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前路椎体拴系术治疗青少年特发性脊柱侧凸的回顾性研究

Anterior Vertebral Body Tethering (AVBT) in the Treatment of Adolescent Idiopathic Scoliosis: A Retrospective Study.

作者信息

Balsano Massimo, Vacchiano Andrea, Spina Mauro, Lodi Federico, Criveller Pietro, Zoccatelli Fabio, Corbolini Alberto, Colombini Antonio Gioele, Campisi Alessio, Giovannetti Riccardo, Infante Maurizio Valentino

机构信息

Regional Spinal Department, University and Hospital Trust, 37126 Verona, Italy.

Orthopedics and Traumatology Department, University and Hospital Trust, 37126 Verona, Italy.

出版信息

J Clin Med. 2024 Dec 20;13(24):7786. doi: 10.3390/jcm13247786.

Abstract

: Anterior Vertebral Body Tethering (AVBT) is a relatively novel minimally invasive surgical technique for the treatment of adolescent idiopathic scoliosis (AIS) that enables deformity correction of the spine diminishing vertebral motion reduction caused by the standard posterior spinal fusion approach. This paper reports the introduction of a new technical variant of AVBT, with the aim of evaluating its effectiveness on the correction of both axial and coronal spinal deformity. : A single-centre single-surgeon retrospective cohort study was conducted. AVBTs were performed between 2020 and 2024. Radiographical values, surgical details, and complications of 67 patients affected by AIS were compared before surgery, immediately after surgery, and at the most recent follow-up. : Postoperative results have revealed a statistically significant coronal curve correction of 29.85% in the main thoracic (MT) curves (from mean preoperative width of 54.81 ± 11.86° to 38.45 ± 10.19°) and of 26.93% in the thoracolumbar (TL/L) curves (from 35.15 ± 11.83° to 25.69 ± 10.50°) in line with that obtained by the standard technique. Coronal correction at the most recent follow-up was maintained. Postoperative axial rotation reduction was found to be statistically significant in the main thoracic (MT) curves (from mean Nash-Moe value of 1.84 ± 0.71 to 1.36 ± 0.73), with a further decrease at the most recent follow-up compared with preoperative values. Improvement in other radiographical measures did not reach statistical significance and the complication rate was comparable to the standard technique. : The extent of coronal correction in patients treated with the proposed modified AVBT technique is satisfactory and in line with results from studies testing the standard AVBT technique. The findings of this study seem to suggest that this technical variant of AVBT is effective in the correction of both axial and coronal deformity, with a surgical complication rate comparable to the standard technique.

摘要

椎体前路栓系术(AVBT)是一种相对新颖的微创手术技术,用于治疗青少年特发性脊柱侧凸(AIS),它能够矫正脊柱畸形,减少标准后路脊柱融合术式所导致的椎体活动度降低。本文报告了一种AVBT新技术变体的引入,旨在评估其对脊柱轴向和冠状面畸形矫正的有效性。:开展了一项单中心单术者的回顾性队列研究。在2020年至2024年期间实施了AVBT手术。比较了67例AIS患者术前、术后即刻及最近一次随访时的影像学数据、手术细节和并发症情况。:术后结果显示,主胸段(MT)曲线的冠状面曲线矫正具有统计学意义,矫正率为29.85%(从术前平均宽度54.81±11.86°降至38.45±10.19°),胸腰段(TL/L)曲线的矫正率为26.93%(从35.15±11.83°降至25.69±10.50°),与标准技术所取得的结果一致。最近一次随访时冠状面矫正得以维持。发现主胸段(MT)曲线术后轴向旋转减少具有统计学意义(从平均Nash-Moe值1.84±0.71降至1.36±0.73),与术前值相比,最近一次随访时进一步降低。其他影像学测量指标的改善未达到统计学意义,并发症发生率与标准技术相当。:采用所提出的改良AVBT技术治疗的患者冠状面矫正程度令人满意,与测试标准AVBT技术的研究结果一致。本研究结果似乎表明,这种AVBT技术变体在矫正轴向和冠状面畸形方面有效,手术并发症发生率与标准技术相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f00f/11728138/a73ed7e0c461/jcm-13-07786-g001.jpg

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