Return to sport and daily life activities after vertebral body tethering for AIS: analysis of the sport activity questionnaire

Alice Baroncini, Per David Trobisch, Angelika Berrer, Philipp Kobbe, Markus Tingart, Jörg Eschweiler, Stephanie Da Paz, Filippo Migliorini, Alice Baroncini, Per David Trobisch, Angelika Berrer, Philipp Kobbe, Markus Tingart, Jörg Eschweiler, Stephanie Da Paz, Filippo Migliorini

Abstract

Purpose: Vertebral body tethering (VBT) is an alternative to fusion for selected scoliosis patients. As VBT does not limit spine mobility, it has been propagated that this technique allows a quicker return to physical activity than fusion. However, no data are available to support this statement. Aim of this study was to quantify how much time patients required to resume preoperative activity level and to seek possible associations between return to physical activity and demographic, radiographic and surgical data.

Methods: One year postoperatively, the validated sport activity questionnaire (SAQ) was administered to all skeletally immature patients who underwent VBT at our institution. SAQ data were analyzed and a multivariate analysis was conducted to investigate associations between SAQ and demographic, radiographic and surgical data.

Results: Thirty-one patients aged 14.5 years completed the SAQ. Within 3 months from VBT, 97% returned to school, 61% resumed physical education, 97% carried a backpack, 68% run, and 82% rode a bike; 70% bent within a month from VBT. Ninety-four percent of patients returned to their preoperative athletic level. Within 3 months, 63% of responders resumed noncontact, 61% contact and 53% collision sports. No relevant associations were observed between the SAQ and demographic, radiographic and surgical data. In particular, number of instrumented vertebrae, level of the lowest instrumented vertebra and postoperative Cobb angle did not influence patients' return to preoperative activities.

Conclusion: VBT allows patients to quickly return to their preoperative activity level, irrespectively of the postoperative Cobb angle or type of instrumentation.

Keywords: Adolescent idiopathic scoliosis; Fusionless anterior scoliosis correction; Patient reported outcome measures; Physical activity; Sport; Sport activity questionnaire; Vertebral body tethering.

Conflict of interest statement

PDT was involved in Globus Medical (personal fees), Medtronic (personal fees), K2M (travel support). AB, AB, PK, MT, JE, SDP, FM were involved in none.

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Figures

Fig. 1
Fig. 1
Flowchart of patients’ recruitment
Fig. 2
Fig. 2
Clinical example of a patient before and 1 year after VBT

