Systematic Reviews
Copyright ©The Author(s) 2022.
World J Orthop. May 18, 2022; 13(5): 481-493
Published online May 18, 2022. doi: 10.5312/wjo.v13.i5.481
Table 1 Study, design, inclusion criteria, study groups feature, follow-up, outcome measures and results of the included trials
Ref.
Design (level of evidence)
Study quality according to AAOS methodology
Inclusion criteria for AVBT
Study group
Control group
AVBT surgical approach
Follow-up
Outcomes at the final FU
Preoperative main features
Results at the final FU
Miyanji et al[14], 2020Retrospective study (level IV)High-quality studyMajor main T or L curves ≥ 40°. Risser score ≤ 3. Sanders score < 5AVBTs (n = 57). Female: 54 (94.74%). Mean age: 12.7 yr (8-16). Curves: Lenke 1: 48; Lenke 2: 6; Lenke 3: 1; Lenke 4: 0; Lenke 5: 1; Lenke 6: 1. Tether location: Thoracic (n = 55); lumbar (n = 2)NoneVATS plus mini-open for TL/L curvesMinimum 24 moClinical and radiological assessment (success: Residual curve < 35° at maturity)Tethered curve mean Cobb: 51°. Tethered curve flexibility: 41.8%. Untethered minor curve Cobb: 31.5°. TK (T5-T12): 18°. LL (L1-S1): -55.4°. Rib hump: 14.9 mm. Lumbar prominence: 3.9 mmTethered curve Cobb: 23°a. Tethered curve correction: 42.9%. Untethered minor curve Cobb: 22.3°a. TK (T5-T12): 22°a. LL (L1-S1): -56.5°. Rib hump: 10.3 mma. Lumbar prominence: 2.3 mma. Successful AVBT: 44 (77.19%)
Baker et al[17], 2021Retrospective study (level IV)Moderate quality studyN/AAVBTs (n = 19 in 17 pts). Female: 12 (70.6%). Mean age: 12.9 yr. Curves: Lenke 1: 9 pts; Lenke 2: 3 pts; Lenke 3: 1 pts; Lenke 4: 0; Lenke 5: 4 pts; Lenke 6: 0. Tether location: Thoracic (n = 13); lumbar (n = 6)NoneVATS plus mini-open for TL/L curvesMinimum 24 mo (2 to 4 yr)Radiological assessment (success: Residual curve < 35° at maturity)Tethered curve Cobb: 45°. Tethered curve flexibility: 63%. Untethered minor curve Cobb: 28°. TK (T5-T12): 20°. LL (L1-S1): -59°. Rib hump: N/A. Lumbar prominence: N/ATethered curve Cobb: 20°a. Tethered curve correction: 73%. Untethered minor curve Cobb: 26°. TK (T5-T12): N/A. LL (L1-S1): -52°. Rib hump: N/A. Lumbar prominence: N/A. Successful AVBT: 9 (52.94%)
Hoernschemeyer et al[20], 2020Retrospective study (level IV)High-quality studyN/AAVBTs (n = 29). Female: 26 (89.65%). Mean age: 12.7 yr (10-16). Curves: Lenke 1: 23; Lenke 2: 1; Lenke 3: 1; Lenke 4: 0; Lenke 5: 4; Lenke 6: 0. Tether location: Thoracic (n = 22); TL (n = 3); lumbar (n = 4)NoneVATS plus mini-open for TL/L curvesMinimum 24 mo (2 to 5 yr)Radiological assessment (success: Residual curve ≤ 30° at maturity)Tethered curve Cobb: MT: 40°. Long thoracic: MT = 56°; L = 22°; Left TL: L = 49°. Tether top, brace bottom: MT = 48°; L=38°. Tether top & bottom: MT = 48°; L = 42°; TK: 36.2°; LL: -60.83°. Rib hump: N/A. Lumbar prominence: N/ATethered curve Cobb: MT: 9°b. Long thoracic: MT = 21°; L = -1°. Left TL: L = 21°b. Tether top, brace bottom: MT = 23°a; L = 24°a. Tether top & bottom: MT = 24°a; L = 15°a; TK: 34.48°; LL: -57°. Rib hump: N/A. Lumbar prominence: N/A. Successful AVBT: 20 (74%)
