Where does the tether break in vertebral body tethering cases? Clinical insights from revision cases after tether breakage.

IF 1.6 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-01-27 DOI:10.1007/s43390-025-01048-5

Mahmoud Alkharsawi, Alice Baroncini, Dong-Gune Chang, Miguel Pishnamaz, Per David Trobisch

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引用次数: 0

Abstract

Purpose: To evaluate the sites where the tether breaks in vertebral body tethering (VBT) cases.

Methods: Intraoperative evaluation of broken tethers in patients who had anterior revision.

Inclusion criteria: anterior revision of VBT cases with explantation of the full implant and photo documentation. Eight patients met the inclusion criteria. The primary variable of interest was the location of tether breakage in relation to the vertebral curve and the tether-screw interface. Another variable of interest was to evaluate the difference in breakage rates between anterior and posterior tethers in double tether cases.

Results: Sixty tethers bridging the intervertebral disc within this cohort of eight patients were found. Seven implants were removed from thoracolumbar curves and one implant from a thoracic curve. We identified 32 tether breakages. Double tethers were used in six patients. In these six cases, 15 breakages were found in the posterior tether and 13 in the anterior tether. Four cases (50%) exhibited breakages at the apex, eight cases (100%) at the lowest instrumented vertebra (LIV), and five cases (63%) at the uppermost-instrumented vertebra (UIV). Five tether breakages (in three cases with double tether) were observed at the screw sites, while the remaining 27 exhibited cord breakages near the intervertebral discs. In double tether systems, statistical analysis did not reveal any significant difference in breakage rates between anterior and posterior tethers.

Conclusions: In VBT cases, the tether breaks mostly at the level of the intervertebral disc, adjacent to the lowest instrumented vertebra.

Level of evidence: Level IV (Case series with no comparison group).

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.