Vertebral Body Stapling: A Fusionless Treatment Option for a Growing Child With Moderate Idiopathic Scoliosis

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2010-01, Vol.35 (2), p.169-176
• Main Authors: BETZ, Randal R, RANADE, Ashish, SAMDANI, Amer F, CHAFETZ, Ross, D'ANDREA, Linda P, GAUGHAN, John P, ASGHAR, Jahangir, GREWAL, Harsh, MULCAHEY, Mary Jane
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Bone Nails; Cerebrospinal fluid. Meninges. Spinal cord; Child; Child, Preschool; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Device Removal; Female; Follow-Up Studies; Humans; Kyphosis - surgery; Lumbar Vertebrae - surgery; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Orthopedic Procedures - instrumentation; Retrospective Studies; Scoliosis - surgery; Thoracic Vertebrae - surgery; Treatment Outcome
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0b013e3181c6dff5

Retrospective review. To report the results of vertebral body stapling (VBS) with minimum 2-year follow-up in patients with idiopathic scoliosis. While bracing for idiopathic scoliosis is moderately successful, its efficacy has been called into question, and it carries associated psychosocial ramifications. VBS has been shown to be a safe, feasible alternative to bracing for idiopathic scoliosis. We retrospectively reviewed 28 of 29 patients (96%) with idiopathic scoliosis treated with VBS followed for a minimum of 2 years. Risser sign of 0 or 1 and coronal curve measuring between 20 degrees and 45 degrees . There were 26 thoracic and 15 lumbar curves. Average follow-up was 3.2 years. The procedure was considered a success if curves corrected to within 10 degrees of preoperative measurement or decreased >10 degrees . Thoracic curves measuring 50% correction on bend film had a success rate of 71.4%. Of the 26 curves, 4 (15%) showed correction >10 degrees. Kyphosis improved in 7 patients with preoperative hypokyphosis (10 degrees. Major complications include rupture of a unrecognized congenital diaphragmatic hernia and curve overcorrection in 1 patient. Two minor complications included superior mesenteric artery syndrome and atelectasis due to a mucous plug. There were no instances of staple dislodgement or neurovascular injury. Analysis of patients with idiopathic scoliosis (IS) with high-risk progression treated with vertebral body stapling (VBS) and minimum 2-year follow-up shows a success rate of 87% in all lumbar curves and in 79% of thoracic curves 35 degrees were not successful and require alternative treatments.