Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Orthopedic Surgery, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA.
Sci Rep. 2021 Nov 29;11(1):23049. doi: 10.1038/s41598-021-02358-0.
Fusion is the current standard of care for AIS. Anterior vertebral body tethering (AVBT) is a motion-sparing alternative gaining interest. As a novel procedure, there is a paucity of literature on safety. Here, we report 90-day complication rates in 184 patients who underwent AVBT by a single surgeon. Patients were retrospectively reviewed. Approaches included 71 thoracic, 45 thoracolumbar, 68 double. Major complications were those requiring readmittance or reoperation, prolonged use of invasive materials such as chest tubes, or resulted in spinal cord or nerve root injury. Minor complications resolved without invasive intervention. Mean operative time and blood loss were 186.5 ± 60.3 min and 167.2 ± 105.0 ml, respectively. No patient required allogenic blood transfusion. 6 patients experienced major (3.3%), and 6 had minor complications (3.3%). Major complications included 3 chylothoracies, 2 hemothoracies, and 1 lumbar radiculopathy secondary to screw placement requiring re-operation. Minor complications included 1 patient with respiratory distress requiring supplementary oxygen, 1 superficial wound infection, 2 cases of prolonged nausea, and 1 Raynaud phenomenon. In 184 patients who underwent AVBT for AIS, major and minor complication rates were both 3.3%.
融合是 AIS 的当前标准治疗方法。椎体前束缚（AVBT）是一种保留运动的替代方法，越来越受到关注。作为一种新的手术方法，关于安全性的文献很少。在这里，我们报告了由一位外科医生为 184 名患者进行 AVBT 的 90 天并发症发生率。对患者进行了回顾性分析。手术入路包括 71 例胸椎、45 例胸腰椎、68 例双节段。主要并发症是需要重新入院或再次手术、长时间使用胸管等侵入性材料或导致脊髓或神经根损伤的并发症。无需侵入性干预即可解决的轻微并发症。平均手术时间和失血量分别为 186.5±60.3 分钟和 167.2±105.0 毫升。没有患者需要异体输血。6 名患者出现重大并发症（3.3%），6 名患者出现轻微并发症（3.3%）。主要并发症包括 3 例乳糜胸、2 例血胸和 1 例因螺钉放置导致的腰椎神经根病需要再次手术。轻微并发症包括 1 例需要补充氧气的呼吸窘迫患者、1 例浅表伤口感染、2 例持续恶心和 1 例雷诺现象。在 184 例因 AIS 而行 AVBT 的患者中，主要和次要并发症发生率均为 3.3%。
