{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:41:06Z","timestamp":1760402466161,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>VATS (video assisted thoracoscopic surgery) is routinely and successfully performed in minor and major complex thoracic procedures. This technique has been recently introduced for the treatment of severe forms of idiopathic scoliosis (IS) with the aim to repair the deformity, reduce morbidity and to prevent its progression in patients with skeletal immaturity. This study aims to present VATS in anterior vertebral body tethering (AVBT) approach to support the pediatric orthopedic surgeons during vertebral body fixation. Surgical and anesthesiologic tips and tricks are reported to assure a safe procedure. The study includes preadolescents with IS and a grade of scoliosis &gt;40\u00b0 that had a high probability of deterioration due to remaining growth (December 2018 to April 2021). Skeletal immaturity of enrolled patients was assessed by Sanders classification and Risser sign. Patients had a Risser score between 0 and 1 and a Sanders score &gt;2 and &lt;5. AVBT technique using VATS was performed by a senior pediatric surgeon assisting the pediatric orthopedic surgeon. Twenty-three patients have been submitted to VATS AVBT in the period of study (age range 9\u201314 years). The patients had a classified deformity Lenke 1A or B convex right and all types of curves were treated. In all patients, the vertebrae submitted to tethering surgery ranged from D5 to D12; mean curve correction was 43%. Three postoperative complications occurred: one late postoperative bleeding requiring a chest tube positioning on 12th postoperative day; one screw dislodged and needed to be removed; one child showed worsening of the scoliosis and needed a posterior arthrodesis. Initial results of VATS AVBT in growing patients with spinal deformities are encouraging. An appropriate selection of patients and a pediatric dedicated multidisciplinary surgical approach decrease intraoperative complications, time of operation and postoperative sequelae and guarantee an optimal outcome.<\/jats:p>","DOI":"10.3390\/children9010074","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T20:42:16Z","timestamp":1641415336000},"page":"74","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Video-Assisted Thoracoscopy for Vertebral Body Tethering of Juvenile and Adolescent Idiopathic Scoliosis: Tips and Tricks of Surgical Multidisciplinary Management"],"prefix":"10.3390","volume":"9","author":[{"given":"Sara","family":"Costanzo","sequence":"first","affiliation":[{"name":"Pediatric Surgery Department, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Pansini","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Colombo","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics and Traumatology, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Caretti","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics and Traumatology, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petar","family":"Popovic","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Lanfranchi","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1160-1456","authenticated-orcid":false,"given":"Anna","family":"Camporesi","sequence":"additional","affiliation":[{"name":"Pediatric Anesthesia and Intensive Care Unit, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Pelizzo","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cVittore Buzzi\u201d Children\u2019s Hospital, 20154 Milano, Italy"},{"name":"Department of Biomedical and Clinical Science \u201cL. Sacco\u201d, University of Milano, 20157 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11832-012-0457-4","article-title":"Epidemiology of adolescent idiopathic scoliosis","volume":"7","author":"Konieczny","year":"2013","journal-title":"J. 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Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"769","DOI":"10.2106\/JBJS.19.01176","article-title":"Anterior spinal growth modulation in skeletally immature patients with idiopathic scoliosis: A comparison with posterior spinal fusion at 2 to 5 years postoperatively","volume":"102","author":"Newton","year":"2020","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.ocl.2021.01.003","article-title":"Anterior vertebral body tethering for adolescent idiopathic scoliosis: Early results and future directions","volume":"52","author":"Baker","year":"2021","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1016\/j.spinee.2021.05.020","article-title":"Does vertebral body tethering cause disc and facet joint degeneration? A preliminary MRI study with minimum two years follow-up","volume":"21","author":"Yucekul","year":"2021","journal-title":"Spine J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"26","DOI":"10.21037\/atm.2019.09.72","article-title":"Standard and magnetically controlled growing rods for the treatment of early onset scoliosis","volume":"8","author":"Helenius","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/MOP.0000000000000432","article-title":"Advances in growing rods treatment for early onset scoliosis","volume":"29","author":"Bekmez","year":"2017","journal-title":"Curr. Opin. 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Implications for scoliosis progression","volume":"21","author":"Stokes","year":"1996","journal-title":"Spine"},{"key":"ref_16","first-page":"798","article-title":"Hyphenated history: The Hueter-Volkmann law","volume":"26","author":"Mehlman","year":"1997","journal-title":"Am. J. 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