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:

23-year-old Frankie from Florida came all the way to the UK to complete a 4-week treatment course at the Scoliosis SOS Clinic. This is his scoliosis story...

Florida Scoliosis Patient

Frankie's father (who actually has scoliosis himself, albeit a far milder case) noticed Frankie's scoliosis when he was 13 years old. Frankie had a slightly unusual gait and asymmetrical shoulders, and he was experiencing some pain in his back. At the age of 16, Frankie went for an X-ray scan which showed that he had quite a significant curvature in his spine - at 40 degrees, the severity of his scoliosis was worse than expected. He wore a back brace for one year, and his curve did actually decrease to 32 degrees.

When Frankie joined the military, he was pleased to find that his scoliosis didn't affect him too much. However, during a particularly rigorous exercise, his back gave out, and so Frankie had to put his career in the military on hold and seek treatment ASAP.

Frankie decided not to undergo treatment in the United States; instead, he researched clinics in Europe as he felt that European practitioners would have more experience with cases like his. A family friend from Greece told Frankie about Scoliosis SOS, and it wasn't long before he enrolled on a 4-week course here.

Treatment Results

The results of Frankie's treatment were significant. He gained height, lost weight, and is now experiencing virtually no sciatica pain. Frankie was also able to improve his already exceptional lung capacity. In total, his lumbar rotation was reduced by 20%.

When asked how he found his experience at the Scoliosis SOS Clinic, Frankie said it was amazing and that we had made him much more aware of his posture. He especially appreciated the way that Scoliosis SOS patients are educated about their condition and why certain exercises are good for them, not just given a set of instructions to follow. The highlight of Frankie's experience at the Scoliosis SOS Clinic was the feeling of progress being made - he could feel muscles that he'd never used before working, and so he knew that he was achieving positive results.

Frankie advises anyone thinking about coming to the UK to receive scoliosis treatment to ensure they can dedicate themselves to the programme so that they will feel the full benefits. He also advises people to 'prepare for greatness - the only thing that's going to happen here is improvement.'

Following his treatment, Frankie is heading back over to the USA and plans to go straight back to the enlistment office to continue his military career. Watch the video below to see Frankie talking about his experience in person:

Our Treatment Programme >   Book a Consultation >

Dancer from Los Angeles with Scoliosis

Faye Warren, now aged 29, was just 8 years old when she was diagnosed with scoliosis. Following her diagnosis, she wore a brace between the ages of 10 and 16, and she suffered from daily pain as a result of her spinal curvature.

Faye was unable to continue with gymnastics, but fought hard to continue with her love of dancing. At school, carrying books and sitting down for long periods caused her great discomfort, and no form of chiropractic treatment or acupuncture seemed to make any difference.

Faye was adamant that she wanted to avoid undergoing scoliosis surgery at all costs, and she was determined to find a treatment option that would allow her to continue dancing professionally.

When Faye came across the Scoliosis SOS Clinic, she knew that our non-surgical treatment programme was exactly what she had been looking for. The small matter of our location - London is more than 5,000 miles from Los Angeles - didn't deter Faye, and after making all the necessary arrangements, she booked herself in for a 4-week treatment course.

 

How we help people with scoliosis

The exercises we teach here at Scoliosis SOS are designed to strengthen the muscles surrounding the spine, bringing the patient into a more central upright position. This prevents progression, improves cosmetic appearance, decreases pain, and gives our patients the best possible chance of avoiding spinal fusion surgery.

 

Feedback from Faye

Here's what Faye had to say at the end of her treatment course:

"I am so glad I found the Scoliosis SOS Clinic. Other treatments would help to temporarily decrease my pain, but it would always return. I knew I needed to find a permanent solution, and it was going to be a complete change of lifestyle.

"I have learnt a great deal about my back and how I can help myself. My pain has been dramatically reduced and I have gained so much confidence.

"My advice to other scoliosis patients looking to travel from overseas is not to hesitate - it is the best decision you will ever make. I cannot put into words how much better I feel."

Book your Scoliosis SOS consultation today - we can provide remote consultations via Skype or telephone call if you can't come to our clinic for an appointment.

