Vertebral Body Tethering is a surgical treatment for children with idiomatic scoliosis that was recently approved by the FDA in 2019. During the procedure, surgeons place screws on the convex side (the side that curves out) of the spine curve. A rope-like device, called a tether, is then secured along the side of the vertebrae.
The tether is pulled taut, partially correcting the deformity of the spine., the device guide children future growth, as child grows taller, the bones growing in straighter alignment as a response to the tension. This method use child’s own growth as the device force to treat scoliosis. Candidates for the procedure must still be growing, most often this procedure is appropriate for children aged 8-15.
How to understand if VBT surgery is right for the children ?
The children who would like to be treated in Turkey by leading orthopedic specialists, they must need some of criteria:
- Have spinal curves that measure 35 to 65 degrees.
- Be diagnosed with the idiomatic scoliosis I.e scoliosis not related to other genetic conditions, neurological diseases, malformations or injury.
- Be at leas 8 years old, and generally younger than 16
- Have significant bone growth left
- Would otherwise need a spinal fusion surgery
Patients who consider to have vertebral body tethering can send their medical reports to get medical tourism services and receive a second medical opinion.
Spine surgery specialist evaluate patient’s medical history and imaging tests. Afterwards, doctor measure the degree of curvature, part of the spine affected, and the most suitable way to proceed with surgery.
Along with EUOS imaging, MRI and X-Ray doctor evaluates the nerves of the spine and spinal cord. X-Ray is not sufficient to evolve the nerves. If the child reach spinal maturity, another treatment will be recommended.
The procedure is performing with evaluation of full spinal MRI to check that there is no unusual condition within the spinal cord is causing the scoliosis. Child is go for pulmonary test to be sure of lung functionality. Blood tests will be taken as well.
On the morning of the surgery, after all checking is done, patient is taken to the operational room.
Vertebral body tethering is performing by the orthopedic surgeon and general surgeon assisting. The procedure is minimally invasive and blood loss is low.
After patient is administered general anesthesia, surgeons will access their spine through small incisions in the side of the chest. Surgeons use fiber-optic camera to help place titanium screws into the convex side of the vertebrae. This helps to slow growth on the side, allowing the convex side of the curvature to catch up with time.
A flexible cable called tether made of synthetic polymer connects the screws and is secured along the side of your child’s vertebrae. The tether is pulled taut and then guides your child’s future growth. As your child grows taller, the tether pulls their spine straighter, gradually correcting the deformity.
After the surgery, there are normally five to six small incisions on one side of your child’s body. The risk of the procedure is risk of the collapsed lung. Since the implants are inserted via access through the chest, and the lungs must be deflated during surgery, this is the area that is most carefully monitored during the post operative period. In rare cases, it is possible for your children spinal curve to over-correct in the opposite direction, this situation may need additional surgery to be performed. Our doctor will review all of the potential risks in person to help you decide to do the surgery or not.
Post surgical period takes 3 days of hospitalization, with usage of IV pain medications. Many patients will only need Motrin and other non-narcotic medications. The patients must follow the exercises for the lungs. The chest tube and urinary catheter are usually removed within 48 hours of surgery. Before patient is discharged, the incisions will be checked and redressed, and X-Rays will be taken to ensure the implants are stable. Many patients are allowed to go home two to three days after the procedure is performed.
Recovery process consisting of walking, climbing stairs and do normal activities, depending on recovery and pain, patients can return to school or work (Adults) since one to three weeks after surgery.
Primary care provider will follow up patient three weeks after surgery, six weeks post operation, patients can send their new MRI screenings to do the check with the surgeon. Most children return to full activity after final check and are allowed to participate in competitive sports. There are no major restrictions on sports or activities, other than activities that are considered dangerous in general.
Patients with scoliosis could receive the innovative vertebrae body tethering procedure in Turkey by visiting the Medical Tourism Services to get consulted.