Spinal Tethering & Stapling

Many of the patients we treat here at the Scoliosis SOS Clinic come to us in search of an alternative to scoliosis surgery, but while our ScolioGold method has consistently proven capable of reducing spinal curvature and improving quality of life (thus eliminating the need for surgical intervention), our exercise-based therapy has on occasion been used in conjunction with surgical treatment when the case called for it. The most common form of scoliosis surgery is spinal fusion, but there are a number of other techniques in use, and some of these have seen a boost in prominence and popularity of late. One approach that you might have heard of is spinal tethering, which comes in two different varieties: vertebral body stapling and vertebral body tethering.  

What is vertebral body stapling?

Vertebral body stapling (VBS) is a less invasive alternative to spinal fusion surgery. This procedure aims to control the progression of the patient’s spinal curvature through the use of special metal staples, which are attached to the vertebrae in the curved part of the spine. This creates a sort of internal scoliosis brace – the staples restrain one side of the spine while allowing the other side to grow normally, thereby countering the progression of the curvature. VBS may be used to treat a thoracic spinal curve measuring 25-35 degrees, or a lumbar curve of under 45 degrees.  

What is vertebral body tethering?

Vertebral body tethering (VBT) uses pedicle screws instead of malleable metal staples. These screws are inserted into the affected vertebrae and attached (tethered) to a flexible cable at the point where the spine curves. This procedure was developed with larger spinal curves in mind. VBT is used in cases of scoliosis where the curve measures 35-70 degrees.  

Benefits of spinal tethering

Both VBS and VBT are preferable to spinal fusion surgery in a number of ways – most importantly:
  • These procedures are less invasive than spinal fusion
  • Spinal fusion is generally only available to scoliosis sufferers who have reached maturity and finished growing; VBS and VBT, by contrast, are recommended for young patients who are still growing

Is spinal tethering effective?

On occasion, a scoliosis sufferer will come to the Scoliosis SOS Clinic in order to improve their flexibility and spinal correction ability before undergoing spinal tethering surgery. Then, after their VBT/VBS procedure, that individual will return to us as a post-surgery patient on a modified programme that’s designed to aid with scar tissue management and general rehabilitation. Our treatment programme also helps to prevent future progression of the patient’s condition. We have treated a number of post-VBT/VBS patients this way, and in our experience, spinal tethering/stapling has no positive impact on spinal rotation. This means that cosmetic changes to the patient’s rib cage are minimal, so be sure to take this into consideration when weighing up your scoliosis treatment options. It’s also worth noting that VBT/VBS are not currently available in the UK due to a lack of research. At time of writing, these procedures are only being carried out in the USA, Canada, New Zealand and India, and many scoliosis patients have had to pay hundreds of thousands of pounds to undergo spinal tethering abroad. Interested in non-surgical scoliosis treatment? Contact Scoliosis SOS today to arrange a consultation.

Orthotics & Insoles for Scoliosis

Scoliosis insoles / orthotics are custom-made devices created to help improve the effect of scoliosis on the patient’s feet and legs. In particular, orthotics for scoliosis sufferers are designed to help correct leg length discrepancy and limit abnormal motion within the body. The change in pressure from your feet can help to limit the progression of scoliosis over time.

Will scoliosis orthotics help me?

If you suffer from scoliosis and uneven legs or flat feet, scoliosis orthotics could help improve your condition. Leg misalignment often occurs when the patient’s spinal curvature causes their pelvis to become uneven, making one leg appear longer than the other. This is known as functional leg length discrepancy (as opposed to an anatomical leg length discrepancy) because the legs aren’t really different lengths. Unfortunately, a functional leg length discrepancy puts excess pressure on the back muscles, and this can lead to scoliosis progressing faster. This is why insoles / orthotics are sometimes prescribed to scoliosis patients.

How do insoles and orthotics work?

When scoliosis orthotics are prescribed, the patient is given custom-made insoles to wear in their shoes. These help to reduce the leg length discrepancy (or, in the case of flat feet, raise the flattened foot arch). The insoles help to arrest the progression of scoliosis, as they help reduce muscle imbalances around the spinal area. Orthopaedic shoes, inserts, and heel lifts are all utilised as forms of orthotic treatment for scoliosis. These types of support help to reduce pain in the hip, leg, and back.

