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Topic:

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Issue:

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Category:

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Title:

Incidence of Tether Breakage in Anterior Vertebral Body Tethering

Author:

Cahill, Patrick J. MD; Miyanji, Firoz MD; Lullo, Brett R. MD; Samdani, Amer F. MD; Lonner, Baron S. MD; Pahys, Joshua M. MD§; Hwang, Steven W. MD; Haber, Lawrence L. MD; Alanay, Ahmet MD; Shah, Suken A. MD; Parent, Stefan MD; Blakemore, Laurel C. MD; Hoernschemeyer, Daniel G. MD; Neal, Kevin M. MD; Harms Study Group; Newton, Peter O. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4):p e323-e328, DOI: 10.1097/BPO.0000000000002619

Level Of Evidence:

IV

# of Patients:

208

Study Type:

Retrospective multicenter study

Location:

10 centers involved in data collection

Summary:

The study assessed the incidence, timing, and outcomes of tether breakage following thoracic anterior vertebral body tethering (TAVBT) in adolescent idiopathic scoliosis patients over a 2–3 year follow-up period.

Methods:

Included patients with right-sided thoracic curves undergoing TAVBT. Follow-up radiographic data were analyzed for tether breakage, defined as an increase in screw angle >5 degrees between adjacent vertebrae. Kaplan-Meier survival analysis estimated cumulative tether breakage rates. Statistical analyses (χ² and t tests) examined relationships between tether breakage, reoperations, and final curve outcomes.

Exclusions:

Patients without at least 2 years of radiographic follow-up.

Results:

Incidence of Tether Breakage: 36% overall, with 88% occurring ≥24 months postoperatively. Cumulative Risk: 19% at 24 months, increasing to 50% at 36 months. Reoperation Rates: 28% of patients with tether breakage required reoperation, including 12% converted to posterior spinal fusion. Curve Outcomes: Final major coronal curve angle was larger in patients with tether breakage (31° ± 12°) versus those without (26° ± 12°, P=0.002).

Conclusions:

Tether breakage is a common complication of TAVBT, with an expected incidence of 50% by 36 months. Tether breakage correlates with higher reoperation rates and larger residual curve angles, emphasizing the need for long-term monitoring and management strategies.

Relevance:

Limitations:

Perspective:

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