Related Experiment Video
Updated: May 3, 2026
Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Incidence and Predictors of Growth Modulation and Overcorrection After Anterior Vertebral Body Tethering
Joshua M Pahys1, Steven W Hwang1, Maureen McGarry1
1Departments of Orthopaedic Surgery and Neurosurgery, Shriners Children's Philadelphia, Philadelphia, PA.
Study Design:
Retrospective review of a prospectively collected single-center adolescent idiopathic scoliosis (AIS) database.
Objective:
To evaluate the incidence and predictors of growth modulation and overcorrection after vertebral body tethering (VBT) in AIS.
Background:
Little data exist regarding which AIS patients will exhibit growth modulation and/or overcorrection after VBT compared to those whose curve correction will remain unchanged (no modulation).
Materials And Methods:
A total of 279 patients with AIS with a minimum 2-year follow-up (range 2-10 yr) were included. There were 262 thoracic and 65 thoracolumbar VBT surgeries performed. Univariate and multivariate regression analyses were performed to identify the potential clinical/radiographic predictive factors for growth modulation and overcorrection.
Results:
Patients with growth modulation and those with no modulation after thoracic VBT were significantly more immature [younger, premenarchal, lower Sanders score/Risser grade, and open triradiate cartilage (TRC)] and physically smaller [lower height, weight, and body mass index (BMI); P <0.02]. Patients with growth modulation versus no modulation after thoracolumbar VBT had lower preoperative Sanders score, weight, and BMI ( P <0.04). Preoperative and first-erect thoracic and lumbar curve magnitudes did not affect growth modulation versus no modulation. Patients with thoracic overcorrection were physically smaller (lower height/weight/BMI) and had lower preoperative and first-erect thoracic curves than patients with growth modulation without overcorrection ( P <0.04). Patients with thoracolumbar overcorrection had open-TRC and lower first-erect lumbar curves than patients with growth modulation without overcorrection ( P <0.04). Open-TRC (odds ratio: 6.8, P <0.001) and lower BMI ( P <0.001) were the only significant predictive factors for thoracic growth modulation in multivariate analysis; none were identified for thoracolumbar growth modulation. Sixty-four percent of patients with overcorrection required revision surgery versus 18% of those with no modulation ( P <0.001).
Conclusions:
AIS patients with open-TRC and lower BMI had a statistically higher rate of thoracic growth modulation and overcorrection after VBT in multivariate analysis. Preoperative and first-erect curve magnitudes did not affect the incidence of growth modulation.
