Scholarlink

Purpose <p>The purpose of this study was to determine the potential long-term morbidity, and risk of unplanned return to the operating room (UPROR) at five years postoperative vertebral body tethering (VBT) surgery for idiopathic scoliosis.</p> Method <p>A total of 120 patients treated with VBT with five years of follow-up were included in this study. Prospectively collected clinical and radiographic data were analyzed retrospectively. Primary outcomes included radiographic Cobb angle and sagittal parameters, which were analyzed preoperatively, immediately post-operatively, and at 1, 2, and 5 years after surgery. Radiographically identified and clinical complications were categorized and reported using the modified Clavien-Dindo system (mCDS).</p> Results <p>Preoperatively, the mean patient age was 12.6 years (95% CI 12.4–12.8), and Risser stages ranged from 0 to 3. The mean main thoracic scoliosis was 51.2° (95% CI 49.7–52.7°). All patients underwent thoracoscopic VBT, with an immediate post-operative improvement to 26.9° (95% CI 25.3–28.5°; p &lt; 0.01). This correction was maintained at the 1-year follow-up at 23.0° (p &lt; 0.01 vs. immediate post-op) and the 2-year follow-up at 27.5° (p = 0.64 vs. immediate post-op). However, mean scoliosis increased by the 5-year follow-up to 33.5° (95% CI 30.4–36.6°; p &lt; 0.01 vs. immediate post-op). Preoperative global kyphosis was 28.5° (95% CI 26.4–30.6°), which remained stable at the 1-year (28.7°; 95% CI 26.5–31.0°) and 2-year (29.2°; 95% CI 26.6–31.8°) post-operative follow-ups. However, global kyphosis increased by 5 years post-operatively to 42.2° (95% CI 38.3–46.0°; p &lt; 0.01 vs. preoperative). According to the modified Clavien-Dindo-Sink classification, there were 38 Grade 0 occurrences, consisting of radiographically suspected tether breakages without associated curve progression or unplanned return to the operating room (UPROR). There were 4 Grade I, 8 Grade II, 20 Grade IIIb, and 2 Grade IVa complications; no Grade IIIa, IVb, or V complications were observed. The minor complication rate (mCDS I and II) was 10%, and the major complication rate (mCDS III and IV) was 18.3%. The overall complication rate was 60% (28.3% if suspected radiographic tether breakages are excluded). The UPROR rate was 15.8%.</p> Conclusion <p>The 5-year complication rate was 60%, which decreased to 28.3% if suspected radiographic tether breakages were excluded. The UPROR rate was 15.8% at 5 years. While global thoracic kyphosis remained stable during the first two years, it increased significantly by the 5-year follow-up.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Complications and unplanned return to the operating room (UPROR) at five years post-operative vertebral body tethering for idiopathic scoliosis

  • 期刊论文

  • 发表日期：

    2026年4月16日

查看全文
  • Ahmad Alelaumi,
  • Flavia Alberghina,
  • Firoz Miyanji,
  • Stefan Parent,
  • PSSG,
  • Ron El-Hawary

摘要

Purpose

The purpose of this study was to determine the potential long-term morbidity, and risk of unplanned return to the operating room (UPROR) at five years postoperative vertebral body tethering (VBT) surgery for idiopathic scoliosis.

Method

A total of 120 patients treated with VBT with five years of follow-up were included in this study. Prospectively collected clinical and radiographic data were analyzed retrospectively. Primary outcomes included radiographic Cobb angle and sagittal parameters, which were analyzed preoperatively, immediately post-operatively, and at 1, 2, and 5 years after surgery. Radiographically identified and clinical complications were categorized and reported using the modified Clavien-Dindo system (mCDS).

Results

Preoperatively, the mean patient age was 12.6 years (95% CI 12.4–12.8), and Risser stages ranged from 0 to 3. The mean main thoracic scoliosis was 51.2° (95% CI 49.7–52.7°). All patients underwent thoracoscopic VBT, with an immediate post-operative improvement to 26.9° (95% CI 25.3–28.5°; p < 0.01). This correction was maintained at the 1-year follow-up at 23.0° (p < 0.01 vs. immediate post-op) and the 2-year follow-up at 27.5° (p = 0.64 vs. immediate post-op). However, mean scoliosis increased by the 5-year follow-up to 33.5° (95% CI 30.4–36.6°; p < 0.01 vs. immediate post-op). Preoperative global kyphosis was 28.5° (95% CI 26.4–30.6°), which remained stable at the 1-year (28.7°; 95% CI 26.5–31.0°) and 2-year (29.2°; 95% CI 26.6–31.8°) post-operative follow-ups. However, global kyphosis increased by 5 years post-operatively to 42.2° (95% CI 38.3–46.0°; p < 0.01 vs. preoperative). According to the modified Clavien-Dindo-Sink classification, there were 38 Grade 0 occurrences, consisting of radiographically suspected tether breakages without associated curve progression or unplanned return to the operating room (UPROR). There were 4 Grade I, 8 Grade II, 20 Grade IIIb, and 2 Grade IVa complications; no Grade IIIa, IVb, or V complications were observed. The minor complication rate (mCDS I and II) was 10%, and the major complication rate (mCDS III and IV) was 18.3%. The overall complication rate was 60% (28.3% if suspected radiographic tether breakages are excluded). The UPROR rate was 15.8%.

Conclusion

The 5-year complication rate was 60%, which decreased to 28.3% if suspected radiographic tether breakages were excluded. The UPROR rate was 15.8% at 5 years. While global thoracic kyphosis remained stable during the first two years, it increased significantly by the 5-year follow-up.