According to the National Scoliosis Foundation, scoliosis – the abnormal curvature of the spine – affects 2 to 3% of the global population, or an estimated 7 million people. In an overwhelming number of cases, there is no known cause – this type of scoliosis is called idiopathic scoliosis. It most commonly occurs in adolescents between the ages of 10 and 15; and girls are eight times more likely than boys to experience curvature that requires medical intervention to correct it.
For decades, treatment has been broken into three main categories, depending on the patient’s age and degree of spinal curve: observation, bracing or surgery:
• Observation: If the spinal curve is mild, physicians may take a “watch and see” approach. As the skeleton matures, sometimes the curve will correct itself, or at the very least, it won’t get worse.
• Bracing: With bracing, patients with a mild-to-moderate curve wear a brace around their torso to help stop the curve from getting worse, though it cannot correct the curve. The brace is worn for several hours every day, usually until the patient stops growing.
• Surgery: In severe cases, patients must undergo surgery to correct the curve. For decades, the most common surgical method has been spinal fusion, where doctors implant rods along the spine that are fastened by screws to keep the spine straight.
While spinal fusion (especially as it relates to the minimally-invasive advances this technique has seen in recent years) has proven effective for correcting scoliosis, it is surgery nonetheless. Yet until recently, other treatment options have been designed to slow or halt curvature growth, which is great. But it isn’t correction.
However, there is encouraging news on this front. In recent years, the FDA has approved an alternative surgical procedure called Vertebral Body Tethering, which appears to hold some promise, though further research on long-term effectiveness is still needed.
What is Vertebral Body Tethering?
With Vertebral Body Tethering (VBT), titanium screws are placed on the curved portion of the spine and connected opposite a flexible cable. Unlike a fixed rod that is fused to the spine, the cable allows for stretching, movement and growth on the side of the spine that needs to “straighten out,” while inhibiting further curvature in the wrong direction.
Vertebral Body Tethering endeavors to halt further curving of the spine, help the patient maintain fuller range-of-motion in the spine, and not inhibit future growth. This means if a child still has plenty of time until she is fully developed, she could experience complete correction. In addition, this surgery is minimally-invasive, requiring only a few small incisions for arthroscopic placing of the cable, rather than leaving a lengthy scar down the back with rod implantation. Less invasive surgery typically equates to fewer days in the hospital and a quicker recovery time too. Furthermore, if the severity of the curve is not cured by Vertebral Body Tethering, surgeons can still go back and perform a traditional fusion surgery down the road, if necessary.
Who is right for Vertebral Body Tethering?
Currently, there are only a handful of physicians performing Vertebral Body Tethering around the world because the technique is still very new and not every patient is a good candidate for the procedure. Ideally, this surgery works best for patients with the following characteristics:
• 10 years or older
• Not fully developed
• Diagnosed with idiopathic scoliosis
• Has a curve between 35 and 60-degrees
What to expect
Patients will undergo surgery and spend a few days in the hospital before returning home to recover over three to four weeks. While patients are still in the hospital, they are fitted for a brace they must wear for three months post-surgery. At the three-month follow-up, patients are typically cleared to remove the brace and return to complete physical activity with little-to-no limitations.
Though more research and observation are needed to see how the spine continues to grow and adapt after this relatively new procedure, but so far, the patients who have undergone it have reported experiencing the benefits of greater mobility, and seemingly, a future with complete scoliosis correction.
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Add a Comment16 Comments
Hi. Is this operation available in Uk? My daughter is 13 with a curve of 54 degrees. A doctor who saw her said that he can do this operation but for more that I read nobody does this operation in Uk. Is very confusing to me. Thanks very much. Ruth.September 6, 2016 - 1:10am
Hi Malana,February 1, 2017 - 12:44pm
Not sure if you got the answers that you need but my son just had this surgery in the U.S. and I'd be happy to answer any questions you have about it.
I have an appointment with a surgeon at Philadelphia Shriners to see if my child is a candidate for vbt. This article was the first time I heard of the surgery being FDA approved. I am very curious about this surgery and would love to talk to you about your son's experience. Would you mind if I called you?November 2, 2017 - 7:48pm
Hi Sarah,August 1, 2017 - 3:50pm
We live in the UK and similarly would like info on how best to go about getting VBT surgery done in the States for my 14yr old son who has a 51 degree Scoliosis. Any help would be much appreciated as I am struggling to know how to proceed.
Did your son have any kind of disability or was his scoliosis without reason? What did it cost to get the operation? My daughter is supposed to be getting spinal fusion op in 10days and all this tethering information is new to me!May 21, 2017 - 7:32am
what was the cost ??March 29, 2017 - 6:27am
Hi SarahMarch 29, 2017 - 6:25am
Can you please contact me as we are planning to get this done for my daughter and I would like some information
Thanks a ton
My daughter is 12 with a curve of 68 degrees (right thoracic), we flew to Philadelphia & met with a Dr at Shriners who said she was not a candidate. I sought a 2nd opinion from a group of Doctors in NYC that are considered the pioneers of this surgery- actually known as ASC, anterior Scoliosis correction, and after looking at all her X-rays, say she is an excellent candidate. It would be helpful to speak with the parent of a child who has had this surgery. Her DR in Chicago has scheduled a fusion in May and I don't want that, but I also don't want to put all my faith into a surgery that ultimately will end in her needing a fusion anyway. Any help in degree of correction, etc would be immensely appreciated. Thank you so very much,March 13, 2017 - 11:20am
Hi, could you tell me how much flexibility you keep after the surgery?February 11, 2017 - 3:45pm
Hi - there is complete flexibility after anterior scoliosis correction (aka VBT) the kids can continue dance, martial arts, gymnastics , snowboarding etc etc without restrictionsFebruary 12, 2017 - 6:48am