Vertebral Body Tethering (VBT) is a procedure which has
garnered a lot of attention from surgeons, patients and families. Below is a list of talking points which should be known about VBT so there can be informative, educated, transparent
discussions about VBT, when compared to the other commonly-performed procedure
Posterior Spinal Fusions. Discussions on these points is necessary before VBT surgery between the surgeon and patients/families to be fully-informed.
|
Tether |
Posterior Spinal Fusion |
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|
Preoperative |
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FDA approved |
Yes |
Yes |
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|
FDA approved diagnoses |
Idiopathic only |
All diagnoses |
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Length of Time Procedure has been Performed in U.S. |
About 16 years |
>100 years; >45 years with metal implants |
|
|
Skeletal Maturity Risser |
0 to 2 |
Any |
|
|
Skeletal Maturity Sander Grade |
2 to 4 |
Any |
|
|
Curve Size |
45 to 60 degrees |
>50 degrees |
|
|
Curve Flexibility |
Sidebender <30 degrees |
Not applicable |
|
|
Compensatory Curve Size |
<45 degrees |
Any size |
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|
Surgical |
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Incisions, Total Number |
3 to 5 |
1 |
|
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Incisions, Total Length |
10 cm |
25 cm |
|
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General Surgeon Assisting? |
Yes |
No |
|
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Need to deflate one lung? |
Yes |
No |
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Major Curve Correction, Immediate |
Mild to Moderate |
Moderate to High |
|
|
3D correction |
Mild to Moderate |
Moderate to High |
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Length of Hospital Stay |
3 days |
3 days |
|
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Risk of Complications |
Low |
Low |
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After Discharge |
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Return to Sports |
6 weeks to 3 months |
6 months |
|
|
Loss of Flexibility |
Little |
Moderate, depends on fusion length |
|
|
Risk of Reoperation |
>20% |
<3% |
|
|
Curve correction over time |
Low to High |
None |
|
|
Risk of Implants Breaking |
100% |
<1% |
|
|
Predictability of Outcome |
Uncertain |
High |
|
|
Long-term Outcome |
Uncertain |
Good |
Thanks to Dr. Mike Vitale, Columbia University in New York,
for discussing this topic and providing the concept idea at the ICEOS meeting
in Salt Lake City.