Can orthotics cure scoliosis?

Orthotics and shoe inserts cannot ‘cure’ one’s spinal curvature, but they can help to relieve some of the painful side effects of this condition. They can also help prevent further curve progression in younger patients who are still growing. Likewise, orthotic treatment cannot cure leg discrepancies or symptoms such as flat feet. They can help improve these conditions and relieve the patient from pain, but insoles for scoliosis will not cure the patient of their condition. If you’re looking for other methods of treating scoliosis without the need for surgery, we provide physical therapy courses here at the Scoliosis SOS Clinic. Our four-week course can improve your curvature dramatically – see the results for yourself here. Contact Scoliosis SOS today to arrange an initial scoliosis consultation. Image courtesy of pixabay.com


Derived from the Greek words hudōr (water) and therapeia (healing), hydrotherapy (also known as aquatic therapy) is a method that is used to treat a variety of different bodily ailments. We recently began incorporating hydrotherapy into our ScolioGold method for scoliosis treatment, and today we’d like to take some time to tell you a little more about it. If you suffer from back pain due to scoliosis – but you’re worried that your reduced flexibility and mobility might hinder you in an exercise-based treatment setting – hydrotherapy is a great solution. Being immersed in water provides support for your body and creates a feeling of well-being without the intensity of land-based exercise.  

How does hydrotherapy work?

Hydrotherapy combines physical rehabilitation treatments with the natural benefits of water-based exercise. The result is a gentle but efficient scoliosis treatment method.

Water has five key properties that play a large part in the effectiveness of hydrotherapy treatment:
  • Buoyancy – The upward pressure in the water eases stress on muscles and joints, soothing the aches and pains that scoliosis can cause.
  • Temperature – Warm water is known for soothing and relaxing the body.
  • Viscosity – The ‘thickness’ of water prompts gentle resistance from the muscles.
  • Turbulence – When placed in moving water, the body naturally moves to maintain balance, exercising the muscles.
  • Hydrostatic Pressure – Hydrostatic pressure provides a natural relief for joint swelling.

What are the benefits of hydrotherapy treatment for scoliosis?

The main benefit of hydrotherapy is that flexibility and mobility are no longer an issue. As mentioned above, the gentle pressure and buoyancy provided by water naturally soothe pain and allow the patient to exercise while at ease. Pain is often dramatically reduced by hydrotherapy, and as a result of this, patients with limited mobility are able to achieve fantastic results through stretching in the water. These stretches strengthen the muscles in the back and can help improve the degree of the curvature. If patients choose, they can also combine hydrotherapy with land-based therapy on one of our ScolioGold courses. Another benefit of hydrotherapy treatment for scoliosis is that it offers more stability and protection from falls for those who struggle with balance. This is a great confidence boost for many patients. There are many other benefits of using hydrotherapy treatment for scoliosis, including:
  • Pain relief from muscle spasms
  • Ease of movement
  • Increased joint range and flexibility
  • Improved strength and endurance
  • Reduction of oedema (excess watery fluid in cavities or tissue in the body)
  • Improved circulation
  • Better cardiovascular fitness
  • Increased level of relaxation

Who can participate in hydrotherapy treatment?

Hydrotherapy is suitable for scoliosis sufferers of all ages. The healing and support provided make it an ideal method of treatment for those who lack confidence when it comes to more traditional forms of exercise. As mentioned above, stability is not an issue for elderly or less mobile patients, as the water allows them to exercise without fear of falling. Here at the Scoliosis SOS Clinic, we have had fantastic feedback from our hydrotherapy treatment sessions to date. We have found that it has offered hope to those patients who thought they would have to deal with their pain for the rest of their lives. Many of these patients did not think they would be able to improve their condition through exercise, but hydrotherapy treatment has provided them with that opportunity.  If you think hydrotherapy treatment might be beneficial for you, please contact Scoliosis SOS today to book an initial consultation.

Specialised scoliosis physiotherapy

Idiopathic scoliosis (which usually arises during puberty, when the body is going through a period of rapid growth) is often treated using a rigid back brace that prevents the spinal curve from progressing as the patient grows. It’s important to note that the aim of this bracing treatment is not to correct / reverse the sideways curvature of the spine, but simply to stop it from getting worse until the body has finished growing. And while bracing can be very effective in that respect, it does very little to assist in building up the muscle strength that will be needed to ensure spinal stability once the brace comes off.

