How Long Can You Delay? Curve Progression While Awaiting Vertebral Body Tethering Surgery

Area of Science:

• Orthopedics
• Spinal Surgery
• Pediatric Orthopedics

Background:

• Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity.
• Vertebral body tethering (VBT) is a surgical option for AIS.
• The impact of delayed VBT has not been extensively studied.

Purpose of the Study:

• To investigate the implications of delaying VBT in AIS patients.
• To assess the effect of delays on surgical planning and outcomes.
• To identify factors associated with curve progression and treatment changes.

Main Methods:

• Retrospective review of AIS patients treated between 2015-2021.
• Analysis of time to surgery from consultation.
• Assessment of patient characteristics, risk factors, and reasons for delay.

Main Results:

• Longer delays correlated with significant curve progression (≥5 degrees).
• Patients with longer delays had a higher risk of needing posterior spinal fusion (PSF) instead of VBT.
• Insurance denials were a primary reason for delays leading to PSF.

Conclusions:

• Surgical delays in AIS patients awaiting VBT can lead to increased curve progression.
• Delays may necessitate more invasive procedures like PSF.
• Optimizing surgical timing and shared decision-making are vital for successful AIS treatment.