Early outcomes of spinal growth tethering for idiopathic scoliosis with a novel device: a prospective study with 2 years of follow-up.
OBJECTIVE
Adolescent idiopathic scoliosis is a 3D spine deformity that worsens during the whole growth. New methods for spinal growth modulation with flexible spinal implants have been described to avoid progression of the deformity during growth spurt. The main limitations are that no specific ancillaries and devices are available, which makes the surgery technically demanding.


METHODS
We have developed a new method of spinal growth tethering using minimal invasive videothoracoscopic approach. Fixation is performed with staples and synthetic ligament on the lateral aspect of vertebral bodies on main curvature convexity. Patients with progressive thoracic idiopathic scoliosis despite the brace treatment were included. The clinical and radiological examinations were compared before and 2 years after surgery.


RESULTS
Six patients with flexible thoracic curves with a mean age 11.2 ± 1.2 years and a mean Cobb angle 45° ± 10° (35-60) were operated. All were skeletally immature. At last follow-up, the Cobb angle was stable. None of the patient underwent fusion.


CONCLUSIONS
The procedure allowed a stabilization of the deformity during growth spurt. Validated devices and further studies with longer term follow-up are needed to confirm the efficiency of this technique. This small cohort of patients is a source of reflection for further medical devices developments.


METHODS
Level 4 case series comparing to not randomized studies.
Orthopedic Pediatric Surgery Department, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble, France. mboudissa@chu-grenoble.fr.|Orthopedic and Traumatology Surgery Department, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble, France. mboudissa@chu-grenoble.fr.
M
M
Boudissa
Orthopedic Pediatric Surgery Department, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble, France.
A
A
Eid
Orthopedic Pediatric Surgery Department, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble, France.
E
E
Bourgeois
Orthopedic Pediatric Surgery Department, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble, France.
J
J
Griffet
Orthopedic Pediatric Surgery Department, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble, France.
A
A
Courvoisier
D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D019736:Prostheses and Implants; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome
Adolescent idiopathic scoliosis; Novel device; Spinal growth tethering; Spinal ligamentoplasty; Vertebral body stapling