Outcomes of posterior spinal fusion and vertebral body tethering in patients with adolescent idiopathic scoliosis and evaluation of quality of life

Abstract

Objectives: Posterior instrumentation and fusion (PEF) is the standard surgical approach and vertebral body tethering (VBT) emerged as an alternative non-fusion technique in the treatment of idiopathic scoliosis. The aim of this study was to compare the correction and health-related life quality of the patients who have undergone PEF and VBT. Materials and Methods: Matched cohorts were obtained among patients whose curves ranged between 40°-70° who had >2 years follow-up. Patients with a lumbar curve included in surgery were excluded. Patients' demographic data, perioperative and follow-up radiographic measurements, and SRS-22 scores were compared. Results: 16 PEF and 18 VBT patients (30F, 4M) were included. The mean age and follow-up were 13.4 (10-17) years and 25.7 (24-32) months. Preoperative upper thoracic, main thoracic (MT), and thoracolumbar (TL) curves were similar among groups. The surgical correction percentage in the MT curve was greater in the PEF group (84%-53%, p<0.001), while the overall correction percentage at two years was similar (80-76%, p=0.616). There was an improvement in self-image and subtotal scores at two years in PEF and VBT groups (p<0.001-p=0.037 and p<0.001-p=0.016). In the PEF group, function scores at six months and two years (p=0.027), pain and sub-total scores at two years (p=0.020, p=0.036) were found to be lower compared to VBT. Conclusion: Following PEF and VBT surgeries, a similar improvement was observed in MT and TL curves. While similar improvement is achieved in SRS22 scores, this improvement is dynamically progressed in VBT. Whether SRS22 scores are better in the VBT group should be examined in larger patient series with longer follow-up.