Table 4.
Complications and revision operations following anterior thoracic vertebral body tethering and posterior lumbar spine tethering
| Patient number | Tether levels; subgroup type; apexes | Complication after surgery; time to complication (months); Levels broken; Location | Revision surgery; time since index surgery (months) | Clinical outcome |
|---|---|---|---|---|
| 1 | T4–T11 AT, T11–L3 PT; T7, L1 |
Cable breakage; 30; L2–L3; Below Lumbar Apex Lumbar overcorrection; 42; NA; Lumbar Curve |
Cable replacement and L3–L4 extension due to L2–L3 cable breakage; 34 Release of T11–T12 tether due to overcorrection; 45 |
Has not achieved skeletal maturity, although has indication for thoracic fusion |
| 2 | T5–T11 AT, T11–L3 PT; T9, L2 | Cable Breakage; 23; L2–L3; Below Lumbar Apex | Cable replacement and L3–L4 extension due to L2–L3 cable breakage; 25 | Main thoracic curve > 30 degrees. Successful correction of lumbar curve with posterior tether |
| 3 | T5–T11 AT, T12–L4 PT; T9, L2 | Cable breakage; 33; L3–L4; Below Lumbar Apex | Nonea | Clinical success without revision |
| 4 | T5–T12 AT, L1–L4 PT; T9, L3 |
Lumbar overcorrection; 2; NA; Lumbar Curve Lumbar overcorrection; 27; NA; Lumbar Curve |
Revision of lumbar tether; 3 Removal of lumbar tether; 29 |
Clinical success following two revision surgeries |
| 5 | T4–T11 AT, T11–L3 PT; T6, L2 |
Unstable L4 set screw; 15; NA; NA Cable Breakage; 31; NA; Thoracic (T9–T10, T10–T11); Below Thoracic Apex |
Replacement of L4 set screw; 15 | Main thoracic and lumbar curve > 30 degrees |
| 6 | T4–T12 AT, T12–L3 PT; T8, L3 | Lumbar overcorrection; 6; NA; Lumbar curve | Cable replaced (no breakage) but T12–L1 lumbar tether not applied; 6 | Clinical success following one revision surgery |
| 7 | T5–T12 AT, T12–L4 PT; T8, L3 | Progression of thoracic curve; 9; NA; Thoracic Curve | T3–T12 posterior spinal fusion; 12 | Main thoracic curve correction with PSF, but has not achieved skeletal maturity |
| 8 | T5–T12 AT; L1–L4 PT; T9, L3 | Possible cable breakage; 42; T12–L1; Above Lumbar Apex | Nonea | Clinical success without revision |
| 9 | T4–T11 AT; T11–L3 PT; T6, L2 | Progression of thoracic curve; 40; NA; Thoracic curve | T1–L1 posterior spinal fusion; 40 | Main thoracic curve correction with PSF. Successful lumbar correction with posterior tether |
| 10 | T6–T12 AT; T12–L4 PT; T10, L3 | Possible cable breakage; 37; T10–T11; below Thoracic Apex | Nonea | Main thoracic curve > 30 degrees. Successful correction of lumbar curve with posterior tether |
| 11 | T6–T12 AT; T12–L4 PT; T10, L2 | None | None | Clinical success without revision |
| 12 | T5–T12 AT; T12–L4 PT; T8, L2 | None | Nonea | Clinical success without revision |
| 13 | T5–T11 AT; T12–L4 PT; T8, L2 | None | None | Main thoracic curve > 30 degrees. Successful correction of lumbar curve with posterior tether |
| 14 | T5–T11 AT, T11–L4 PT; T8, L1 | None | None | Clinical success without revision |
Clinical success was defined as a patient who reached skeletal maturity with a ≤ 30° curve magnitude at most recent post-operative visit
aPatients 3, 8, 10, and 12 have suspected cable breakage but do not have indication for surgery given successful correction and skeletal maturity