The 2021 winner of the prestigious Thomas E. Whitecloud Award from the Scoliosis Research Society (SRS) is a paper which compared vertebral tethering to posterior spinal fusion for the treatment of scoliosis.
Vertebral Tethering Paper Wins Major SRS Award
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The Whitecloud Awards are named after Dr. Thomas S. Whitecloud, III, a pioneer in the spinal deformity field and a co-founder of the International Meeting on Advanced Spine Techniques.
The winning paper, “The Harms Study Group Retrospective Comparison Study on Anterior Vertebral Body Tethering (AVBT) versus Posterior Spinal Fusion (PSF) for Primary Thoracic Curves,” was announced at the 28th International Meeting on Advanced Spine Techniques (virtual).
The authors were Peter O. Newton, M.D., Stefan Parent, M.D., Ph.D.; Firoz Miyanji, M.D.; Ahmet Alanay, M.D.; Baron Lonner, M.D.; Kevin M. Neal, M.D.; Daniel Hoernschemeyer, M.D.; Burt Yaszay, M.D.; Laurel C. Blakemore, M.D.; Suken A. Shah, MD; and the Harms Study Group.
Upon receiving this award, author Peter O. Newton, M.D., explained the purpose of the study saying, in part: “This large-scale multi-center, multi-national study provides critical postoperative outcomes information for patients, parents and surgeons utilizing a matched comparison of AVBT [Anterior Vertebral Body Tethering] and PSF [Posterior Spinal Fusion]. Decision making regarding the ‘best’ surgical approach to progressive idiopathic scoliosis will vary based on patient specific goals and expectations, and we hope this data will inform such discussions regarding these two very different approaches to scoliosis.”
Interestingly, the outcomes from this study did not match with the research team’s hypothesis that outcomes would be comparable in both groups. The research team matched 122 thoracic anterior vertebral body tethering patients to 122 patients undergoing posterior spinal fusion for idiopathic scoliosis.
“At an average of 2.6 years after vertebral body tethering,” said Dr. Newton to OTW, “74% of patients had a curve less than 35 degrees. This compares to 99% of patients after posterior spinal fusion. Revision surgery was 6 times more likely after vertebral body tethering compared to posterior spinal fusion.”
When OTW asked how this might change surgeons counseling of patients and their families, Dr. Newton stated, “I hope this data will provide valuable information surgeons can share with their patients as they consider these two surgical approaches to adolescent idiopathic scoliosis.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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