Vertebral Body Tethering: Rationale, Results, and Revision.

Vertebral body tethering is a nonfusion technique for the surgical correction of adolescent idiopathic scoliosis. For skeletally immature patients for whom vertebral body tethering is indicated, it is an alternative option to the gold standard posterior spinal fusion (PSF) and may at least partially preserve motion in instrumented segments of the spine. Benefits of the procedure include the possibility of avoiding the long-term sequelae of PSF such as adjacent segment disease and proximal junctional kyphosis. Recent retrospective case series of vertebral body tethering have shown promising results with correction rates up to 70% but greater variability in outcomes compared with PSF. The complication profile of the procedure also appears to differ from PSF with tether breakage and overcorrection as primary concerns in addition to approach-related complications. Although early outcomes have been promising, additional studies to optimize surgical timing, long-term outcomes, and the possible role of tethering in the more skeletally mature patient are required.