Scoliosis affects about 2-3 percent of the American population. This disease causes your spine to curve to one side and usually develops during childhood or early adolescence. For most patients, scoliosis treatment often relies on the help of a rigid brace. Although braces can prevent the progression of abnormal curvature, they can’t reverse the existing problem.
As a result, children with severe scoliosis may need surgery. If you’re looking for a less invasive form of surgery for your child, you should consider vertebral body tethering. While it may be a fairly new surgical procedure, it effectively reverses curvature caused by scoliosis. Below is a guide that explains what the VBT procedure is and how it works.
What is Vertebral Body Tethering (VBT)?
Unlike spinal fusion, which uses stiff rods or bone grafts, vertebral body tethering uses a sturdy but flexible cord to pull on the outside of the abnormal curve, thus straightening the spine.
This FDA-approved procedure uses your child’s own growth process to align their spine. Your surgeon may recommend VBT based on the degree of your child’s spinal curve and their skeletal maturity. The components that make vertebral body tethering work include:
- Cord: Made of special polymer to realign the spine
- Bone Screws: They are inserted into the vertebrae to secure the cord
- Set Screws: These are positioned on top of the bone screws to maintain the cord’s tension
- Anchors: These are circular titanium alloy implants placed against the vertebrae to support the bone screws
How Does VBT Work?
Vertebral body tethering operates according to the principles of Hueter-Volkmann Law. It states that compressive forces that apply pressure to the spine slow down bone growth. VBT uses this idea to achieve growth modulation, allowing the spine to grow along a healthier path. Here are the steps that are taken during vertebral body tethering.
Step 1: Evaluation
During your child’s evaluation, a pediatric spine surgeon will ask for your child’s medical history and perform a physical examination. The surgeon will conduct imaging tests to identify the part of the spine affected, measure the degree of curvature, and how best to proceed with surgery.
The surgeon may also perform an X-ray of the spine to show bone placement and X-rays of the hand to help determine if your child has enough growth left for VBT. EOS imaging will also be done to show your child’s spine in a weight-bearing position, while an MRI will be performed to evaluate the nerves of the spine.
Step 2: Surgery
On the day of your child’s surgery, you will arrive at the hospital, and your child will be admitted. During surgery, the surgeon will administer general anesthesia to your child and access their spine through small incisions in the side of the chest.
The surgeons will then use a fiber-optic video camera to help place titanium screws along the outside edge of your child’s abnormal spinal curve, and a strong, flexible cord is threaded through the screws.
They will then tighten the cord, guiding the growth of the spine. As your child grows taller, the cord will pull their spine straighter, gradually treating scoliosis.
The operation may take about 3 to 5 hours.
Step 3: Post-Surgery
After surgery, your child will be in pain, so they will receive IV pain medication until they’re able to take oral medication. They will also need help when getting out of bed and walking.
Pulmonary monitoring is crucial after surgery. The medical professionals will show them exercises to do so that their lungs can recover fast.
They may discharge your child two to three days after the procedure. But before that, the doctor will conduct X-rays to ensure the implants are stable. They’ll also check and redress their incisions.
Step 4: Follow-Up Care
Your child will follow up with their doctor three weeks after surgery to ensure the wound is healing properly. After about six weeks, your child may need to return for an evaluation by a pediatric spine surgeon. During this appointment, the surgeon may conduct X-rays and other imaging tests to assess the spinal alignment and position of the implants.
Your child may continue to visit the doctor every six months so that they can assess the changes in their scoliosis. In most cases, the VBT implants will remain in your child’s spine throughout their lifetime.
Why is VBT Good for Treating Scoliosis in Children?
Unlike scoliosis braces, which only prevents curve progression, VBT can help reverse abnormal curvature. Here are some additional benefits of VBT:
Less Invasive Procedure
Because VBT is a minimally invasive surgery, your surgeon will enact slight trauma to your child’s delicate tissues. This leads to minimal blood loss and post-operative pain. Also, your child will have quicker recovery times.
Discreet Incisions
During the VBT procedure, the surgeon will access your child’s spine through an incision under their arm, making it easy to conceal the post-operative scars.
More Flexibility and Movement in the Spine
Since VBT uses a fusion-less system, your child won’t lose any mobility or flexibility in their spine. It also ensures your child maintains as much natural movement as possible, unlike other scoliosis treatments. This means your child can safely take part in their favorite physical activities, like sports, dance, and more.
Little Downtime
Your child can return to school 2-3 weeks after surgery. They may also not need bracing or physical therapy. Although they can take part in physical activities, they aren’t allowed to bend and twist excessively for a while.
Who is Qualified for VBT?
Unfortunately, not everyone can undergo vertebral body tethering. To qualify for the VBT treatment, you must:
- Be diagnosed with idiopathic scoliosis
- Be at least 10 years old
- Have a spinal curve of 35 to 70-degree angle
- Have a skeletal maturity of 0-2 on the Risser scale
Get Comprehensive Scoliosis Treatment for Your Child
Looking for effective scoliosis treatment? Look no further than The Advanced Spine Center. We offer effective, non-invasive VBT procedures to help straighten your child’s spine. Contact us to learn more about VBT.