Vertebral body tethering: Another option for treating scoliosis in children

 

                

                ROCHESTER, Minn. — Fusion surgery has been the long-standing treatment for people with scoliosis - a side-to-side curve of the spine. But other options have become available — including vertebral body tethering for children with scoliosis.\

               Mild scoliosis cases are monitored over time. Small curves in growing children can progress rapidly without treatment. Moderate scoliosis in growing children is treated with bracing. Until recently, severe scoliosis could only be treated with fusion surgery.

                 "Fusion had been a reliable treatment approach with a durable long-term result and powerful correction of the spinal curvature," Dr. Larson says. "But with fusion, the spine no longer grows, and there is no flexibility of the spine over the fused vertebrae. Some patients and families value spinal motion and growth, and would prefer another treatment approach for severe scoliosis."

                                      

                                When the cord is tightened during the surgery, the spine straightens. As the child grows, the spine may straighten even more. Growing children with moderate to severe scoliosis and certain curve types are eligible for the procedure.

                                 Although spinal motion and growth remains, there are potential downsides to the procedure. At this time, there is a higher risk for a second surgery compared with fusion surgery, due to overcorrection or undercorrection of the scoliosis. The long-term durability of the procedure is not known, and a fusion surgery may be required eventually.

                                 "Patients and families should be informed about their treatment options," Dr. Larson says. "Some families would like an alternative to fusion surgery. More information is coming out about nonfusion scoliosis surgery. If patients are interested in vertebral body tethering, I would encourage them to go to an experienced center, as this is an emerging technology."

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