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Published on: May 31, 2017
Does removing the spinal tether in a porcine scoliosis model result in persistent deformity? A pilot study
Ashish Patel1, Frank Schwab, Renaud Lafage
1Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, 380 2nd Avenue, Suite 1001, New York, NY 10010, USA. md.ashish@gmail.com
Background:
Using a tethering technique, a porcine model of scoliosis has been created. Ideally, tether release before placement and evaluation of corrective therapies would lead to persistent scoliosis.
Questions/Purposes:
Does release of the spinal tether result in persistent deformity?
Methods:
Using a unilateral spinal tether and ipsilateral rib cage tethering, scoliosis was initiated on seven pigs. The spinal tether was released after progression to a Cobb angle of 50°. Biweekly radiographs were taken for 18 weeks after tether release to evaluate longitudinal changes in coronal and sagittal Cobb angles. Postmortem fine-cut CT scans were used to evaluate vertebral and disc wedging and axial rotation; results were compared to a previously published data set of 11 animals euthanized before release of the tether (control group).
Results:
Radiographic analysis demonstrated two responses to tether release: a persistent deformity group and an autocorrective group. Differences between these two groups included number of days with the tether in place before reaching a Cobb angle of 50° and degree of deformity immediately after scoliosis induction. CT analysis of the tether release versus tether intact groups demonstrated progression in vertebral body wedging without differences in apical rotation.
Conclusions:
With the appropriate inducing parameters, release of the spinal tether does not systematically result in deformity correction. Tether release resulted in a reduction in Cobb angle in the first several weeks followed by steady curve progression. Deformity progression was confirmed using detailed CT morphometric analysis.