Posterior dynamic distraction had better short-term outcomes vs. vertebral body tethering
Key takeaways:
- Posterior dynamic distraction yielded better operative time, blood loss and length of stay vs. vertebral body tethering.
- Distraction yielded better curve correction at 6-month and 2-year follow-up.
SAN DIEGO — Results showed posterior dynamic distraction device better index correction, less blood loss and shorter length of stay compared with vertebral body tethering for adolescent idiopathic scoliosis.
However, Todd A. Milbrandt, MD, FAAOS, and colleagues found higher rates of revision with the posterior dynamic distraction device.
“The bottom line is that this is still a brand-new field, and we do not have the numbers to prove conclusively if there is one technology that is better than the other. But, for now, we are starting to get a better picture, that is that [posterior dynamic distraction device] PDDD technology is better in the short-term,” Milbrandt, division chief for pediatric orthopedic surgery at the Mayo Clinic and president of the Pediatric Orthopaedic Association of North America, told Healio. “Kids can quickly get out of the hospital and the surgery is faster. However, what we all want to know is what is going to be better in the long-term and that is yet to be determined.”
Patients with adolescent idiopathic scoliosis who met criteria to receive PDDD (n = 20) were matched by age, sex, Risser, curve type and magnitude to patients undergoing vertebral body tethering (n = 20). Milbrandt and colleagues compared results between the two groups out to 2-year follow-up.
In his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting, Milbrandt said patients who underwent PDDD had statistically significantly better average operative time, blood loss and length of stay. Patients in the PDDD group had better curve correction at 6-month and 2-year follow-up compared with patients in the vertebral body tethering group, according to Milbrandt. However, he said there was no difference in percent correction between the two groups over time.
“[PDDD and vertebral body tethering are] new technologies. Even though these were approved in 2019, it has not taken off until maybe 2021 or 2022. We are still early in our understanding of what this means for our patients,” Milbrandt told Healio. “The next steps will be to collect larger groups. There are certain studies and registries that are collecting this information now, including the newest registry from the Pediatric Orthopaedic Society of North America. As we watch and observe these patients through time, we will have an even better sense as to which is going to be the best technology.”
Todd A. Milbrandt, MD, FAAOS, of the Mayo Clinic, can be reached at milbrandt.todd@mayo.edu.
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Larson AN, et al. Paper 292. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.
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