Spinal fusion hardware versus VBT

The USA's Food and Drug Administration (FDA) recently announced that it had approved its very first spinal tethering device for correcting idiopathic scoliosis in children and adolescents.

The Tether™ vertebral body tethering system is designed to help correct spinal curvatures in young patients whose bones have yet to fully mature.

Made up of titanium anchors, bone screws and set screws, along with a flexible polymer cord, the device aims to prevent further curve progression, theoretically eliminating the need for spinal fusion surgery.

 

What does this mean for young scoliosis patients in the USA?

Manufactured by Zimmer Biomet, the spinal tether device has been presented as something of a breakthrough in paediatric scoliosis management. It is an innovative treatment option that aims to improve quality of life for young patients with idiopathic scoliosis.

Dr Baron Lonner, Professor of Orthopaedic Surgery at New York City's Mount Sinai Hospital, applauded the FDA's decision, noting that vertebral body tethering (VBT) could become a "mainstream option for scoliosis treatment" in due course.

The Tether™ VBT system is designed to help young scoliosis patients with a Cobb angle of 30-65 degrees.

 

Idiopathic scoliosis in children

Idiopathic scoliosis is the most common form of scoliosis. The causes of idiopathic scoliosis are unknown (this is what the word 'idiopathic' means). It is typically diagnosed in children and adolescents between the ages of 10 and 18.

The most commonly-prescribed medical treatment for idiopathic scoliosis is bracing. If the brace does not successfully halt the progression of the patient's spinal curve, surgery may be recommended.

Though often effective, the spinal fusion procedure can lead to problems of its own, with patients sometimes facing such issues as restricted motion and arthritis down the line.

The FDA's decision to approve this new tethering device could give young scoliosis sufferers a new hope in tackling their spinal issues.

 

Is vertebral body tethering effective?

In June 2018, NHS England published a report titled Evidence Review: Vertebral Body Tethering for Treatment of Idiopathic Scoliosis.

This review examined the effectiveness of VBT and the complication rates associated with this treatment method.

Here are two key findings from NHS England's report...

  • 5 out of 25 patients required repeat surgery: "At skeletal maturity, Ames, Samdami et al reported 5 patients from the cohort of 25 requiring repeat surgery to loosen the tether in order to treat or prevent overcorrection (Ames, Samdani, & Betz, 2016)."

  • In total, 44% of patients experienced some complications. In addition to the 5 patients who required repeat surgery (see above), another 5 experienced "transient thigh pain or numbness", and there was 1 patient with "unresolved intercostal neuralgia".
  • There's not yet enough evidence of VBT's effectiveness: "It is not possible at present, given the lack of experimental studies, to confirm that this treatment is relatively effective, safe and acceptable when compared to standard care."

 

Scoliosis treatment at the Scoliosis SOS Clinic

While the FDA's decision may be welcome news to young scoliosis sufferers in the USA, vertebral body tethering still has a long way to go as an alternative to spinal fusion surgery, and it remains to be seen just how effective the Tether™ will be in the long term. Note also that this treatment method still requires the patient to undergo an operation.

If you're seeking a less invasive option for yourself or a loved one with scoliosis, you may be interested in the treatment courses that we deliver here at the Scoliosis SOS Clinic in London, England. Our ScolioGold programme combines a variety of non-surgical methods to create a unique approach that is unlike anything offered elsewhere.

Better still, the ScolioGold method is constantly evolving in line with advances in the field of non-surgical treatment, ensuring that our therapeutic programme continues to deliver the best possible results.

Contact Scoliosis SOS to book a ScolioGold consultation >>

FURTHER READING:

Scoliosis SOS Clinic Principal Erika Maude with Katy Ford

Did you see the Scoliosis SOS team on TV earlier this week?

A Matter of Life and Debt is a BBC One documentary series that focuses on credit unions, responsible moneylenders, and the people whose lives have been transformed by ethical loans.

The third episode of A Matter of Life and Debt's current series aired on Wednesday (21 August 2019), and it featured a segment about our Clinic Principal Erika Maude and the loan that helped her to set up the Scoliosis SOS Clinic back in 2006.

Having been let down by a high-street bank, Erika instead sought assistance from Foundation East, a responsible lender that provides finance and support for businesses. They approved Scoliosis SOS for a loan of £50,000 - a sum that, thanks to the clinic's instant success, was repaid within just nine months!

If you missed our appearance on A Matter of Life and Debt, don't worry - you can catch it again on BBC iPlayer!

More Media Coverage   About Scoliosis SOS

The final 2 days of the 2019 SOSORT (Society On Scoliosis Orthopaedic and Rehabilitation Treatment) meeting in San Francisco proved to be just as productive and educational as the start of the conference.

 Erika Maude SOSORT Presentation

Friday 26 April

Friday began with a variety of scientific paper award sessions, including those on the 'Impact of Sports Activities on Adolescent Scoliosis Patients' (from a team at the Italian Scientific Institute) and the 'Effects of Inspiratory Muscle Training on Respiratory Muscle Strength' (from a research group at Bezmiâlem University in Istanbul, Turkey). This was followed by a moving presentation from Dr. Scott Haldeman on the work of World Spine Care, a global charity on a mission to improve lives in under-served communities by aiming to create a world in which everyone has access to the highest possible quality of spine care.

