The effect of vertebral body tethering on spine range of motion in adolescent idiopathic scoliosis: a pilot study

Purpose: Posterior spinal fusion and instrumentation (PSF) and vertebral body tethering (VBT) are corrective surgical techniques used in treating adolescent idiopathic scoliosis (AIS). Comparing the preservation of spine range of motion (ROM) following PSF and VBT for treatment of AIS has yet to be explored. The purpose of this work was to retrospectively compare global spine ROM in adolescents (9-18 years of age) without spine deformity, adolescents with untreated AIS, adolescents having undergone PSF, and adolescents having undergone VBT to gain insight on the effect of VBT on spine motion.

Methods: Twenty participants were recruited into four groups including Control (n = 6), untreated AIS (n = 5), post-operative PSF (n = 4) and post-operative VBT (n = 5). Three-dimensional kinematics of the spine were collected and analyzed using an intersegmental spine model during constrained forward flexion, right-left lateral bending, and right-left axial twist movements.

Results: The PSF group displayed significantly lower spine ROM than the two non-operative groups during thoracic and total left axial twist (p ≤ 0.048), whereas thoracic and total ROM during right-left lateral bending is almost equally lower in the PSF (p ≤ 0.03) and VBT (p ≤ 0.01) groups when compared to the Control and AIS groups.

Conclusion: These results suggest some preservation of spine motion in the transverse plane following VBT. This study provides initial evidence of some potential preservation of spine ROM following VBT; however, further prospective investigation of VBT is needed to assess and confirm these hypotheses.