Vertebral body tethering (VBT) is a surgical procedure used to treat scoliosis, a sideways curvature of the spine. It is a minimally invasive alternative to traditional spinal fusion surgery. During VBT, screws or anchors are placed into the vertebrae on the convex side of the curve. A flexible cord or tether is then attached to these screws, which helps to correct the curvature and guide the growth of the spine as the patient continues to grow. VBT aims to achieve spinal alignment without fusing the vertebrae, allowing more flexibility and preserving natural spine movement.
The procedure is the first choice before a spinal fusion surgery. The method allows the spine to grow naturally without any issues. The process is minimally invasive; hence, the recovery is quicker than an open surgery.
The surgery helps children perform routine functions without pain or hassle. The treatment involves attaching a flexible cord to the spine to guide the growth of the spine in the right direction. The method helps in improving the sideways curvature of the spine.
Who needs Vertebral Body Tethering?
Mentioned below are some of the medical scenarios that reflect the need for spinal surgery:
Idiopathic Scoliosis- It is a medical condition in which the spine of an adolescent grows in a bent position. Hence, it obstructs the routine activity of the kid and leads to various other issues. The condition can be characterised by symptoms such as pain, restlessness, and other similar problems. It is a common form of scoliosis and leads to an abnormal curve in the spine. The term itself defines no specific cause of the medical issue.
Scoliosis curves of 40 to 65 degrees– A spinal angle exceeding 45 degrees is considered dangerous for the spine. The spinal bent obstructs the individual’s daily routine, leading to different medical issues.
Skeletal Maturity- VBT is effective when the patient’s skeletal growth plates are still open, allowing the spine to be guided as it grows.
Advantages of Vertebral Body Tethering
Mentioned below are the advantages of spine tethering that helps to lower back pain:
Motion along with spine improvement– Vertebral body surgery is more effective than spinal fusion. The surgery allows the patient to move freely along with the growth of the spine in the right direction. The surgery does not restrict the patient’s motion; hence, the patent can perform different activities without any restrictions. A spinal fusion doesn’t allow the individual to move freely or perform back-related activities. Therefore, body tethering is recommended for adolescents rather than spinal fusion.
Correction of Curve– The surgery involves attaching support to the spine to improve the improper curve of the spine. It helps in the proper movement of the spine along with its correction. The patient feels much more relaxed in tethering than in fusion surgery.
Potential for Correction- VBT can significantly correct the scoliotic curve, improving the spine’s alignment.
Reduced Risk of Adjacent Level Degeneration- By preserving motion, VBT may reduce the risk of adjacent level degeneration in the spine, a concern with fusion procedures.
Minimally Invasive- VBT is a less invasive procedure than spinal fusion, involving smaller incisions, resulting in reduced tissue damage and quicker recovery.
Growth-Friendly- VBT is especially beneficial for adolescents with scoliosis who are still growing. The tether allows for guided spine growth, accommodating the patient’s natural growth process.
Faster Recovery- Patients undergoing VBT typically experience a quicker recovery compared to traditional fusion surgery, enabling a faster return to normal activities.
Complete Relief– Many patients benefit from the surgery for a lifetime. Hence, they do not require any other surgical procedure and can perform different activities involving the back. Therefore, it is one of the most significant advantages of scoliosis
tethering.
How is Vertebral Body Tethering performed?
The surgery is performed by a spinal surgeon along with a general surgeon. The affected spinal cord of the child is continuously monitored throughout the surgery to avoid any complications or risks during the surgery. The surgery is a minimally invasive one for the safety of the child and to ensure minimal blood loss. Screws are fitted on the pre-selected part of the vertebrae to improve the posture. After fitting the screws, a braided rope is passed through them to maintain the correct posture of the curved spine. The procedure is concluded by placing a drain in the patient’s chest. The drain stays in the chest until the patient is discharged. It helps remove accumulated fluids like blood to prevent complications, reduce pressure on organs, and aid lung expansion. Monitoring drainage assists in postoperative care and infection prevention. The decision is based on individual needs and the surgeon’s judgement for optimal recovery.
Post-Surgery Care Guidelines
Mentioned below are the guidelines that need to be followed to allow speedy recovery after the surgery:
Light Exercises– The surgery makes the child eligible to enjoy sports and perform routine activities like walking, bending, and climbing stairs. But it is advised to begin such activities after having a detailed inspection with the doctor. Starting all the activities helps to avoid any injury or sudden shock to the operated spine.
No Shower– A patient may have multiple bandages at the incision site after the surgery. Keeping the dressings clean and dry is advised to avoid infection. Hence, doctors also recommend avoiding bathing 4 to 5 days after the surgery. After a certain period and after having a follow-up with the doctor, the operated child can bathe easily.
Conclusion
Vertebral Body Tethering is a spinal surgery helpful in repairing the disturbing curves of the spine. The surgery helps to improve the improper posture or angle of the spine. The surgery is usually performed for children experiencing back pain who cannot perform spine-related activities.
FAQs
Q. What is Vertebral Body Tethering?
A. It is a spinal surgery helpful to improve the disturbing curve of the spine with the help of minimal invasive procedures.
Q. When is Vertebral Body Tethering performed?
A. Medical conditions such as idiopathic scoliosis, scoliosis curve of more than 45 degrees, sufficient vertebral body size to accommodate screws, and other similar issues require spinal surgery.
Q. Who is a candidate for VBT?
A. Adolescent patients (ages 10-18) with moderate to severe idiopathic scoliosis and remaining growth potential are potential candidates.
Q. What are the advantages of VBT?
A. VBT is minimally invasive, growth-friendly, offers potential curve correction, and allows for future revisions if needed.
Q. Is VBT reversible?
A. Yes, VBT is a reversible procedure, providing an option for adjustments or revisions in the future if required.
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