106 Participants Needed

Spinal Tethering for Scoliosis

Recruiting at 11 trial locations
TS
TF
Overseen ByTyler Farber
Age: < 65
Sex: Any
Trial Phase: Academic
Sponsor: Pediatric Spine Foundation
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is anterior vertebral body tethering (AVBT) safe for humans?

Studies on anterior vertebral body tethering (AVBT) for scoliosis show that it has some risks, with about 3.3% of patients experiencing major complications like fluid buildup in the chest or nerve issues, and another 3.3% having minor issues like nausea or wound infections. However, no patients needed blood transfusions, and most complications were manageable.12345

How is the treatment Anterior Vertebral Body Tethering (AVBT) for scoliosis different from other treatments?

Anterior Vertebral Body Tethering (AVBT) is unique because it corrects scoliosis without the need for spinal fusion, allowing for continued growth and flexibility in the spine. Unlike traditional methods that involve fusing the spine, AVBT uses a flexible cord to guide the spine's growth, making it a promising option for children who are still growing.13678

What is the purpose of this trial?

Anterior vertebral body tethering (AVBT) is a novel, minimally invasive, growth modulation technique that was recently approved by the FDA under a Humanitarian Device Exemption (HDE). The goal of AVBT is to control curve progression by applying compression on the convex side of the spine deformity. While there has been great initial enthusiasm about the technique as an alternate treatment option to spinal fusion for skeletally immature children with scoliosis, there is a need to better understand the long-term outcomes.The purpose of this study is to report the long-term clinical outcomes of skeletally immature patients treated with AVBT, specifically:1. The effect on three-dimensional spine growth as compared to normal controls2. Maintenance of major Cobb angle less than or equal to 50 degrees at skeletal maturity3. Complications associated with both the procedure and the device

Research Team

RE

Ron El-Hawary, MD

Principal Investigator

Dalhousie University

Eligibility Criteria

This trial is for skeletally immature children with idiopathic scoliosis who have a major Cobb angle between 30° and 65°, have not had prior spinal surgery at the levels to be treated, and are unable to use bracing. They must also be able to return for follow-up visits and agree to participate in study procedures.

Inclusion Criteria

Bracing did not work or caused me issues.
My bones are strong enough for screw fixation.
I have been diagnosed with idiopathic scoliosis.
See 3 more

Exclusion Criteria

I have a condition that makes spinal surgery not beneficial for me.
I have an infection or skin issue at the surgery area.
Evidence of poor bone quality
See 3 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo anterior vertebral body tethering surgery

Surgery and immediate recovery

Follow-up

Participants are monitored for complications and spine growth outcomes

5 years

Treatment Details

Interventions

  • Anterior Vertebral Body Tethering
Trial Overview The trial studies Anterior Vertebral Body Tethering (AVBT), a new minimally invasive technique for controlling spine curve progression in children with scoliosis. It will compare long-term outcomes of AVBT patients with normal controls regarding spine growth and maintenance of curvature.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Anterior Vertebral Body TetheringExperimental Treatment1 Intervention
The subject is will receive anterior vertebral body tethering surgery, as clinically indicated, after all pre-operative assessments are complete.

Anterior Vertebral Body Tethering is already approved in United States for the following indications:

🇺🇸
Approved in United States as The Tether - Vertebral Body Tethering System for:
  • Progressive idiopathic scoliosis in skeletally immature patients with a major Cobb angle of 30 to 65 degrees

Find a Clinic Near You

Who Is Running the Clinical Trial?

Pediatric Spine Foundation

Lead Sponsor

Trials
2
Recruited
320+

Findings from Research

In a study comparing 23 patients who underwent anterior vertebral body tethering (AVBT) and 26 patients treated with posterior spinal fusion (PSF) for idiopathic scoliosis, the PSF group showed significantly better long-term correction of spinal deformity, with a mean thoracic curve of 16° compared to 33° in the AVBT group after an average follow-up of 3.4 years.
AVBT resulted in a higher rate of revision procedures (9 in the AVBT group, including 3 conversions to PSF) and a notable incidence of broken tethers (52%), indicating potential challenges in maintaining correction compared to PSF, although patient-reported outcomes were similar between both groups.
Anterior Spinal Growth Modulation in Skeletally Immature Patients with Idiopathic Scoliosis: A Comparison with Posterior Spinal Fusion at 2 to 5 Years Postoperatively.Newton, PO., Bartley, CE., Bastrom, TP., et al.[2023]
In a study comparing anterior vertebral body tethering (AVBT) to posterior spinal fusion (PSF) in 237 patients with idiopathic scoliosis, AVBT resulted in a higher percentage of patients (76%) having a thoracic curve of less than 35° at follow-up compared to 97.4% in the PSF group, indicating that PSF may provide better long-term curve correction.
However, 16% of AVBT patients required subsequent surgical procedures, including conversions to PSF, compared to only 1.3% in the PSF group, suggesting that while AVBT can be effective, it may also lead to more complications requiring additional surgeries.
Anterior Vertebral Body Tethering Compared with Posterior Spinal Fusion for Major Thoracic Curves: A Retrospective Comparison by the Harms Study Group.Newton, PO., Parent, S., Miyanji, F., et al.[2023]
The study involved 57 skeletally immature patients with idiopathic scoliosis, showing that anterior vertebral body tethering (aVBT) significantly corrected the main thoracic Cobb angle from an average of 40.4° to 18.7° after an average follow-up of 55.2 months, indicating its efficacy in treating scoliosis.
No major complications were reported, affirming the safety of aVBT, although 12.3% of patients required revision surgeries, highlighting a need for further refinement in the technique.
Prospective Follow-up Report on Anterior Vertebral Body Tethering for Idiopathic Scoliosis: Interim Results from an FDA IDE Study.Samdani, AF., Pahys, JM., Ames, RJ., et al.[2021]

References

Anterior Spinal Growth Modulation in Skeletally Immature Patients with Idiopathic Scoliosis: A Comparison with Posterior Spinal Fusion at 2 to 5 Years Postoperatively. [2023]
Anterior Vertebral Body Tethering Compared with Posterior Spinal Fusion for Major Thoracic Curves: A Retrospective Comparison by the Harms Study Group. [2023]
Prospective Follow-up Report on Anterior Vertebral Body Tethering for Idiopathic Scoliosis: Interim Results from an FDA IDE Study. [2021]
Risk of early complication following anterior vertebral body tethering for idiopathic scoliosis. [2021]
Early operative morbidity in 184 cases of anterior vertebral body tethering. [2022]
Thoracoscopic Vertebral Body Tethering for Adolescent Idiopathic Scoliosis: A Minimum of 2 Years' Results of 21 Patients. [2021]
Anterior Vertebral Body Tethering for Adolescent Scoliosis with Growth Remaining: A Retrospective Review of 2 to 5-Year Postoperative Results. [2021]
Efficacy of Anterior Vertebral Body Tethering in Skeletally Mature Children with Adolescent Idiopathic Scoliosis: A Preliminary Report. [2021]
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