Vertebral body tethering (VBT), approved by the FDA in August 2019, is a new surgical treatment option for idiopathic scoliosis in growing children whose scoliosis continues to progress despite bracing.
This growth modulation treatment uses anchors and an attached flexible cord to guide the spine into an upright alignment as a child grows. It's used in AIS patients with significant growth remaining and flexible curves between 45 and 65 degrees.
ApiFix is a new procedure for selected AIS patients with curves up to 60 degrees. It features short segment pedicle screw based instrumentation inserted around the apex of the main curve. The system has a ratchet mechanism that enables gradual postoperative device elongation and curve correction.
The ratchet is activated by performing specific spinal exercises to strengthen the curve. Compared to a spinal fusion, it has shorter segments and less anchors; it preserves motions without fusing the spine.
Spinal Fusion is a surgery to permanently connect two or more vertebrae in a patient's spine, eliminating motion between them. It involves techniques designed to mimic the normal healing process of broken bones. The surgeon places bone or bone-like material within the space between two spinal vertebrae. Metal plates, screws and rods are used to hold the vertebrae together so they can heal into one solid unit.
Spinal Fusion has been performed for over a century, consists of the majority of surgical treatment of AIS today, and is often considered the gold standard. In some rare complicated severe scoliosis cases, doctors may need to perform Halo-Gravity Traction first on patients before the fusion surgery.