Presentation
Idiopathic scoliosis. Progression of curves. Pre-op.
Patient Data
Right-convex thoracic curve centered at T8. No vertebral abnormality. Left-sided heart and stomach. Normal hips.
Vertebral body tethering from T6 to L2. Improvement in the magnitude of the thoracic curve.
Change in the distance between the vertebral body screws at T11 and T12. New compared to previous. Appearances indicative of tether failure.
Comparison of the pre- and post-failure x-rays. There is a subtle, but definite increase in the distance between the vertebral body screws.
Case Discussion
When reviewing vertebral body tethering, it is important to scrutinize the position and relative distances between the supporting vertebral body metalwork. The tether is not visible on an x-ray and we therefore rely on changes in metalwork position, or alteration in the curve over time to deduce tether failure.