TY - JOUR
T1 - Body mass index affects outcomes after vertebral body tethering surgery
AU - Pediatric Spine Study Group
AU - Mishreky, Amir
AU - Parent, Stefan
AU - Miyanji, Firoz
AU - Smit, Kevin
AU - Murphy, Joshua
AU - Bowker, Riley
AU - Al Khatib, Nedal
AU - El-Hawary, Ron
AU - Abdullah, Abdullah Saad Abdulfattah
AU - Ahn, Edward
AU - Akbarnia, Behrooz
AU - Akoto, Harry
AU - Albanese, Stephen
AU - Anari, Jason
AU - Anderson, John
AU - Anderson, Richard
AU - Andras, Lindsay
AU - Bauer, Jennifer
AU - Bellaire, Laura
AU - Betz, Randy
AU - Birch, Craig
AU - Blakemore, Laurel
AU - Boachie-Adjei, Oheneba
AU - Bonfield, Chris
AU - Bouton, Daniel
AU - Brassard, Felix
AU - Brockmeyer, Douglas
AU - Brooks, Jaysson
AU - Bumpass, David
AU - Cahill, Pat
AU - Chemaly, Olivier
AU - Cheung, Jason
AU - Cheung, Kenneth
AU - Cho, Robert
AU - Christman, Tyler
AU - Beauchamp, Eduardo Colom
AU - Couture, Daniel
AU - Crawford, Haemish
AU - Crawford, Alvin
AU - Dahl, Benny
AU - Demirkiran, Gokhan
AU - Devito, Dennis
AU - Diab, Mohammad
AU - Sebaie, Hazem
AU - El-Hawary, Ron
AU - Emans, John
AU - Erickson, Mark
AU - Fabregas, Jorge
AU - Gomez, Jaime
AU - Schulz, Jacob
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Scoliosis Research Society.
PY - 2022/5
Y1 - 2022/5
N2 - Purpose: To compare the outcomes of anterior Vertebral Body Tethering (AVBT) surgery between overweight and non-overweight patients. Methods: AIS/JIS patients with AVBT with 2-year follow-up from a multi-center pediatric spine database were evaluated pre-operatively, 1st post-operative erect, and 2 years post-operatively. ANOVA was used to compare 3 categories of BMI with significance as per Tukey–Kramer HSD post hoc test. Risk of scoliosis progression was analysed with Mid-P exact test. Results: 121 patients (51 underweight, 58 normal, 12 overweight; mean age 12.5 ± 1.6 yr; BMI 18.8 ± 4.6 kg/m2) were identified. Comparing underweight, normal, and overweight groups: mean pre-operative age (13 yr, 13 yr, 12 yr), scoliosis (52°, 50°, 52°), pre-operative kyphosis (29°, 28°, 33°), peri-operative scoliosis correction (44%, 42%, 46%), and complications by 2-year follow-up (23%, 24%, 17%) were similar between groups. There was one broken tether in each of the underweight and normal weight groups. Change in percent scoliosis correction from 1st erect to 2-year post-operative (i.e., growth modulation phase) was not significantly different between groups; however, the risk ratio for scoliosis progression during this period was 4.74 (1.02–22.02; p = 0.04) for overweight patients. Conclusion: Our findings demonstrate that, as compared to normal weight and underweight patients, overweight patients did not have a statistically significant difference in intra-operative scoliosis correction or in risk of experiencing complication; however, overweight patients had a risk ratio of 4.74 for progression of scoliosis during the growth modulation phase of treatment from first erect radiographs to minimum 2-year follow-up. Level of evidence: III.
AB - Purpose: To compare the outcomes of anterior Vertebral Body Tethering (AVBT) surgery between overweight and non-overweight patients. Methods: AIS/JIS patients with AVBT with 2-year follow-up from a multi-center pediatric spine database were evaluated pre-operatively, 1st post-operative erect, and 2 years post-operatively. ANOVA was used to compare 3 categories of BMI with significance as per Tukey–Kramer HSD post hoc test. Risk of scoliosis progression was analysed with Mid-P exact test. Results: 121 patients (51 underweight, 58 normal, 12 overweight; mean age 12.5 ± 1.6 yr; BMI 18.8 ± 4.6 kg/m2) were identified. Comparing underweight, normal, and overweight groups: mean pre-operative age (13 yr, 13 yr, 12 yr), scoliosis (52°, 50°, 52°), pre-operative kyphosis (29°, 28°, 33°), peri-operative scoliosis correction (44%, 42%, 46%), and complications by 2-year follow-up (23%, 24%, 17%) were similar between groups. There was one broken tether in each of the underweight and normal weight groups. Change in percent scoliosis correction from 1st erect to 2-year post-operative (i.e., growth modulation phase) was not significantly different between groups; however, the risk ratio for scoliosis progression during this period was 4.74 (1.02–22.02; p = 0.04) for overweight patients. Conclusion: Our findings demonstrate that, as compared to normal weight and underweight patients, overweight patients did not have a statistically significant difference in intra-operative scoliosis correction or in risk of experiencing complication; however, overweight patients had a risk ratio of 4.74 for progression of scoliosis during the growth modulation phase of treatment from first erect radiographs to minimum 2-year follow-up. Level of evidence: III.
KW - BMI
KW - Growth modulation
KW - Obesity
KW - Scoliosis
KW - VBT
KW - Vertebral body tethering
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UR - http://www.scopus.com/inward/citedby.url?scp=85122878584&partnerID=8YFLogxK
U2 - 10.1007/s43390-021-00455-8
DO - 10.1007/s43390-021-00455-8
M3 - Article
C2 - 35013996
AN - SCOPUS:85122878584
SN - 2212-134X
VL - 10
SP - 563
EP - 571
JO - Spine deformity
JF - Spine deformity
IS - 3
ER -