References

    1. Trobisch P, Suess O, Schwab F. Idiopathic scoliosis. Deutsch Arztebl Int. 2010;107(49):875–883. doi: 10.3238/arztebl.2010.0875.
    1. Fabricant PD, Admoni S-h, Green DW, Ipp LS, Widmann RF. Return to athletic activity after posterior spinal fusion for adolescent idiopathic scoliosis: analysis of independent predictors. J Pediatr Orthop. 2012;32(3):259–265. doi: 10.1097/BPO.0b013e31824b285f.
    1. Tarrant RC, OʼLoughlin PF, Lynch S, Queally JM, Sheeran P, Moore DP, Kiely PJ. Timing and predictors of return to short-term functional activity in adolescent idiopathic scoliosis after posterior spinal fusion: a prospective study. Spine. 2014;39(18):1471–1478. doi: 10.1097/BRS.0000000000000452.
    1. Sarwahi V, Wendolowski S, Gecelter R, Maguire K, Gambassi M, Orlando D, Lo Y, Amaral T. When do patients return to physical activities and athletics after scoliosis surgery?: a validated patient questionnaire based study. Spine. 2018;43(3):167–171. doi: 10.1097/BRS.0000000000002284.
    1. Rubery PT, Bradford DS. Athletic activity after spine surgery in children and adolescents: results of a survey. Spine. 2002;27(4):423–427. doi: 10.1097/00007632-200202150-00019.
    1. Samdani AF, Ames RJ, Kimball JS, Pahys JM, Grewal H, Pelletier GJ, Betz RR. Anterior vertebral body tethering for idiopathic scoliosis: two-year results. Spine. 2014;39(20):1688–1693. doi: 10.1097/BRS.0000000000000472.
    1. Samdani AF, Ames RJ, Kimball JS, Pahys JM, Grewal H, Pelletier GJ, Betz RR. Anterior vertebral body tethering for immature adolescent idiopathic scoliosis: one-year results on the first 32 patients. Eur Spine J. 2015;24(7):1533–1539. doi: 10.1007/s00586-014-3706-z.
    1. Newton PO, Bartley CE, Bastrom TP, Kluck DG, Saito W, Yaszay B. Anterior Spinal growth modulation in skeletally immature patients with idiopathic scoliosis: a comparison with posterior spinal fusion at 2–5 years postoperatively. J Bone Joint Surg. 2020 doi: 10.2106/JBJS.19.01176.
    1. Hoernschemeyer DG, Boeyer ME, Robertson ME, Loftis CM, Worley JR, Tweedy NM, Gupta SU, Duren DL, Holzhauser CM, Ramachandran VM. Anterior vertebral body tethering for adolescent scoliosis with growth remaining: a retrospective review of 2–5-year postoperative results. J Bone Joint Surg. 2020;102(13):1169–1176. doi: 10.2106/JBJS.19.00980.
    1. Newton PO, Kluck DG, Saito W, Yaszay B, Bartley CE, Bastrom TP. Anterior spinal growth tethering for skeletally immature patients with scoliosis: a retrospective look two to four years postoperatively. J Bone Joint Surg. 2018;100(19):1691–1697. doi: 10.2106/JBJS.18.00287.
    1. Jain V, Lykissas M, Trobisch P, Wall EJ, Newton PO, Sturm PF, Cahill PJ, Bylski-Austrow DI. Surgical aspects of spinal growth modulation in scoliosis correction. Instr Course Lect. 2014;63:335–344.
    1. Baroncini A, Trobisch PD, Migliorini F. Learning curve for vertebral body tethering: analysis on 90 consecutive patients. Spine Deform. 2020 doi: 10.1007/s43390-020-00191-5.
    1. Chen E, Sites BD, Rubenberg LA, Meador GD, Braun JT, Schroeck H. Characterizing anesthetic management and perioperative outcomes associated with a novel, fusionless scoliosis surgery in adolescents. AANA J. 2019;87(5):404–410.
    1. Mariconda M, Andolfi C, Cerbasi S, Servodidio V. Effect of surgical correction of adolescent idiopathic scoliosis on the quality of life: a prospective study with a minimum 5-year follow-up. Eur Spine J. 2016;25(10):3331–3340. doi: 10.1007/s00586-016-4510-8.
    1. Rice SG. Medical conditions affecting sports participation. Pediatrics. 2008;121(4):841–848. doi: 10.1542/peds.2008-0080.
    1. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–349. doi: 10.1016/j.jclinepi.2007.11.008.
    1. Baroncini A, Rodriguez L, Verma K, Trobisch PD. Feasibility of single-staged bilateral anterior scoliosis correction in growing patients. Glob Spine J. 2019;21:219256821989290. doi: 10.1177/2192568219892904.
    1. Trobisch PD, Kobbe P, Baroncini A. Die dynamische skoliosekorrektur als therapieoption bei adoleszenter idiopathischer skoliose (dynamic scoliosis correction as alternative treatment for patients with adolescent idiopathic scoliosis: a non-fusion surgical technique) Zeitschrift fur Orthopadie und Unfallchirurgie. 2019 doi: 10.1055/a-0983-1265.
    1. Elsadig M, Aslanturk O, Ozturk H, Akman YE, Sinan Kahraman S, Yetisyigit Y, Tunay Sanli T, Karadereler S, Enercan M, Hamzaoglu A (2020) Surgical treatment of thoracolumbar/lumbar curves with vertebral body tethering/non-fusion anterior scoliosis correction using double screw-double cord fixation
    1. Denis F (1984) Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clinical Orthop Relat Res (189):65–76
    1. Baroncini A, Migliorini F, Trobisch PD [2020] Non-Fusion anterior scoliosis correction (ASC) positively influences sagittal parameters. 27th, April, Athens, Greece, Athens

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit