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Sagittal Spinal Alignment 2 Years After Vertebral Body Tethering.

Jun Ouchida¹, Alexander Schupper², Joshua Pahys²

¹Department of Orthopaedics, Nagoya University Graduate school of Medicine, Nagoya, Japan.

|March 17, 2026

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This summary is machine-generated.

Vertebral body tethering (VBT) effectively corrects idiopathic scoliosis in skeletally immature patients, maintaining sagittal spinal alignment. This study provides evidence against concerns regarding sagittal plane derangement after VBT.

Area of Science:

Orthopedics
Spinal Surgery
Pediatric Orthopedics

Background:

Vertebral body tethering (VBT) is a non-fusion surgical option for idiopathic scoliosis.
Concerns exist regarding potential sagittal plane malalignment following VBT due to ongoing skeletal growth.

Purpose of the Study:

To evaluate changes in sagittal spinal alignment after VBT in skeletally immature patients with idiopathic scoliosis.
To utilize pelvic incidence-based measures to assess alignment changes.

Main Methods:

Retrospective cohort study of 87 patients with thoracic idiopathic scoliosis undergoing VBT.
Analysis of preoperative and 2-year postoperative radiographs, including coronal and sagittal parameters (vertebral pelvic angles - VPA).
Linear regression used to model T4PA and L1PA by pelvic incidence; T4-L1 mismatch compared to healthy adults.

Keywords:

coronal correction fusionless surgery growth modulation growth-related changes idiopathic scoliosis pediatric scoliosis pelvic incidence sagittal balance sagittal spinal alignment skeletally immature spinal deformity vertebral body tethering vertebral pelvic angle

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Main Results:

Significant improvement in thoracic scoliosis from 49 to 23 degrees post-VBT (P <.01).
Increase in T4PA (3 to 6 degrees) and L1PA (5 to 8 degrees) postoperatively (P <.01).
Postoperative T4-L1 mismatch showed significant correlation with pelvic incidence, with improved alignment within the adult prediction interval.

Conclusions:

VBT effectively corrects the coronal deformity in idiopathic scoliosis.
Patients undergoing VBT maintain sagittal alignment as measured by VPA.
Findings suggest VBT does not lead to sagittal plane malalignment concerns.