![]() Vertebral tethering could be a good option for an athlete who’s on the cusp of their pre-adolescent growth spurt who participates in activities that require spinal mobility. ![]() Then think about your child’s stage of growth, the activities that are important to them, and the level of uncertainty you feel comfortable with. I think it’s helpful to look at the surgical options side by side: vertebral body tethering and spinal fusion surgery. Do you have any advice for families trying to decide between vertebral body tethering and spinal fusion? We have seen this with other moveable devices placed in the body, such as with total joint replacements that later required revision surgeries. Potentially this could generate debris in the chest or abdominal cavity, which could, in theory, create scar tissue. Because the spine has more mobility, there will likely be some friction where the tether attaches to the screws. We also don’t know the potential long-term effects of attaching the tethering device to the spine. Vertebral body tethering may maintain spinal mobility, but that hasn’t been proven and we don’t know how much mobility the patient will maintain over time. ![]() How comfortable are we with the uncertainties around this procedure?.How would my child be affected if the section of their spine with scoliosis were immobile?.Is the curve within the range of 30 to 60 degrees?.Is the curve in a mobile section of the spine?.Is my child at a stage of growth where VBT could correct their scoliosis?.Things to think about when considering VBT What remains unknown about vertebral body tethering? Once a young teen has finished growing, it’s no longer possible to affect the growth of their spine. On average, boys tend to gain the most height between the ages of 12 and 15. For girls, this typically takes place between the ages of 10 and 14. This procedure works by changing how the spine grows and is most effective during the adolescent growth spurt. Could vertebral body tethering work for an older teen? The thoracic (mid) spine is less mobile, so lost mobility there will have less of an impact on a patient’s future activities. This matters most if the curve is in a highly mobile section of the spine, such as the lumbar (lower) spine. VBT may maintain some mobility in the affected area of the spine. The location of the curve is also important. Patients need to have enough growing left that their spine can grow straighter after the procedure. (Illustration: Tasha McAbee, Boston Children’s) Who might benefit from vertebral body tethering? This restricts growth on one side of the spine, allowing the shorter side to catch up. As the child grows, the tension of the tether allows the other side of the spine to lengthen out and catch up with the tethered side.įor vertebral body tethering, a flexible tether is attached to the curved side of the spine. ![]() We do this by attaching a flexible cord, known as a tether, to the spine on the outside of the curve. Vertebral body tethering restricts the growth on one side of a scoliosis curve so the spine will grow straighter. Daniel Hedequist, chief of Boston Children’s Spine Division, talks about vertebral body tethering and what patients and families should consider when deciding if it’s a good option for them. While early studies have deemed vertebral body tethering safe, physicians have very little information about the procedure’s long-term risks or how stable their patients’ spines will be five, 10, or 20 years from now. However, VBT also comes with a host of questions. Compared to spinal fusion surgery, VBT offers quicker recovery times and the potential for greater spine mobility after surgery. ![]() A new option emerged in 2019 when the Food and Drug Administration approved a treatment called vertebral body tethering (VBT). (Photos: Karen Elsner, Boston Children's/Design: Sebastian Stankiewicz, Boston Children's)įor years, teens and tweens with idiopathic scoliosis had three treatment options: monitoring, bracing, or spinal fusion surgery. Daniel Hedequist discusses the pros and cons of vertebral body tethering. ![]()
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