Issue link: https://viewer.e-digitaledition.com/i/1439655
T HE FDA A PPROV ED VBT for use in pediatric scoliosis patients in 2019 as an alternative to spinal fusion. The procedure, which had already been in use in Canada and Europe, is performed at only a handful of hospitals around the world. But new research suggests it could have a promising future for the subset of patients deemed appropriate candidates for the surgery. "The patients who are potentially candidates for VBT ... have remaining growth and ... moderate and fl exible curves up to 60 or 65 degrees," says Baron S. Lonner, MD, Chief of Minimally Invasive Scoliosis Surgery at Mount Sinai Hospital and Professor of Orthopaedic Surgery at Icahn School of Medicine. "Finding[s] from my own patients … [show they] did indeed have similar curve correction as for fusion in a two-year follow-up." HOW VBT WORKS Zimmer Biomet Spine's The Tether, so far the only FDA-approved VBT system in the U.S., employs anchors, bone screws and set screws made from titanium alloys used in common spine implants. These are placed on the side of the curvature on the patient's spine. A cord, made from a strong fl exible polymer, is then secured and tightened to partially straighten the spine. "The concept is to have progressive curve correction over time as the patient matures and then reaches skeletal maturity with a corrected curvature," Dr. Lonner says. Unlike spinal fusion, VBT allows patients to retain their full fl exibility, making it an appealing choice for young athletes, such as those who swim, dance or prac- tice gymnastics. Showing Promise for Some Patients BY CARI WADE GERVIN VERTEBR AL BODY TE THERING VBT, A SURGICAL ALTERNATIVE TO SPINAL FUSION FOR PATIENTS WITH SE VERE SCOLIOSIS, IS NOT IN WIDESPRE AD USE, BUT RESE ARCH SHOWS IT COULD HELP CERTAIN POPUL ATIONS, YOUNG ATHLE TES IN PARTICUL AR. STILL, THERE ARE DR AWBACKS. Vertebral Body Tethering 1 2