Chest tube management following two row vertebral body tethering for adolescent idiopathic scoliosis

Abstract

Background

The current gold standard of scoliosis correction procedures is still posterior spinal fusion, an extensively studied procedure. anterior vertebral body tethering is a newer surgical technique for the correction of scoliotic curves. Consequently, best practices have yet to be determined.

Methods

A single-institution, retrospective, review of all patients diagnosed with adolescent idiopathic scoliosis who underwent two row anterior vertebral body tethering between June 2020 and April 2022 was performed.

Results

Over the study period, 95 patients met inclusion: 79 females (83.2%) and 16 males (16.8%), age 14.4 ± 2.5 years, with a body mass index of 20.0 ± 2.9, and an average of 8.4 ± 2.1 levels treated. 28 (29.5%) procedures were for double curves and 67 (70.5%) for single curves. After tethering, a chest tube was positioned in each corrected side. A total of 123 chest tubes were analyzed, including 67 single curves and 28 double curves. The average chest tube duration was 2.5 ± 1.1 days and the average length of stay was 5.0 ± 2.0 days. The average chest tube output eight hours prior to removal was 61.1 ± 45.6 mL. There was no significant difference in average length of stay for patients who underwent correction of a single curve versus a double curve nor was there a difference in average length of stay or chest tube duration for revisions compared to primary procedures. For the entire cohort, the 30-day emergency department visit rate was 7.4% (n = 7) and the readmission rate was 4.2% (n = 4).

Conclusions

This early review of a 2-year two row vertebral body tethering postoperative experience provides a report of a safe and effective approach to chest tube management at a single academic center.

Keywords:

• Chest tubes
• anterior vertebral body tethering
• thoracotomy
• thoracoscopy
• pulmonary complications

Transparency

Declaration of funding

There was only departmental funding supporting this project, no sponsorship.

Declaration of financial/other relationships

Brooke O'Connell, Abel De Varona-Cocero, Djani Robertson, Leslie James, Robert Cerfolio, and Michael Zervos have no financial relationships to disclose. Stephanie Chang is a consultant for AstraZeneca and Atricure. Costas Bizekis has received honoraria from Medtronic, Steris, and Boston Scientific. Juan Carlos Rodriguez Olaverri has received honoraria from Globus Medical, Medtronic, and Zimmer Biomet. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Juan Carlos Rodriguez-Olaverri and Leslie Jams were involved in the conception and design of the paper. Brooke O'Connell, Djani Robertson, and Abel De Varona-Cocero were involved in data collection, analysis, and interpretation of the data; Brooke O'Connell and Juan Carlos Rodriguez Olaverri were responsible for drafting of the paper. Stephani Chang, Michael Zervos, Robert Cerfolio, and Costas Bizekis were responsible for critical revisions for intellectual content. All authors were involved in the final approval of the version to be published and all authors agree to be accountable for all aspects of the work.

Acknowledgements

The authors would like to acknowledge two individuals for their invaluable assistance with data collection for this patient cohort.

Prior presentation

Abstract accepted as a podium presentation at the 2022 Global Spine Congress, June 1st-4th, 2022 in Las Vegas, Nevada.