Anterior vertebral body tethering for idiopathic scoliosis in growing children:A systematic review  

作　　者：Davide Bizzoca Andrea Piazzolla Lorenzo Moretti Giovanni Vicenti Biagio Moretti Giuseppe Solarino 

机构地区：[1]UOSD Spinal Deformity Centre,AOU Consorziale Policlinico di Bari,Bari 70124,Italy [2]Department of Biomedical Sciences and Human Oncology,University of Bari“Aldo Moro”,Bari 70124,Italy [3]Orthopaedic and Trauma Unit,AUO Consorziale Policlinico di Bari,Bari 70124,Italy [4]Department of Basic Medical Sciences,Neuroscience and Sense Organs,Orthopaedic and Trauma Unit,University of Bari“Aldo Moro”,Bari 70124,Puglia,Italy

出　　处：《World Journal of Orthopedics》2022年第5期481-493,共13页世界骨科杂志（英文版）

摘　　要：BACKGROUND The management of idiopathic scoliosis(IS)in skeletally immature patients should aim at three-dimensional deformity correction,without compromising spinal and chest growth.In 2019,the US Food and Drug Administration approved the first instrumentation system for anterior vertebral body tethering(AVBT),under a Humanitarian Device Exception,for skeletally immature patients with curves having a Cobb angle between 35°and 65°.AIM To summarize current evidence about the efficacy and safety of AVBT in the management of IS in skeletally immature patients.METHODS From January 2014 to January 2021,Ovid Medline,Embase,Cochrane Library,Scopus,Web of Science,Google Scholar and PubMed were searched to identify relevant studies.The methodological quality of the studies was evaluated and relevant data were extracted.RESULTS Seven clinical trials recruiting 163 patients were included in the present review.Five studies out of seven were classified as high quality,whereas the remaining two studies were classified as moderate quality.A total of 151 of 163 AVBT procedures were performed in the thoracic spine,and the remaining 12 tethering in the lumbar spine.Only 117 of 163(71.8%)patients had a nonprogressive curve at skeletal maturity.Twenty-three of 163(14.11%)patients required unplanned revision surgery within the follow-up period.Conversion to posterior spinal fusion(PSF)was performed in 18 of 163(11%)patients.CONCLUSION AVBT is a promising growth-friendly technique for treatment of IS in growing patients.However,it has moderate success and perioperative complications,revision and conversion to PSF.

关 键 词：Idiopathic scoliosis Spinal growth modulation Anterior spinal instrumentation Curve correction Anterior vertebral body tethering Paediatric spine Growing spine Skeletally immature patients Growth-friendly spinal implants 

分 类 号：R726.8[医药卫生—儿科]