How Long Can You Delay? Curve Progression While Awaiting Vertebral Body Tethering Surgery

Background: The implications of delaying surgical intervention for patients with adolescent idiopathic scoliosis (AIS) wishing to undergo vertebral body tethering (VBT) have not yet been explored. It is important to understand how these delays can impact surgical planning and patient outcomes. Methods: This was a retrospective review that analyzed all AIS patients treated between 2015 and 2021 at a single tertiary center. Time to surgery from initial surgical consultation and ultimate surgical plan were assessed. Patient characteristics, potential risk factors associated with increased curve progression, and reasons for delay were also analyzed. Results: 174 patients were evaluated and 95 were scheduled for VBT. Four patients later required a change to posterior spinal fusion (PSF) due to excessive curve progression. Patients requiring PSF were shown to have significantly longer delays than those who received VBT. Additionally, longer delays, younger age, greater curve progression, and lower skeletal maturity were correlated with significant curve progression (≥5 degrees). Conclusions: Surgical delays for AIS patients awaiting VBT may lead to significant curve progression and necessitate more invasive procedures. Patients with longer delays experienced an increased risk of needing PSF instead of VBT. Of those requiring PSF, the majority were due to insurance denials. Optimizing surgical timing and shared decision-making among patients, families, and healthcare providers are essential for achieving the best outcomes.

• Publication year

  2024

• Venue

  Journal of Clinical Medicine

• Publication date

  2024-04-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.3390/jcm13082209PMID 38673483PMCID 11050359
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Biomechanical modeling and assessment of lumbar vertebral body tethering configurations

  2023cited by this paper
• Vertebral body tethering: An alternative to posterior spinal fusion in idiopathic scoliosis?

  2023cited by this paper
• Socioeconomic Factors Correlation With Idiopathic Scoliosis Curve Type and Cobb Angle Severity

  2023cited by this paper
• Measurable Lumbar Motion Remains 1 Year After Vertebral Body Tethering

  2022cited by this paper
• When successful, anterior vertebral body tethering (VBT) induces differential segmental growth of vertebrae: an in vivo study of 51 patients and 764 vertebrae

  2022cited by this paper
• Disparities in Pediatric Scoliosis: The Impact of Race and Insurance Type on Access to Nonoperative Treatment for Adolescent Idiopathic Scoliosis

  2022cited by this paper
• Measurable Thoracic Motion Remains at 1 Year Following Anterior Vertebral Body Tethering, with Sagittal Motion Greater Than Coronal Motion

  2021cited by this paper
• Development of a Shared Decision-Making Tool for Adolescents With Scoliosis to Decide Between Observation Versus Fusion Surgery

  2021cited by this paper
• Anterior Vertebral Body Tethering for Adolescent Scoliosis with Growth Remaining: A Retrospective Review of 2 to 5-Year Postoperative Results.

  2020cited by this paper
• The Natural History of Adolescent Idiopathic Scoliosis

  2019cited by this paper
• The Insurance Approval Process for Proton Beam Therapy Must Change: Prior Authorization Is Crippling Access to Appropriate Health Care.

  2019cited by this paper
• Insurance Approval for Proton Beam Therapy and its Impact on Delays in Treatment.

  2019cited by this paper
• The Effect of the Risser Stage on Bracing Outcome in Adolescent Idiopathic Scoliosis.

  2016cited by this paper
• Impact of Surgical Waiting-List Times on Scoliosis Surgery: The Surgeon's Perspective

  2015cited by this paper
• Does delaying surgery in immature adolescent idiopathic scoliosis patients with progressive curve, lead to addition of fusion levels?

  2014cited by this paper
• Anterior Vertebral Body Tethering for Idiopathic Scoliosis: Two-Year Results

  2014cited by this paper
• Optimal surgical care for adolescent idiopathic scoliosis: an international consensus

  2014cited by this paper
• Impact of surgical waiting time on paediatric spinal deformity patients

  2013cited by this paper
• Is larger scoliosis curve magnitude associated with increased perioperative health-care resource utilization?: a multicenter analysis of 325 adolescent idiopathic scoliosis curves.

  2012cited by this paper
• Empirically derived maximal acceptable wait time for surgery to treat adolescent idiopathic scoliosis

  2011influential reference
• Disease severity and treatment in adolescent idiopathic scoliosis: the impact of race and economic status.

  2010cited by this paper
• Growth modulation by means of anterior tethering resulting in progressive correction of juvenile idiopathic scoliosis: a case report.

  2010cited by this paper
• Brace wear control of curve progression in adolescent idiopathic scoliosis.

  2010cited by this paper
• Adolescent idiopathic scoliosis.

  2008influential reference
• Insurance Status and Delay in Orthotic Treatment in Children

  2007cited by this paper
• Management of juvenile idiopathic scoliosis.

  2007influential reference
• Growth and progression of adolescent idiopathic scoliosis in girls

  2005cited by this paper
• Prediction of progression of the curve in girls who have adolescent idiopathic scoliosis of moderate severity. Logistic regression analysis based on data from The Brace Study of the Scoliosis Research Society.

  1995cited by this paper
• Idiopathic Scoliosis in Males A Natural History Study

  1988cited by this paper
• THE NATURAL HISTORY OF IDIOPATHIC SCOLIOSIS

  1988cited by this paper
• The prediction of curve progression in untreated idiopathic scoliosis during growth.

  1984cited by this paper
• Curve progression in idiopathic scoliosis.

  1983cited by this paper
• Untreated scoliosis in the adult.

  1978cited by this paper

• Impact of growth on spinal biomechanics and tether force in VBT: a simulation study

  2025cites this paper
• How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis? A Nonrandomized Clinical Trial.

  2025cites this paper
• Predicting Nonidiopathic Scoliosis from Plain Radiographs

  2025cites this paper
• A comparison of patients receiving vertebral body tethering for adolescent idiopathic scoliosis in the public and private hospital setting

  2024cites this paper
• Rates of School Absences in Pediatric Scoliosis Patients and Work Absences in Their Parents/Caregivers: A Retrospective Analysis

  2024cites this paper