侧凸的研究。两名研究人员独立筛选了文献，提取的数据，并评估纳入研究的偏倚风险。临床疗效数据，计划外的再操作,并提取了并发症。使用R4.1.0进行荟萃分析。
在荟萃分析中纳入了26项涉及1045名患者的研究。术后即刻主曲线修正率为46.6%±13.8%(16%-69%),末次随访时修正率为53.2%±17.9%(16%-79%)。所有纳入研究的单臂荟萃分析结果显示，VBT总体有效。总体临床成功率为73.02%(95%置信区间[CI]:68.31%-78.05%)。合并总计划外再手术率为8.66%(95%CI:5.53%-13.31%)。并发症的总发生率为36.8%(95%CI:23.9%-49.7%)。根据随访时间进行亚组分析,随访时间>36个月的患者临床成功率提高,计划外再操作率,与随访时间<36个月的患者相比，并发症的发生率。初步结果显示,经过36个月的随访,只有7.17%(95%CI:4.81%-10.55%)的患者需要后路脊柱融合术(PSF),近93%的患者避免了脊柱融合术.
目前来自不同国家至少3年随访的证据表明，VBT是治疗脊柱侧凸的有效手术方法。73.88%的患者取得临床成功。然而，大约七分之一的患者(15.8%)需要计划外的再次手术，但只有7.17%需要PSF。约一半（52.17%）的患者出现并发症。由于研究数量和质量的限制,我们的结论可能存在偏差,需要通过随访时间较长的进一步研究进行验证.
