BACKGROUND Vertebral body tethering (VBT) is a well-recognized, non-fusion alternative for idiopathic scoliosis in children with growth remaining. To date, there have been almost no published outcome studies with postoperative follow-up of >2 years. We aimed to fill this gap by evaluating mid-term outcomes in our first 31 consecutive patients. METHODS We retrospectively assessed additional clinical and radiographic data (mean, 5.7 ± 0.7 years) from our first 31 consecutive patients. Assessments included standard deformity measures, skeletal maturity status, and any additional complications (e.g., suspected broken tethers or surgical revisions). Using the same definition of success (i.e., all residual deformities, instrumented or uninstrumented, ≤30° at maturity; no posterior spinal fusion), we revisited the success rate, revision rate, and suspected broken tether rate. RESULTS Of our first 31 patients treated with VBT, 29 (of whom 28 were non-Hispanic White and 1 was non-Hispanic Asian; 27 were female and 2 were male) returned for additional follow-up. The success rate dropped to 64% with longer follow-up as deformity measures increased, and the revision rate increased to 24% following 2 additional surgical revisions. Four additional suspected broken tethers were identified, for a rate of 55%, with only 1 occurring beyond 4 years. No additional patients had conversion to a posterior spinal fusion. We observed a mean increase of 4° (range, 2° to 8°) in main thoracic deformity measures and 8° (range, 6° to 12°) in thoracolumbar deformity measures. CONCLUSIONS With >5 years of follow-up, we observed a decrease in postoperative success, as progression of the deformity was observed in most subgroups, and an increase in the revision and suspected broken tether rates. No additional patients had conversion to a posterior spinal fusion, which may indicate long-term survivorship. LEVEL OF EVIDENCE Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

---

前椎体栓系：一个随访 4.3 至 7.4 年的单中心队列。


背景 椎体栓系 （VBT） 是一种公认的非融合替代方案，用于治疗仍有生长发育的儿童的特发性脊柱侧弯。迄今为止，几乎没有已发表的术后随访 >2 年的结局研究。我们旨在通过评估前 31 例连续患者的中期结局来填补这一空白。方法 我们回顾性评估了前 31 例连续患者的额外临床和影像学数据 （平均值 5.7 ± 0.7 年）。评估包括标准畸形测量、骨骼成熟状态和任何其他并发症（例如，疑似系绳断裂或手术翻修）。使用相同的成功定义（即所有残留畸形，有器械或无器械，成熟时 ≤30°;无脊柱后部融合术），我们重新审视了成功率、翻修率和疑似断裂系绳率。结果 在我们前 31 例接受 VBT 治疗的患者中，29 例 （其中 28 例为非西班牙裔白人，1 例为非西班牙裔亚裔;27 例为女性，2 例为男性）返回进行额外随访。随着畸形措施的增加，随访时间延长，成功率下降到 64%，在 2 次额外的手术翻修后，翻修率增加到 24%。另外确定了 4 例疑似系绳断裂，发生率为 55%，其中只有 1 例发生在 4 年之后。没有其他患者转为脊柱后路融合术。我们观察到主要胸部畸形测量平均增加 4° （范围，2° 至 8°），胸腰椎畸形测量平均增加 8° （范围，6° 至 12°）。结论 在 >5 年的随访中，我们观察到术后成功率降低，因为在大多数亚组中观察到畸形进展，翻修率和疑似系绳断裂率增加。 没有其他患者转为脊柱后路融合术，这可能表明长期生存。证据级别 治疗级别 III .有关证据级别的完整描述，请参阅作者说明。