{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:07:03Z","timestamp":1793653623317,"version":"4.5.1"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior vertebral body tethering (AVBT) is a growth-modulation technique theorized to correct adolescent idiopathic scoliosis (AIS) without the postoperative stiffness imposed by posterior spinal fusion. However, data are limited to small series examining short-term outcomes. To assess AVBT\u2019s potential as a viable alternative to posterior spinal fusion (PSF), a comprehensive comparison is warranted. The purpose of this meta-analysis was to compare postoperative outcomes between patients with AIS undergoing PSF and AVBT. Our primary objective was to compare complication and reoperation rates at available follow-up times. Secondary objectives included comparing mid-term Scoliosis Research Society (SRS)-22 scores, and coronal and sagittal-plane Cobb angle corrections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a systematic review of outcome studies following AVBT and\/or PSF procedures. The inclusion criteria included the following: AVBT and\/or PSF procedures; Lenke 1 or 2 curves; an age of 10 to 18 years for &gt;90% of the patient population; &lt;10% non-AIS scoliosis etiology; and follow-up of \u22651 year. A single-arm, random-effects meta-analysis was performed. Deformity corrections, complication and reoperation rates, and postoperative SRS-22 scores were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Ten AVBT studies (211 patients) and 14 PSF studies (1,069 patients) were included. The mean follow-up durations were similar for both groups. Pooled complication rates were 26% for AVBT versus 2% for PSF, and reoperation rates were 14.1% for AVBT versus 0.6% for PSF with nonoverlapping confidence intervals (CIs). The pooled reoperation rate among studies with follow-up times of \u226536 months was 24.7% in AVBT versus 1.8% in PSF. Deformity correction, clinical outcomes, and mid-term SRS-22 scores were similar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our study showed greater rates of complications and reoperations with AVBT compared with PSF. Reoperation rates were significantly greater in AVBT studies with longer follow-up (\u226536 months). Deformity correction, clinical outcomes, and mid-term SRS-22 scores were similar. While a potential fusionless treatment for AIS merits excitement, clinicians should consider AVBT with caution. Future long-term randomized prospective studies are needed.<\/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.oa.21.00002","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T10:05:22Z","timestamp":1624442722000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":49,"title":["Complications, Reoperations, and Mid-Term Outcomes Following Anterior Vertebral Body Tethering Versus Posterior Spinal Fusion"],"prefix":"10.2106","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2748-3052","authenticated-orcid":false,"given":"Max","family":"Shin","sequence":"first","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7469-8980","authenticated-orcid":false,"given":"Gabriel R.","family":"Arguelles","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7129-1007","authenticated-orcid":false,"given":"Patrick J.","family":"Cahill","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0643-0506","authenticated-orcid":false,"given":"John M.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2333-9061","authenticated-orcid":false,"given":"Keith D.","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2190-6333","authenticated-orcid":false,"given":"Jason B.","family":"Anari","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4]]},"reference":[{"key":"R1-20240801","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2174\/1874325001610010143","article-title":"Adolescent idiopathic scoliosis","volume":"10","author":"Choudhry","year":"2016","journal-title":"Open Orthop J"},{"key":"R2-20240801","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13013-018-0157-z","article-title":"Long-term outcome of posterior spinal fusion for the correction of adolescent idiopathic scoliosis","volume":"13","author":"Ghandhari","year":"2018","journal-title":"Scoliosis Spinal 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