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Related Experiment Video

Updated: Jan 16, 2026

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
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Vertebral Growth Modulation Through Periosteal Resection and Fixed Length Deformity Overcorrection: Computational and

Matthew A Halanski1,2, Cameron Jeffers1,2, Yousuf Abubakr3

  • 1Phoenix Children's Hospital Phoenix Arizona USA.

JOR Spine
|October 3, 2025
PubMed
Summary

Posterior vertebral body tethering (VBT) techniques that shift the center of rotation posteriorly preserve disc height and promote corrective growth. These posterior implants offer a promising alternative to standard VBT for spinal deformities.

Keywords:
Heuter‐Volkmananimal modelgrowth modulationkyphosispediatricphysisvertebral body tethering (VBT)

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Area of Science:

  • Spine surgery
  • Orthopedic biomechanics
  • Growth modulation techniques

Background:

  • Vertebral body tethering (VBT) is a fusionless surgery for spinal deformities using asymmetric growth inhibition.
  • Standard VBT's anterior center of rotation may reduce disc height and inhibit vertebral growth.
  • Growth-promoting strategies are needed to expand VBT's capabilities.

Purpose of the Study:

  • To determine how center of rotation location during overcorrection impacts vertebral growth.
  • To evaluate growth-promoting techniques like anterior periosteal transection.
  • To assess a novel posterior implant for growth modulation.

Main Methods:

  • Finite element modeling (FEM) simulated anterior vs. posterior centers of rotation.
  • Assessed effects on disc height, physeal stress, and sagittal vertebral growth.
  • Large animal studies in swine evaluated periosteal transection and a posterior implant in a kyphotic model.

Main Results:

  • FEM showed posterior rotation increased disc height and promoted growth; anterior rotation inhibited growth.
  • Periosteal transection did not significantly accelerate vertebral growth.
  • The posterior implant achieved overcorrection and induced significant corrective growth modulation.

Conclusions:

  • Anterior periosteal resection/transection did not reliably enhance vertebral growth.
  • Shifting the corrective center of rotation posteriorly with a fixed-length device preserved disc height and promoted growth.
  • Posterior, length-stable implants are a viable alternative to standard VBT, especially when conventional methods are insufficient.