Incidence and Predictors of Growth Modulation and Overcorrection After Anterior Vertebral Body Tethering.

Document Type

Article

Publication Date

2-15-2026

Abstract

STUDY DESIGN: Retrospective review of a prospectively collected single-center adolescent idiopathic scoliosis (AIS) database.

OBJECTIVE: To evaluate the incidence and predictors of growth modulation and overcorrection after vertebral body tethering (VBT) in AIS.

BACKGROUND: Little data exist regarding which AIS patients will exhibit growth modulation and/or overcorrection after VBT compared to those whose curve correction will remain unchanged (no modulation).

MATERIALS AND METHODS: A total of 279 patients with AIS with a minimum 2-year follow-up (range 2-10 yr) were included. There were 262 thoracic and 65 thoracolumbar VBT surgeries performed. Univariate and multivariate regression analyses were performed to identify the potential clinical/radiographic predictive factors for growth modulation and overcorrection.

RESULTS: Patients with growth modulation and those with no modulation after thoracic VBT were significantly more immature [younger, premenarchal, lower Sanders score/Risser grade, and open triradiate cartilage (TRC)] and physically smaller [lower height, weight, and body mass index (BMI); P < 0.02]. Patients with growth modulation versus no modulation after thoracolumbar VBT had lower preoperative Sanders score, weight, and BMI ( P < 0.04). Preoperative and first-erect thoracic and lumbar curve magnitudes did not affect growth modulation versus no modulation. Patients with thoracic overcorrection were physically smaller (lower height/weight/BMI) and had lower preoperative and first-erect thoracic curves than patients with growth modulation without overcorrection ( P < 0.04). Patients with thoracolumbar overcorrection had open-TRC and lower first-erect lumbar curves than patients with growth modulation without overcorrection ( P < 0.04). Open-TRC (odds ratio: 6.8, P < 0.001) and lower BMI ( P < 0.001) were the only significant predictive factors for thoracic growth modulation in multivariate analysis; none were identified for thoracolumbar growth modulation. Sixty-four percent of patients with overcorrection required revision surgery versus 18% of those with no modulation ( P < 0.001).

CONCLUSIONS: AIS patients with open-TRC and lower BMI had a statistically higher rate of thoracic growth modulation and overcorrection after VBT in multivariate analysis. Preoperative and first-erect curve magnitudes did not affect the incidence of growth modulation.

Publication Title

Spine (Phila Pa 1976)

Volume

51

Issue

4

First Page

286

Last Page

293

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