Vertebral Body Tethering as part of scoliosis treatment

What is vertebral body tethering?

Vertebral body tethering (VBT) is a less invasive surgical procedure that can modulate the bone growth of the spine during rapid growth spurt periods, especially during the adolescent years when curvatures typically progress. Patients with little or no skeletal growth remaining can also go for the procedure, depending on the flexibility of the curve. VBT is based off the Hueter-Volkmann principle, which states that “bone under more pressure will grow slower and denser than bone not under stress.”

VBT is attempting to influence the secondary reaction caused by the curve i.e. the uneven loading of the curve. It is not attempting to influence the genetic and environmental factors that initiate scoliosis.

Below is a comparison of VBT and spinal fusion surgery;

Vertebral Body Tethering

  • Less invasive
  • Less surgical hardware required
  • Curve reduction dependent on curve flexibility
  • Less blood loss and risk of infection
  • Can be used on pre-skeletal maturity
  • Spinal Motion sparing
  • Long-term complications are unknown

Spinal Fusion Surgery

  • Highly invasive
  • Extensive surgical hardware
  • Can achieve significant curve reduction in rigid curves
  • Requires self-donated blood transfusions
  • Requires growing rods prior for younger patients
  • Significant decrease in spinal motion
  • Known high long-term complication rates