Does removing the spinal tether in a porcine scoliosis model result in persistent deformity? A pilot study

Clin Orthop Relat Res. 2011 May;469(5):1368-74. doi: 10.1007/s11999-010-1750-5.

Abstract

Background: Using a tethering technique, a porcine model of scoliosis has been created. Ideally, tether release before placement and evaluation of corrective therapies would lead to persistent scoliosis.

Questions/purposes: Does release of the spinal tether result in persistent deformity?

Methods: Using a unilateral spinal tether and ipsilateral rib cage tethering, scoliosis was initiated on seven pigs. The spinal tether was released after progression to a Cobb angle of 50°. Biweekly radiographs were taken for 18 weeks after tether release to evaluate longitudinal changes in coronal and sagittal Cobb angles. Postmortem fine-cut CT scans were used to evaluate vertebral and disc wedging and axial rotation; results were compared to a previously published data set of 11 animals euthanized before release of the tether (control group).

Results: Radiographic analysis demonstrated two responses to tether release: a persistent deformity group and an autocorrective group. Differences between these two groups included number of days with the tether in place before reaching a Cobb angle of 50° and degree of deformity immediately after scoliosis induction. CT analysis of the tether release versus tether intact groups demonstrated progression in vertebral body wedging without differences in apical rotation.

Conclusions: With the appropriate inducing parameters, release of the spinal tether does not systematically result in deformity correction. Tether release resulted in a reduction in Cobb angle in the first several weeks followed by steady curve progression. Deformity progression was confirmed using detailed CT morphometric analysis.

MeSH terms

  • Animals
  • Bone Screws*
  • Disease Models, Animal
  • Disease Progression
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / growth & development
  • Lumbar Vertebrae / surgery*
  • Male
  • Orthopedic Procedures / instrumentation*
  • Pilot Projects
  • Range of Motion, Articular
  • Ribs / growth & development
  • Ribs / surgery
  • Scoliosis / diagnostic imaging
  • Scoliosis / etiology*
  • Scoliosis / physiopathology
  • Swine
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / growth & development
  • Thoracic Vertebrae / surgery*
  • Time Factors
  • Tomography, X-Ray Computed