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Updated: May 12, 2026

Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion
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Preoperative Fulcrum Flexibility >80% Is Associated With Clinical Success in Vertebral Body Tethering.

Kai Chun Augustine Chan1, Chi Chun Garvin Cheung1, Kai Him Ambrose Chan1

  • 1Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.

Global Spine Journal
|May 10, 2026
PubMed
Summary

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Vertebral Body Tethering (VBT) effectively corrects scoliosis in growing spines. Preoperative curve flexibility over 80% predicts successful outcomes and minimizes progression risk.

Area of Science:

  • Orthopedics
  • Spinal Surgery
  • Pediatric Orthopedics

Background:

  • Scoliosis management in growing patients presents challenges.
  • Vertebral Body Tethering (VBT) is a surgical technique for progressive spinal deformities.
  • Predicting VBT outcomes requires understanding pre- and intraoperative factors.

Purpose of the Study:

  • To investigate the relationship between preoperative and intraoperative factors and VBT surgical outcomes.
  • To identify predictors of successful coronal correction and clinical success after VBT.

Main Methods:

  • Single-center prospective study of 41 consecutive VBT patients with >2 years follow-up.
  • Radiographic parameters (curve magnitude, correction rate) were primary outcomes.
  • Preoperative flexibility, skeletal maturity, and intraoperative factors were analyzed.
Keywords:
fulcrum flexibilitygrowth modulationidiopathic scoliosisskeletal maturityvertebral body tethering

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Last Updated: May 12, 2026

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Main Results:

  • VBT significantly improved curve magnitude (49° to 17.4°) with a 64.6% initial correction rate, maintained at 2 years.
  • Preoperative flexibility correlated with sustained correction.
  • Preoperative flexibility >80% predicted postoperative clinical success (AUC 0.760).

Conclusions:

  • VBT effectively improves scoliosis curve magnitude and shoulder imbalance in growing spines.
  • Flexible curves (>80% flexibility) are associated with persistent coronal correction and higher clinical success rates.
  • Growth modulation is linked to skeletal immaturity in VBT patients.