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Vertebral Body Tethering (VBT) In 2014 A fusionless treatment option for scoliosis in the growing spine UPDATED March 2014.

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Presentation on theme: "Vertebral Body Tethering (VBT) In 2014 A fusionless treatment option for scoliosis in the growing spine UPDATED March 2014."— Presentation transcript:

1 Vertebral Body Tethering (VBT) In 2014 A fusionless treatment option for scoliosis in the growing spine UPDATED March 2014

2 Spinal Tethering Old use: FDA approved as a “dynamic stabilizer” in the posterior lumbar (lower) spine New use: Physician directed scoliosis treatment as a dynamic stabilizer in the growing anterior thoracic (upper) spine “Growth modulation”- partially restraining one side of the spine to allow growth on the other side to reverse the abnormal scoliosis growth pattern

3 Here is a bone model of the tether (white cord) attached to bone screws in the vertebral bodies of the spine (anterior) front of the spine (posterior) back of the spine

4 Components Titanium pedicle screws placed on the convexity (outside) of the vertebrae causing scoliosis Polyethylene-terephthalate (PET)* flexible tether connects to each screw and when tightened, compresses the adjacent screws to help straighten the spine –Cable safety extensively studied –Animal and computer simulation models show scoliotic correction –Early adolescent cases show scoliotic correction * Dynesys system by Zimmer spine

5 “Ideal” candidate Idiopathic scoliosis (adolescent or juvenile) or Idiopathic “like” (i.e. post syrinx decompression) >10yrs old with remaining spine growth ( done TOO young increases risk of overcorrecting the curve) Thoracic, thoracolumbar or lumbar curves 30° to 60°

6 Tethering advantages FUSIONLESS Allows the spine to grow Allows the spine to move and bend Most are one time surgery ( may need an adjustment of tether if overcorrection seen) “burns no bridges”, can do a later fusion if needed

7 During surgery Case #1 Feb yo female  Tethering   Staples  Before surgery 5 days after surgery

8 Case #1 35° 3 years later Before surgery

9 Case #3 Aug yo male 2 years later 38° 1 st erect 25° 6°6° Before surgery

10 Case #6 Oct yo female Before surgery 44° 36° 6° 2 years later

11 Case #11 Feb yo female Before surgery18 months later 50° 3°

12 Case #65 Nov yo female Before surgery 6 weeks later

13 Unknowns New use of an existing technology No long term follow-up Potential for overcorrection (curve opposite way) Refined criteria for “ideal” candidate Quicker return to all activities (currently 6 weeks)

14 For More Information If you have questions about tethering (VBT), please feel free to contact Janet Cerrone, PA-C


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