Saturday, November 26, 2022

 Blog Topic: Talking Points about Thoracic Vertebral Body Tethering vs. ApiFix

Vertebral Body Tethering (VBT) and the ApiFix device are procedures which have garnered a lot of attention from surgeons, patients and families.  Below is a list of talking points which should be known about VBT and ApiFix so there can be informative, educated, transparent discussions about VBT and ApiFix, when compared to the other commonly-performed procedure Posterior Spinal Fusions.  Discussions on these points is necessary before VBT or ApiFix surgery between the surgeon and patients/families to be fully-informed.

Talking Points to discuss with your surgeon:

Saturday, November 5, 2022




In past blog posts we have presented Magnetically-Controlled (MAGEC) Growing Rods.

1)     There was the three-part series on the following dates:

3-9-2017          MAGEC: Part 1

5-3-2017          MAGEC: Part 2

5-18-2017        MAGEC: Part 3


2)     On 11-28-2021 a study on the use of MAGEC vs. Posterior Spinal Fusion vs. Vertebral Body Tethering in 8-11 year old patients was presented


3)     On 8-23-2022 we presented a comparison of the Shilla Growth Guidance system vs. the MAGEC Growing Rods.  This blog post was a compilation of talking points for discussions with surgeons when these constructs are options for treatment.


In this blog post we will demonstrate the use of MAGEC Growing Rods in a patient with neuromuscular scoliosis due to spastic quadriplegic cerebral palsy


This first figure shows an 8 year old boy with spastic quadriplegic cerebral palsy (CP).  He uses a stander and gait trainer, and has pain in his back when sitting. There is a 92 degree scoliosis (left picture) and 94 degree kyphosis (right picture).  It is common at this magnitude of deformity that back pain occurs when sitting, which is very problematic if they cannot stand and must use a wheelchair for all activities.  These children may not be able to attend school or take car ride due to back pain.



When the patient lays down the scoliosis improves from 92 to 65 degrees and the kyphosis from 94 to 29 degrees, which is VERY flexible for a patient with CP.





As you see below the 92 degree scoliosis and 94 degree kyphosis both improve to 44 degrees by placement of magnetically-controlled growing rods (MCGRs) from T2 down to L5.  Stopping the growing rod short of the pelvis is possible since the hips are level, which decreases the infection risk and preserves some motion of the low back.




The below slide is 4 years and 3 months after surgery. The MCGRs have been lengthened 8 times in the office over that time period. No surgeries have been done over those 4 years, 3 months.  The two yellow arrows point to the area on each growing rod that has been lengthened.




The last slide shows how the spine deformity has improved…..with the MCGRs.  Treatment is ongoing…..