In fact, bracing tends to have a negative effect on muscle strength.

Scoliosis braces typically have to be worn for over 20 hours a day in order to achieve the best treatment outcome. During the bracing period, the muscles around the spine are likely to become inactive because the brace is doing their job (i.e. supporting the spine) for them. This often results in a weakening of the spinal muscles, which may lead to the patient becoming reliant on the support of the brace.

But physical therapy can help with this problem.

There is a lot of clinical evidence to suggest that bracing delivers better outcomes for the patient when combined with scoliosis-specific physiotherapy. A 2011 study1 found that combining these two approaches reduces the risk of future curve progression and thus the likelihood that spinal fusion surgery will eventually be required. It has also been shown2 that completing a scoliosis-specific exercise programme limits the reversal of spinal correction when bracing ends. Not only are scoliosis-specific exercises recommended in the SOSORT 2011 guidelines for people with adolescent idiopathic scoliosis who are undergoing brace treatment, but several authors who developed scoliosis braces (such as the Milwaukee, Boston, Lyon and Chêneau braces) have proposed that scoliosis-specific exercises should be used to complement brace treatment. Indeed, the newly-developed Sforzesco and Gensingen braces are specifically designed to be worn in conjunction with exercise-based therapy. In short: it’s good to receive physiotherapy for your scoliosis even if it’s also being treated with a brace. Integrating scoliosis-specific exercises with a bracing treatment helps to provide a more complete rehabilitation programme for growing patients with idiopathic scoliosis.

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Links & References

  • ScolioGold Therapy – The Scoliosis SOS Clinic’s own combination of proven exercise-based scoliosis treatment techniques
  • Contact Scoliosis SOS – Arrange an initial consultation (to be conducted at our clinic in London or via Skype / telephone)
 1. Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J,  Grivas TB, Knott P, Kotwicki T, Maruyama T, Minozzi S, O’Brien JP, Papadopoulos D, Rigo M, Rivard CH, Romano M, Wynne JH, Villagrasa M, Weiss HR, Zaina F: 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 2012, 7:3 2. Zaina F, Negrini S, Atanasio S, Fusco C, Romano M, Negrini A: Specific exercises performed in the period of brace weaning can avoid loss of correction in Adolescent Idiopathic Scoliosis (AIS) patients: Winner of SOSORT’s 2008 Award for Best Clinical Paper. Scoliosis 2009, 4(1):8.
Back pain isn’t generally associated with being young, but scoliosis (a curvature of the spine that often leads to back pain) very often develops quite early in life – usually during adolescence. If your spinal curve went unnoticed and/or untreated during teenage years, you may well find yourself seeking scoliosis treatment as you enter your early 20s. Don’t worry – no age is ‘too late’ to start treatment, and the many 20-year-old patients we’ve treated here at the Scoliosis SOS Clinic have seen fantastic results. 

scoliosis treatment for a 20 year old

A person who is suffering from scoliosis may suffer from pain, stiffness, postural problems, and self-esteem issues. Common symptoms include back pain (as mentioned above), muscular imbalance, uneven shoulders/legs/hips, and a visibly curved back.

However, even when weighed against all the problems that scoliosis can cause, spinal fusion surgery (the most common treatment for spinal curves that have progressed past a certain point) is still an incredibly daunting procedure that some young scoliosis patients would prefer to avoid. At Scoliosis SOS we use a range of non-surgical treatment techniques to reduce spinal curvature and improve patient quality of life without surgical intervention.

Case study: Ornela, a 21-year-old scoliosis patient from Albania

Ornela was diagnosed with scoliosis at 19 years old. Seeking treatment, she travelled from Albania to our clinic to undergo a 4-week non-surgical treatment course. Watch the video below to find out what she had to say about her experience with Scoliosis SOS:

ScolioGold therapy combines a number of non-surgical techniques to give scoliosis sufferers a non-invasive option for combating their condition. As Ornela experienced, our non-surgical treatments have proven extremely effective for patients of all ages – click here for more ‘before and after’ examples of patients aged 20-39. No matter how old you are, we are more than happy to review your individual case and recommend the most suitable course of action for you. Contact Scoliosis SOS now to arrange an initial consultation.