Category Archives: Scoliosis Surgery
Non-fusion surgeries for scoliosis are gaining popularity with patients and their parents as a motion-sparing alternative to traditional scoliosis fusion surgery. Two of these procedures (VBT and ApiFix) have been “CE mark” approved in Europe and used “off label” for years in the United States, but recently received FDA HDE approval for both devices, paving the way for careful and selective usage.
Surgical intervention for idiopathic scoliosis dates all the way back to 1865 (France) and resulted in one of the first medical malpractice cases (which later paved the way for the concept of evidence-based medicine). From its controversial beginnings, the discussion has continued on through the decades as newer surgical techniques and hardware became available — with the Harrington rods in the 1960s through the mid 1980s, and the Cortel-Dubousset (C-D) hooks and rods instrumentation as its current predecessor.
Adolescent scoliosis is one of those tricky conditions that can evade detection for a long time after it develops. Its subtle symptoms are often dismissed until a rapid growth phase causes the spine’s abnormal curve to suddenly worsen.
Even then, scoliosis can continue to fly under the radar while the curve progresses. In one study, patients with moderate to severe scoliosis went undiagnosed more than 10 percent of the time.
Fusionless scoliosis tethering (otherwise known as vertebral body tethering or VBT) is a less invasive surgical procedure that has been used for the past 7 years by a select number of Orthopedic surgeons. While still a highly invasive surgical procedure, as all spinal surgeries are, it does offer some significant advantages over the more widely used spinal fusion for scoliosis procedures.
As many as one in 10 scoliosis patients will ultimately get a referral for spinal fusion surgery. Each year, nearly 40,000 choose to endure this invasive procedure.
But just because a doctor recommends spinal fusion doesn’t mean it’s your only — or even best — option.
Before you commit to having your spine fused, it’s important to fully consider the risks of scoliosis surgery. To reach the spine, a surgeon must cut through five layers of spinal muscles, including surrounding ligaments, tendons and the spine’s entire posterior joint system. Stabilizing the curve involves running a solid metal rod through a column of 3-inch screws and hooks inserted into the bone along the entire length of the curve. It’s a highly invasive surgery that requires months of recovery time.