Orthopedics

Vertebral Body Tethering Surgery

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If bracing doesn’t work to correct pediatric scoliosis, doctors typically turn to surgery. For years, spinal fusion was the only option for children with severe scoliosis or other spine deformities. That approach stiffened the spine and limited flexibility. Today, vertebral body tethering (VBT), a minimally invasive procedure, can guide the spine into proper alignment. VBT uses a flexible cord, attached to several points along the spine. It relies on continued growth to pull the spine straight. VBT is much less restrictive than traditional spinal fusion. It is also called non-fusion scoliosis surgery or minimally invasive scoliosis surgery and is a highly effective.

Vertebral body tethering is most appropriate for children ages 8 to 15 who have:

  • Idiopathic scoliosis
  • A spine strong enough to support the anchors
  • A curve between 45 and 65 degrees; if the curve is less, it might cause overcorrection and if it is more, the treatment is less effective

How It Works

The surgeon fastens several screws (called anchors) to the bones of the spine (vertebrae) along the curve line. Then the surgeon attaches a flexible cord made of synthetic polymer (called a tether) to the screws. This tether slows the growth on the curved side and allows the other side to catch up. The anchors and tether generally remain in the body permanently.

The Procedure

First, our orthopedist will perform certain testing to make sure VBT is appropriate. This will include:

  • X-rays, to show where the bones are
  • EOS imaging, which lets us see your child’s spine when it is bearing weight
  • Magnetic resonance imaging, to evaluate the nerves in the spine and spinal cord

The procedure takes four to five hours. We use general anesthesia. We will follow up with a six-week exam, including X-rays, to check the spinal alignment. After six weeks, your child will likely be able to return to full activity—including dance or competitive sports. There are no major restrictions, though we recommend avoiding sky diving and bungee jumping. We will continue to assess your child’s spine every six months until they finish growing.

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