Nikita Cobetto, Marie-Ève Fecteau, Christiane Caouette, Marine Gay, A Noelle Larson, Dan Hoernschemeyer, Melanie Boeyer, Ron El-Hawary, Ahmet Alanay, Carl-Eric Aubin
{"title":"2年多中心验证模拟生长调节腰椎椎体系扎术的手术计划工具。","authors":"Nikita Cobetto, Marie-Ève Fecteau, Christiane Caouette, Marine Gay, A Noelle Larson, Dan Hoernschemeyer, Melanie Boeyer, Ron El-Hawary, Ahmet Alanay, Carl-Eric Aubin","doi":"10.1007/s43390-025-01123-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Vertebral body tethering (VBT) for lumbar curves may have wider application than for thoracic curves due to greater growth potential than thoracic spine and benefits of preserved flexibility. Predicting long-term correction remains challenging, with high revision rates and complications (14-32%) including under-/over-correction, tether breakage, adding-on. This study aimed to validate a planning tool for lumbar VBT using a patient-specific finite element model (FEM) integrating mechanobiological growth modulation as a function of preoperative skeletal maturity.</p><p><strong>Methods: </strong>Thirty-five retrospective idiopathic scoliosis patients who underwent lumbar VBT, with or without concomitant thoracic VBT, were included. A personalized FEM calibrated to preoperative spine deformity, flexibility and weight was created using 3D radiographic reconstructions. The FEM was linked to an algorithm integrating spine growth and mechanobiological growth modulation, calibrated using preoperative Sanders score. VBT surgery was simulated to replicate immediate postoperative correction and predict two-year correction. Simulated Cobb angles, sagittal curves, and apical axial rotation were compared to actual two-year radiographic measurements.</p><p><strong>Results: </strong>Preoperative Cobb angles averaged 37 ± 12° (thoracic) and 48 ± 9° (thoraco-lumbar/lumbar). Immediate postoperative correction was 38 ± 15% and 59 ± 16%, with two-year corrections of 44 ± 24% and 73 ± 21%, respectively. Simulated postoperative correction was accurate within 3° (Cobb angles), while simulated 2-year outcomes were accurate within 3° (Cobb), 2° (kyphosis), 4° (lordosis), and 3° (axial rotation), showing no significant differences from reference results (p < 0.05; statistical power 90%).</p><p><strong>Conclusion: </strong>The patient-specific FEM and growth modulation algorithm accurately predicted two-year correction. This tool can support preoperative planning, reduce surgeon variability, and potentially improve VBT outcomes by providing a predictive tool to help surgical planning.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multicenter validation of a surgical planning tool for lumbar vertebral body tethering simulating growth modulation over 2 years.\",\"authors\":\"Nikita Cobetto, Marie-Ève Fecteau, Christiane Caouette, Marine Gay, A Noelle Larson, Dan Hoernschemeyer, Melanie Boeyer, Ron El-Hawary, Ahmet Alanay, Carl-Eric Aubin\",\"doi\":\"10.1007/s43390-025-01123-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Vertebral body tethering (VBT) for lumbar curves may have wider application than for thoracic curves due to greater growth potential than thoracic spine and benefits of preserved flexibility. Predicting long-term correction remains challenging, with high revision rates and complications (14-32%) including under-/over-correction, tether breakage, adding-on. This study aimed to validate a planning tool for lumbar VBT using a patient-specific finite element model (FEM) integrating mechanobiological growth modulation as a function of preoperative skeletal maturity.</p><p><strong>Methods: </strong>Thirty-five retrospective idiopathic scoliosis patients who underwent lumbar VBT, with or without concomitant thoracic VBT, were included. A personalized FEM calibrated to preoperative spine deformity, flexibility and weight was created using 3D radiographic reconstructions. The FEM was linked to an algorithm integrating spine growth and mechanobiological growth modulation, calibrated using preoperative Sanders score. VBT surgery was simulated to replicate immediate postoperative correction and predict two-year correction. Simulated Cobb angles, sagittal curves, and apical axial rotation were compared to actual two-year radiographic measurements.</p><p><strong>Results: </strong>Preoperative Cobb angles averaged 37 ± 12° (thoracic) and 48 ± 9° (thoraco-lumbar/lumbar). Immediate postoperative correction was 38 ± 15% and 59 ± 16%, with two-year corrections of 44 ± 24% and 73 ± 21%, respectively. Simulated postoperative correction was accurate within 3° (Cobb angles), while simulated 2-year outcomes were accurate within 3° (Cobb), 2° (kyphosis), 4° (lordosis), and 3° (axial rotation), showing no significant differences from reference results (p < 0.05; statistical power 90%).</p><p><strong>Conclusion: </strong>The patient-specific FEM and growth modulation algorithm accurately predicted two-year correction. This tool can support preoperative planning, reduce surgeon variability, and potentially improve VBT outcomes by providing a predictive tool to help surgical planning.</p>\",\"PeriodicalId\":21796,\"journal\":{\"name\":\"Spine deformity\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-06-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine deformity\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s43390-025-01123-x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine deformity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s43390-025-01123-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Multicenter validation of a surgical planning tool for lumbar vertebral body tethering simulating growth modulation over 2 years.
Purpose: Vertebral body tethering (VBT) for lumbar curves may have wider application than for thoracic curves due to greater growth potential than thoracic spine and benefits of preserved flexibility. Predicting long-term correction remains challenging, with high revision rates and complications (14-32%) including under-/over-correction, tether breakage, adding-on. This study aimed to validate a planning tool for lumbar VBT using a patient-specific finite element model (FEM) integrating mechanobiological growth modulation as a function of preoperative skeletal maturity.
Methods: Thirty-five retrospective idiopathic scoliosis patients who underwent lumbar VBT, with or without concomitant thoracic VBT, were included. A personalized FEM calibrated to preoperative spine deformity, flexibility and weight was created using 3D radiographic reconstructions. The FEM was linked to an algorithm integrating spine growth and mechanobiological growth modulation, calibrated using preoperative Sanders score. VBT surgery was simulated to replicate immediate postoperative correction and predict two-year correction. Simulated Cobb angles, sagittal curves, and apical axial rotation were compared to actual two-year radiographic measurements.
Results: Preoperative Cobb angles averaged 37 ± 12° (thoracic) and 48 ± 9° (thoraco-lumbar/lumbar). Immediate postoperative correction was 38 ± 15% and 59 ± 16%, with two-year corrections of 44 ± 24% and 73 ± 21%, respectively. Simulated postoperative correction was accurate within 3° (Cobb angles), while simulated 2-year outcomes were accurate within 3° (Cobb), 2° (kyphosis), 4° (lordosis), and 3° (axial rotation), showing no significant differences from reference results (p < 0.05; statistical power 90%).
Conclusion: The patient-specific FEM and growth modulation algorithm accurately predicted two-year correction. This tool can support preoperative planning, reduce surgeon variability, and potentially improve VBT outcomes by providing a predictive tool to help surgical planning.
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.
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