SRS226 - Evaluating surgical strategies for adolescent idiopathic scoliosis: a meta-analysis of posterior spinal fusion and vertebral body tethering

Abstract Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity commonly affecting adolescents worldwide. Surgical management traditionally involves posterior spinal fusion (PSF), which achieves stable deformity correction but may limit spinal motion and growth potential. Vertebral body tethering (VBT) has emerged as a motion-preserving alternative aimed at modulating spinal growth while correcting curvature. This systematic review and meta-analysis compared PSF and VBT in terms of deformity correction, complication and revision rates, and postoperative functional outcomes. Data from multiple clinical studies were analyzed using standardized methods for pooling and evaluating outcomes. Results indicated that PSF generally provides more consistent and reliable curve correction with fewer complications and revisions, while VBT offers advantages in preserving motion and facilitating earlier postoperative recovery. However, VBT demonstrated greater variability in results and a higher likelihood of requiring additional interventions. These findings highlight the need for individualized treatment planning that considers curve severity, skeletal maturity, and long-term functional goals. PSF remains a robust corrective option, whereas VBT represents a promising motion-sparing approach for carefully selected patients. Further research is warranted to refine patient selection criteria and optimize long-term outcomes of non-fusion techniques.