Patient-Reported Outcomes Are Equivalent in Patients Who Receive Vertebral Body Tethering Versus Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis

Anterior vertebral body tethering (AVBT), or spinal growth tethering, is an emerging technology that recently received Food and Drug Administration (FDA) approval through a humanitarian device exemption designation to treat idiopathic scoliosis patients with remaining growth. This study compared patients who underwent AVBT with those treated with standard-of-care posterior spinal fusion (PSF) to determine inherent differences in patients and families who seek cutting-edge treatments. The authors reviewed 62 PSF patients from a multicenter registry and 20 AVBT patients from an FDA-approved investigational clinical trial. The authors examined demographics, preoperative clinical and radiographic variables, and health-related quality of life (HRQOL). All included patients preoperatively were classified as Lenke type 1 or 2 with a thoracic curve of 35 degrees to 60 degrees, a lumbar curve less than 35 degrees, and a skeletal maturity score of Risser sign 0 or Sanders bone age of 4 or less. Idiopathic scoliosis patients treated with surgical intervention were primarily White females who were 12 years old. No differences in demographics, clinical variables, and radiographic measures were detected between the PSF and AVBT cohorts. The AVBT group showed more thoracic flexibility on bending radiographs, correcting on average 59% compared with 43% for PSF patients (P=.005). Patients had similar HRQOL total scores and scores across each of the 5 domains of the Scoliosis Research Society Questionnaire Version 22. The percentage of patients scoring below 4.0 within each domain was comparable between cohorts. Scoliosis patients who underwent vertebral tethering at a level of deformity magnitude and maturity similar to those who underwent posterior fusion did not differ at baseline regarding demographics, clinical variables, and HRQOL.