Lau Kenney Ki Lee, Kwan Kenny Yat Hong, Wong Teenie Kwan Tung, Cheung Jason Pui Yin
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong.
Department of Orthopaedics and Traumatology, Queen Mary Hospital, Pokfulam, Hong Kong.
Orthop Res Rev. 2024 Dec 10;16:305-315. doi: 10.2147/ORR.S502053. eCollection 2024.
Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity among teenagers worldwide. Vertebral body tethering (VBT) is an innovative, minimally invasive technique developed to address spinal curvature by modulating vertebral growth. However, the existing body of evidence regarding the effectiveness and safety of VBT in treating AIS is fragmented and requires thorough consolidation and critical assessment.
Six databases were thoroughly examined, yielding 11 relevant systematic reviews and meta-analyses. The methodological quality of the included studies was evaluated using the Joanna Briggs Institute's critical appraisal checklist. The key findings were encapsulated using a narrative synthesis approach.
The reviews indicated notable improvements in coronal plane radiographic parameters, transverse plane clinical outcomes, and health-related quality of life scores following VBT. Nevertheless, the complication rates associated warrant attention. Additionally, the variability in methodological quality across the included reviews underscores the necessity for more robust and systematic investigations in this domain.
This umbrella review revealed promising results for VBT as a treatment option for AIS. However, further research is needed to address knowledge gaps and limitations, focusing on long-term outcomes, patient selection, standardized techniques, and comparison with traditional treatments.
青少年特发性脊柱侧凸(AIS)是全球青少年中普遍存在的脊柱畸形。椎体牵张术(VBT)是一种创新的微创技术,旨在通过调节椎体生长来解决脊柱侧弯问题。然而,关于VBT治疗AIS有效性和安全性的现有证据零散,需要全面整合和批判性评估。
对六个数据库进行了全面检索,得到11项相关的系统评价和荟萃分析。使用乔安娜·布里格斯研究所的批判性评价清单对纳入研究的方法学质量进行评估。采用叙述性综合方法总结关键发现。
这些评价表明,VBT术后冠状面影像学参数、横断面临床结局以及健康相关生活质量评分均有显著改善。然而,相关的并发症发生率值得关注。此外,纳入评价的方法学质量存在差异,这凸显了在该领域进行更有力、更系统研究的必要性。
这项综合性评价显示VBT作为AIS的一种治疗选择有良好前景。然而,需要进一步研究以填补知识空白和局限性,重点关注长期结局、患者选择、标准化技术以及与传统治疗方法的比较。