Utility of an allograft tendon for scoliosis correction via the costo‐transverse foreman

Abstract

Current convex tethering techniques for treatment of scoliosis have centered on anterior convex staples or polypropylene tethers. We hypothesized that an allograft tendon tether inserted via the costo-transverse foramen would correct an established spinal deformity. In the pilot study, six 8-week-old pigs underwent allograft tendon tethering via the costo-transverse foreman or sham to test the strength of the transplanted tendon to retard spine growth. After 4 months, spinal deformity in three planes was induced in all animals with allograft tendons. In the treatment study, the allograft tendon tether was used to treat established scoliosis in 11 8-week-old pigs (spinal deformity > 50˚). Once the deformity was observed (4 months) animals were assigned to either no treatment group or allograft tendon tether group and progression assessed by monthly radiographs. At final follow-up, coronal Cobb angle and maximum vertebral axial rotation of the treatment group was significantly smaller than the non-treatment group, whereas sagittal kyphosis of the treatment group was significantly larger than the non-treatment group. In sum, a significant correction was achieved using a unilateral allograft tendon spinal tether, suggesting that an allograft tendon tethering approach may represent a novel fusion-less procedure to correct idiopathic scoliosis. ß

New horizons in spine research: Intervertebral disc repair and regeneration

“…Tethering procedures have received increasing interest for fusionless treatment of adolescent idiopathic scoliosis. A posterior allograft tendon tether was effective at controlling spinal deformities in growing pigs, suggesting this method shows promise as a potential method for scoliosis correction …”

“…A posterior allograft tendon tether was effective at controlling spinal deformities in growing pigs, suggesting this method shows promise as a potential method for scoliosis correction. 24 Although relatively uncommon, post-operative spinal infections can be a devastating complication after spinal surgery, and a mouse model of spine implant infection was developed using in vivo bioluminescence and fluorescence imaging to non-invasively quantify bacterial burden and host inflammation longitudinally. 25 A composite biomaterial strategy used to treat a rabbit in vivo spinal tuberculosis model found that anti-tuberculosis drugs had better penetration using hydroxyapatite microspheres but poly (lactic-co-glycolic acid) carriers were better for distribution.…”