Our Summary

This paper reviews a recent surgical procedure known as vertebral body tethering (VBT) used for treating adolescent idiopathic scoliosis, a condition that causes the spine to curve abnormally. The researchers conducted a comprehensive analysis using various databases and selected 19 studies for review, with 16 included in their final analysis.

The results showed that VBT significantly reduced spinal curvature in patients. The average angle of the curve was reduced from around 48 degrees before surgery to about 22 degrees after surgery. However, there were some complications associated with the procedure. Approximately 23% of patients experienced some form of complication, with the most common being the breakage of the tether (the cord used in the procedure). About 7% of patients needed a spinal fusion surgery, which is a more invasive procedure.

The authors conclude that while VBT is effective in reducing spinal curvature and preventing the need for more invasive procedures in most patients, the complication rate is relatively high. They suggest more research is needed to understand why these complications occur and to determine the best timing for the procedure. Overall, VBT appears to be a promising new treatment for adolescent idiopathic scoliosis.

FAQs

  1. What is vertebral body tethering (VBT) and what condition does it treat?
  2. What were the main findings of the research on the effectiveness of VBT in treating adolescent idiopathic scoliosis?
  3. What are the complications associated with VBT and how often do they occur?

Doctor’s Tip

One helpful tip a doctor might give a patient considering scoliosis surgery, such as vertebral body tethering (VBT), is to carefully weigh the potential benefits and risks of the procedure. It is important to have a thorough discussion with your healthcare provider about the expected outcomes, potential complications, and alternative treatment options. Additionally, following post-operative care instructions and attending regular follow-up appointments are essential for a successful recovery. It is also important to maintain a healthy lifestyle, including regular exercise and proper nutrition, to support the healing process and overall spinal health.

Suitable For

Patients who are typically recommended scoliosis surgery are those with adolescent idiopathic scoliosis, particularly those with moderate to severe spinal curvature that is progressing despite conservative treatments such as bracing. Surgery may also be recommended for patients who experience pain, difficulty breathing, or other complications related to their scoliosis. Additionally, patients who have reached skeletal maturity or have a curve angle greater than 40-50 degrees may also be candidates for surgery.

Timeline

Before scoliosis surgery:

  1. Diagnosis of scoliosis through physical examination and imaging tests
  2. Monitoring the progression of the curvature through regular check-ups
  3. Non-surgical treatments such as bracing, physical therapy, and pain management
  4. Discussion with a surgeon about the risks and benefits of surgery
  5. Pre-operative tests and evaluations to ensure the patient is a suitable candidate for surgery

After scoliosis surgery:

  1. Hospitalization for a few days to monitor recovery and manage pain
  2. Gradual return to normal activities with physical therapy and rehabilitation
  3. Follow-up appointments with the surgeon to monitor healing and spinal alignment
  4. Long-term monitoring of spinal health to prevent complications or recurrence of the curve
  5. Improvement in quality of life, reduced pain, and better posture for the patient.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vertebral body tethering surgery for scoliosis?
  2. How long is the recovery time following surgery and what can I expect during the recovery process?
  3. What are the long-term outcomes of vertebral body tethering surgery compared to traditional spinal fusion surgery?
  4. How do I know if I am a good candidate for vertebral body tethering surgery versus other treatment options?
  5. What is the success rate of vertebral body tethering surgery in terms of reducing spinal curvature and preventing progression of the scoliosis?
  6. Are there any lifestyle changes or restrictions I will need to follow after undergoing vertebral body tethering surgery?
  7. How often will I need follow-up appointments or monitoring after surgery to ensure the success of the procedure?
  8. What is the experience of the surgical team in performing vertebral body tethering surgery and what is their success rate with this procedure?
  9. Are there any alternative treatment options available for scoliosis that I should consider before deciding on surgery?
  10. What is the expected cost of vertebral body tethering surgery and will my insurance cover the procedure?

Reference

Authors: Roser MJ, Askin GN, Labrom RD, Zahir SF, Izatt M, Little JP. Journal: Spine Deform. 2023 Nov;11(6):1297-1307. doi: 10.1007/s43390-023-00723-9. Epub 2023 Jul 11. PMID: 37432604