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 - McIntosh, Amy
AU - Ramo, Brandon
N1 - Funding Information:
Amir Mishreky has nothing to disclose. Stefan Parent reports personal fees from EOS-imaging, personal fees from Spinologics, personal fees from K2M, personal fees from EOS-imaging, personal fees from Medtronic, personal fees from DePuy Synthes Spine, other from Academic Research chair in spine deformities of the CHU Sainte-Justine (DePuy), grants from DePuy Synthes Spine, grants from Canadian Institutes of Health Research, grants from Pediatric Orthopaedic Society of North America, grants from Scoliosis Research Society, grants from Medtronic, grants from EOS imaging, grants from Canadian Foundation for Innovation, grants from Setting Scoliosis Straight Foundation, grants from Natural Sciences and Engineering Council of Canada, grants from Fonds de recherche Québec—Santé, grants and other from Orthopaedic Research and Education Foundation, other from DePuy Synthes, other from Medtronic, other from Orthopaediatrics, from null, outside the submitted work. Firoz Miyanji consults for Zimmer Biomet. Kevin Smit receives grant from Zimmer Biomet. Joshua Murphy consults for OrthoPediatrics, Depuy Synthes Spine and is a member of the physician advisory board. Riley Bowker has nothing to disclose. Nedal Al Khatib has nothing to disclose. Pediatric Spine Study Group reports grants from Pediatric Orthopaedic Society of North America, grants from Food and Drug Administration, grants from NuVasive, grants from DePuy Synthes Spine, grants from Children’s Spine Foundation, and grants from Growing Spine Foundation. Ron El-Hawary reports grants and personal fees from Depuy Synthes Spine, grants and personal fees from Medtronic Spine, personal fees and other from Orthopediatrics, other from Pediatric Spine Foundation, other from Scoliosis Research Society, personal fees from Wishbone Medical, personal fees from Globus Medical, outside the submitted work.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Scoliosis Research Society.
PY - 2022
Y1 - 2022
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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U2 - 10.1007/s43390-021-00455-8
DO - 10.1007/s43390-021-00455-8
M3 - Article
C2 - 35013996
AN - SCOPUS:85122878584
JO - Spine Deformity
JF - Spine Deformity
SN - 2212-134X
ER -