Pehlivanoglu et al[21], 2020Prospective cohort study (level IV)High-quality studyAge: 9-14 yr. Risser ≤ 2. Sanders ≤ 4). Curve progression after at least 6 mo of brace (> 40°). MT curve > 35°. Curve flexibility > 30%AVBTs (n = 21). Female: 15 (71.43%). Mean age: 11.1 yr (9-14). Curves: Lenke 1: 21. Tether location: Thoracic (n = 21)NoneVATSMinimum 24 moRadiological assessmentTethered curve Cobb: 48.2°. Tethered curve flexibility: N/A. Untethered minor curve Cobb: 24.8°. TK (T5-T12): 26.8°; LL (L1-S1): -51.3°. Rib hump: N/A. Lumbar prominence: N/ATethered curve Cobb: 10.1°a. Tethered curve flexibility: N/A. Untethered minor curve Cobb: 9.6°a. TK (T5-T12): 26°; LL (L1-S1): -51.8°. Rib hump: N/A. Lumbar prominence: N/A. Successful AVBT: 20 (95.24%)
Newton et al[22], 2020Retrospective case-control study (level III)High-quality studyAge: 9-15 yr. Primary thoracic idiopathic scoliosis. Cobb angle: 40°-67°. Risser ≤ 1. No prior spine surgeryAVBTs (n = 23). Female: 16 (69.56%). Mean age: 12 yr (9-15). Curves: Lenke 1: 23. Tether location: Thoracic (n = 23)PSF (n = 26). Female: 23 (88.46%). Mean age: 13 yr (10-14). Curves: Lenke 1: 26. Tether location: Thoracic (n = 26)VATSMinimum 24 mo (2 to 5 yr)Clinical and radiological assessment (success: Residual curve < 35° at maturity)AVBT group: Tethered curve Cobb: 53°. Untethered curve Cobb: 34°. TK (T2-T12): 25°. LL (L1-S1): N/A. Rib hump: N/A. Lumbar prominence: N/A. PSF group: MT: 54°; LT: 34°; TK (T2-T12): 25°AVBT group: Tethered curve Cobb: 33°a. Untethered minor curve Cobb: 29°. TK (T2-T12): 12°; LL (L1-S1): N/A. Rib hump: N/A. Lumbar prominence: N/A. Successful AVBT: 12 (52%). PSF group: MT: 16°a; LT: 12°a; TK (T2-T12): 29°
Wong et al[23], 2019Prospective cohort study; a single-centre, Phase-2A pilot study (level IV)High-quality studyJuvenile or adolescent IS. Age: ≥ 8 and < 15 yr. Risser stage = 0. Bone age of ≤ 13 yr (hand/wrist X-ray). Major right thoracic scoliosis with a Cobb angle of 35°-55° and Lenke-1 curve pattern. TK (T5-T12) < 40°. Instrumentation to be applied no more cephalad than T4 and no more caudal than L2 (inclusive). Menses < 4 moAVBTs (n = 5). Female: All. Mean age: 11 yr (9-12). Curves: Lenke 1: All. Tether location: Thoracic (all)NoneVATSMinimum 4 yrClinical and radiological assessmentTethered curve mean Cobb: 40°. Tethered curve flexibility: 63.7%. Untethered curve Cobb: 20.6°. TK (T5-T12): N/A; LL (L1-S1): N/A; Rib hump: N/A. Lumbar prominence: N/ATethered curve Cobb: 18.9°a. Tethered curve correction: 53.8%. Untethered minor curve Cobb: 5°. Successful AVBT: 3 (60%)
Samdani et al[24], 2014Retrospective study (level IV)Moderate quality studyN/AAVBTs (n = 11). Female: 8 (73%). Mean age: 12.3 yr. Curves: Lenke 1: All. Tether location: Thoracic (all)NoneVATSMinimum 24 moClinical and radiological assessmentTethered curve Cobb: 44°. Tethered curve flexibility: 57%. Untethered curve Cobb: 25.1°. TK (T5-T12): 20.8°; LL (L1-S1): -47.5°. Rib hump: N/A. Lumbar prominence: N/ATethered curve Cobb: 13.5°a. Tethered curve correction: 70%. Untethered curve Cobb: 7.2°. TK (T5-T12): 21.6°; LL (L1-S1): -54.9°. Successful AVBT: 9 (81.8%)