Clinic Principal Erika Maude (pictured above) then presented the Scoliosis SOS Clinic's work: 'Exploring the Cost Effectiveness of an Intensive Physiotherapeutic Scoliosis Specific Exercise (PSSE) Programme in a UK Adult Population'. Many of our patients will recall being asked to complete quality of life questionnaires at various points during their treatment programmes, and we are very grateful to everyone who has helped to contribute to this ground-breaking piece of research and prove that our ScolioGold therapy is a cost-effective alternative to the existing treatments of bracing and surgery that are currently offered by the UK's National Health Service. We will be uploading the full video recording of Erika 's presentation at the San Francisco conference later next week.

The day concluded with a talk from orthopaedic specialist Mr Peter Newton, current president of the SRS (Scoliosis Research Society), on the organisation's work as a networking hub for spinal specialists from all over the world.

 

Georgie Frere SOSORT Presentation

Saturday 27 April

Saturday saw Rachel Mulvaney, Vice President of Curvy Girls, speak on the 'Power of Peer Support' and showcase the amazing work this society does to help girls with scoliosis across the globe.

Our Clinical Manager Georgie Frere (pictured above) also gave an excellent insight into the importance of 'Strategies to Improve Home Exercise Compliance in Patients with Scoliosis', something that we are very passionate about supporting our patients with when they return home after completing a treatment course at our clinic. Every patient receives a personalised exercise schedule, and we have also been trialling the use of paper exercise diaries for some of our patients to see if this improves their motivation at home. Georgie's presentation has also been recorded and will be uploaded to our YouTube channel shortly.

 

Looking ahead to SOSORT 2020

Next year's SOSORT conference will be held in Melbourne, Australia, and the Scoliosis SOS team are already hard at work finalising their scientific abstracts for submission before the deadline in October 2019. The 2020 conference looks set to be bigger than ever, and will be teaming up with SpineWeek to offer a scientific collaboration bringing together clinicians and scientists from around the world and from very different scientific societies.

Learn More About Scoliosis SOS >   Upcoming Treatment Course Dates >

SOSORT 2019 in San Francisco

SOSORT (Society On Scoliosis Orthopaedic and Rehabilitation Treatment) is a non-profit organisation that aims to encourage the development of conservative - i.e. non-surgical - treatment methods for scoliosis and other spinal conditions. The cornerstone of SOSORT's work is their Annual Meeting, which takes place in a different location each year and comprises a variety of scientific and educational events.

The Scoliosis SOS Clinic have had a consistent presence at these Annual Meetings for a number of years now. Clinic Principal Erika Maude, Clinic Manager Georgie Frere and ScolioGold Therapist Kara Cattell are currently in San Francisco, California for SOSORT's 14th International Conference on Scoliosis Management. This year, more than 300 participants from across 6 different continents have gathered together to discuss the latest developments, research and techniques for non-surgical scoliosis patient care.

On Thursday, attendees listened to lectures from keynote speakers Dr Manuel Rigo - who was Erika's doctor when she herself underwent treatment in Spain back in 2002 - and Dr Stuart Weinstein, an orthopaedic surgeon and US healthcare policy advisor.

Dr Rigo gave a brilliant insight into the history of exercise-based therapy for scoliosis (dating back to the 18th century, when wall bars were first invented by a Swedish physician) and finished with an overview of modern-day physiotherapy methods from around the world.

Dr Weinstein's talk focused on health economics and how, with scoliosis surgery being one of the biggest health costs for teenage populations in many countries, healthcare providers are going to be under increasing pressure in the near future to find more cost-effective ways to treat this patient group - namely with less invasive, more conservative methods. This is a particularly popular topic at the moment, and Erika hopes that her upcoming scientific presentation on the health economics of patient quality of life will greatly add to the evidence supporting the wider use of exercise therapy to treat scoliosis patients.

Be sure to check the Scoliosis SOS blog next week for more information on Erika's presentation, as well as Georgie's presentation on patient compliance.

Our Scoliosis Research >   Our Treatment Method >

Scoliosis Surgery Headlines

Last night (10 April 2019), 18-year-old Chloe Donhou from Essex underwent spinal fusion surgery to correct her 60+ degree scoliosis. This wouldn't normally be headline news - scoliosis affects approximately 3% of the population, and countless spinal fusion procedures are carried out worldwide each year - but Chloe's operation was noteworthy because it was televised.

Channel 5's Operation Live is a groundbreaking television series that's exactly what its title suggests: live TV broadcasts of surgical operations, interspersed with commentary from the medical professionals involved. At the centre of last night's instalment was Chloe, who has spent much of the last 18 years in pain as a result of her spinal curvature.

Speaking to the Express ahead of her operation, Chloe said: "This is something I've been waiting for my whole life. It's finally happened. It's the little things people don't understand...if I go bowling with friends, I'll be in agony the next day."

Chloe's spinal fusion procedure was carried out by the orthopaedic team at The Royal London Hospital, and watched by viewers all over the UK.

Read some of the reactions to Chloe's spinal fusion surgery on Twitter >

 

Is spinal fusion surgery the only answer for people with scoliosis?

Here at the Scoliosis SOS Clinic, we provide exercise-based physical therapy that helps people with scoliosis to live better lives. We quite frequently hear from individuals who are looking for alternatives to spinal fusion surgery - as effective as the operation is, there's always a risk associated with any surgical procedure, and many scoliosis patients prefer not to go through with it.

Over the last 12-13 years, we have helped many people with scoliosis to improve their condition and avoid spinal fusion surgery. Our internationally-renowned ScolioGold treatment method has proven capable of:

  • Reducing pain
  • Making spinal curves smaller
  • Improving muscle balance and flexibility
  • Boosting overall quality of life

If you would like to find out more about the Scoliosis SOS Clinic and the treatment we provide, please telephone 0207 488 4428 or fill out our online enquiry form.

Before & After X-Rays >   Book a Consultation >

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