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Topic:

​

Issue:

Spine

Category:

Developmental

Title:

A New Look at Vertebral Body Tethering (VBT): Through the Modified Clavien-Dindo-Sink (mCDS) Classification

Author:

Vorhies, John S. MD; Hauth, Lucas BS; Garcia, Samantha BS; Roye, Benjamin D. MD; Poon, Selina MD; Sturm, Peter F. MD, MBA‖,; Glotzbecker, Michael MD; Fletcher, Nicholas D. MD; Stone, Joseph D. MD; Cahill, Patrick J. MD; The Pediatric Spine Study Group; Anari, Jason B. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

May/June 2024

Reference:

44(5):p e389-e393, DOI: 10.1097/BPO.0000000000002653

Level Of Evidence:

​

# of Patients:

171

Study Type:

Retrospective comparative study

Location:

Multicenter pediatric spine deformity database

Summary:

This study evaluates the complication rates of anterior vertebral body tethering (AVBT) for idiopathic scoliosis (IS) using the modified Clavien-Dindo-Sink (mCDS) classification system. Aims to compare AVBT's complication profile to that of posterior spinal fusion (PSF).

Methods:

Data analyzed retrospectively for AVBT patients with a minimum follow-up of 9 months. Complications graded using mCDS by two pediatric spine surgeons.

Exclusions:

Not specified

Results:

69 complications were reported in 55 (32%) patients. Most common complication grade: Grade IIIb (42%). 49% of complications were Grade III or higher, requiring procedural/surgical intervention or ICU admission. Compared to PSF, which has 7% of complications classified as Grade III or higher.

Conclusions:

AVBT shows a higher rate of significant complications (Grade III or higher) compared to PSF. Findings highlight the learning curve and early challenges associated with implementing a new surgical technique like VBT compared to the established PSF. The mCDS classification provides a structured means to evaluate and compare complications in these surgical modalities.

Relevance:

Limitations:

Perspective:

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