{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:28:33Z","timestamp":1790216913538,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12,21]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior vertebral body tethering (AVBT) is an alternative to posterior spinal fusion (PSF) for the surgical treatment of scoliosis. The present study utilized a large, multicenter database and propensity matching to compare outcomes of AVBT to PSF in patients with idiopathic scoliosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with thoracic idiopathic scoliosis who underwent AVBT with a minimum 2-year follow-up retrospectively underwent 2 methods of propensity-guided matching to PSF patients from an idiopathic scoliosis registry. Radiographic, clinical, and Scoliosis Research Society 22-Item Questionnaire (SRS-22) data were compared preoperatively and at the \u22652-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 237 AVBT patients were matched with 237 PSF patients. In the AVBT group, the mean age was 12.1 \u00b1 1.6 years, the mean follow-up was 2.2 \u00b1 0.5 years, 84% of patients were female, and 79% of patients had a Risser sign of 0 or 1, compared with 13.4 \u00b1 1.4 years, 2.3 \u00b1 0.5 years, 84% female, and 43% Risser 0 or 1 in the PSF group. The AVBT group was younger (p &lt; 0.001), had a smaller mean thoracic curve preoperatively (48 \u00b1 9\u00b0; range, 30\u00b0 to 74\u00b0; compared with 53 \u00b1 8\u00b0; range, 40\u00b0 to 78\u00b0 in the PSF group; p &lt; 0.001), and had less initial correction (41% \u00b1 16% correction to 28\u00b0 \u00b1 9\u00b0 compared with 70% \u00b1 11% correction to 16\u00b0 \u00b1 6\u00b0 in the PSF group; p &lt; 0.001). Thoracic deformity at the time of the latest follow-up was 27\u00b0 \u00b1 12\u00b0 (range, 1\u00b0 to 61\u00b0) for AVBT compared with 20\u00b0 \u00b1 7\u00b0 (range, 3\u00b0 to 42\u00b0) for PSF (p &lt; 0.001). A total of 76% of AVBT patients had a thoracic curve of &lt;35\u00b0 at the latest follow-up compared with 97.4% of PSF patients (p &lt; 0.001). A residual curve of &gt;50\u00b0 was present in 7 AVBT patients (3%), 3 of whom underwent subsequent PSF, and in 0 PSF patients (0%). Forty-six subsequent procedures were performed in 38 AVBT patients (16%), including 17 conversions to PSF and 16 revisions for excessive correction, compared with 4 revision procedures in 3 PSF patients (1.3%; p &lt; 0.01). AVBT patients had lower median preoperative SRS-22 mental-health component scores (p &lt; 0.01) and less improvement in the pain and self-image scores between preoperatively and the \u22652-year follow-up (p &lt; 0.05). In the more strictly matched analysis (n = 108 each), 10% of patients in the AVBT group and 2% of patients in the PSF group required a subsequent surgical procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>At a mean follow-up of 2.2 years, 76% of thoracic idiopathic scoliosis patients who underwent AVBT had a residual curve of &lt;35\u00b0 compared with 97.4% of patients who underwent PSF. A total of 16% of cases in the AVBT group required a subsequent surgical procedure compared with 1.3% in the PSF group. An additional 4 cases (1.3%) in the AVBT group had a residual curve of &gt;50\u00b0 that may require revision or conversion to PSF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.22.00127","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T11:03:30Z","timestamp":1671620610000},"page":"2170-2177","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":46,"title":["Anterior Vertebral Body Tethering Compared with Posterior Spinal Fusion for Major Thoracic Curves"],"prefix":"10.2106","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9437-7973","authenticated-orcid":false,"given":"Peter O.","family":"Newton","sequence":"first","affiliation":[{"name":"Division of Orthopedics & Scoliosis, Rady Children\u2019s Hospital, San Diego, 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University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0819-663X","authenticated-orcid":false,"given":"Baron S.","family":"Lonner","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mount Sinai Hospital, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8870-8286","authenticated-orcid":false,"given":"Kevin M.","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nemours Children\u2019s Health, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-5754","authenticated-orcid":false,"given":"Daniel G.","family":"Hoernschemeyer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri Health Care, Columbia, 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