%0 Multicenter Study
%T Bilateral vertebral body tethering: identifying key factors associated with successful outcomes.
%A Hoernschemeyer DG
%A Elliott P
%A Lonner BS
%A Eaker L
%A  
%A Boeyer ME
%J Eur Spine J
%V 33
%N 2
%D 2024 Feb 5
%M 38180517
%F 2.721
%R 10.1007/s00586-023-08074-9
%X <B>OBJECTIVE: </B>The treatment of operative double major pediatric spinal deformities (e.g., Lenke 3 or 6) with bilateral vertebral body tethering (VBT) can be significantly more challenging when compared to other deformity patterns (e.g., Lenke 1) or treatment with a posterior spinal fusion. We aimed to identify preoperative and perioperative characteristics that were associated with successful postoperative outcomes in patients treated with both a thoracic and thoracolumbar (e.g., bilateral) tether.<BR><B>METHODS: </B>We retrospectively assessed radiographic and clinical data from patients enrolled in a large multi-center study who had a minimum postoperative follow-up of two years. Standard radiographic parameters were extracted from standing spine and left hand-wrist radiographs at various timepoints. We classified patients based on their preoperative deformity pattern (Primary Thoracic [TP] vs. Primary Thoracolumbar [TLP]) and assessed: (1) deformity balance, (2) tilt of the transitional vertebra, and (3) postoperative success.<BR><B>RESULTS: </B>We analyzed data from thirty-six patients (TP: 19 and TLP: 17). We observed no relationship between deformity balance at first erect and postoperative success (p = 0.354). Patients with a horizontal transitional vertebra at first erect were significantly (p = 0.001) more likely to exhibit a successful outcome when compared to those who exhibited a tilted transitional vertebra (83% vs. 62%). Patients who had TLP were also more likely to exhibit a successful outcome when compared to patients who exhibited TP (76% vs. 50%).<BR><B>CONCLUSIONS: </B>These data indicate that double major deformities can be successfully treated with VBT, particularly for those who exhibit TLP.