 

Further reading

Curvy Girls is an international support group for young girls with scoliosis. Leah Stoltz from New York started the group after sitting in on a meeting of adult scoliosis sufferers and deciding that there ought to be a similar support network exclusively for under-18s. Leah very kindly agreed to answer some questions from the Scoliosis SOS team - scroll down to read the interview in full.

Curvy Girls Scoliosis Support Group

So, Leah - for those who may not know, what kind of support does Curvy Girls provide for scoliosis sufferers?

Curvy Girls provides peer support to young girls dealing with scoliosis. What's awesome about our meetings - and the reason our organisation is so successful - is that we're entirely teen-run. When girls hold their groups, it's only girls in the meetings, so it's a safe and comfortable environment.

What treatment(s) have you undergone for your own spinal curve?

I wore a Boston brace for two and a half years, and then had spinal fusion surgery (T5-L4).

Were you pleased with the results?

I was very pleased with the outcome of my surgery and I try to talk about it as much as possible. Something I've noticed a lot is that you really only hear (and see on social media) scary or worrisome stories of surgeries not going well. For the innumerable number of cases that go well, they don't necessarily need to talk about it as much because it was easier to manage. That's one of the reasons I try to talk about my story so much: to make surgery less scary for those who are about to undergo it.

You live in the USA - how challenging is it to access effective scoliosis treatment in America today?

I grew up and still reside in New York, so for me it was very easy to get access to bracing and surgery, as well as to surgeons who specialise in scoliosis. On the other hand, curvy girls who live in more remote areas of the US might have to travel great distances to receive care. 

When doing research for our book, Straight Talk with the Curvy Girls, we found out that Europe is way ahead of the US when it comes to conservative care - scoliosis-specific exercises and 3D bracing. In 2012, there was only one place in the whole of the US that offered this treatment, and for most of us it was hours away by plane. I am proud to say that, through the advocacy of Curvy Girls, families in the US now have greater access to these conservative care options.

What is the single most important piece of advice you'd give a young person who's just been diagnosed with scoliosis?

Talk about how you're feeling! Don't keep it bundled inside. Find support - a trusted friend, a parent, a Curvy Girl. Curvy Girls has support groups all over the world, as well as an online forum, Instagram page, Facebook group, book...there are so many ways to feel supported and to talk with other girls who are going through what you are going through (or who have already been through the same things).

For the benefit of the friends and families of scoliosis sufferers, could you shine a little bit of light on the thoughts and emotions of someone who's going through scoliosis?

A scoliosis diagnosis is something that just happens to us; we feel like we don't have control over it, and sometimes it can feel like there's no end in sight. We're told to wear the brace, which is a very passive activity, and on top of that we're not even sure it will definitely help! And then sometimes we're told to wear the brace under the threat of surgery, which is a terrifying idea. I wasn't fortunate enough to know about the Schroth method prior to my surgery, but what I love about it is that it gives us a bit more control over a situation that can feel like it's out of our hands.

We understand you're looking for a new UK representative - what does this role entail, and what sort of person are you looking for?

Yes we are! The best Curvy Girls leader is one who has the desire to help others as well as themselves. She should not only want to give support, but be open to asking for and receiving it when she needs it as well. Girls with scoliosis between the ages of 11 and 18 are eligible. We provide all the support necessary to become a CG leader. If you're open to learning, we're open to teaching! Application details here.

What's next for Curvy Girls? What are the Foundation's aims for the future?

World domination! In all seriousness, we just want to make sure there's support for girls wherever they are. My personal goal is that support should be offered in tandem with any diagnosis, brace, or surgery consultation. It's easy to just focus on treating the physical symptoms of scoliosis, but there's also an emotional component that's far too frequently ignored. Curvy Girls is the emotional brace for scoliosis!

Visit www.curvygirlsscoliosis.com for more information about the Curvy Girls Scoliosis Foundation, or click here to learn about the exercise-based scoliosis treatment courses we provide here at the Scoliosis SOS Clinic in London, England.
Although there is no cause for the curvature of the spine in that majority of cases we treat here at Scoliosis SOS, and in scoliosis patients in general, there are several medical conditions which can lead to the development of scoliosis. 
 
Today, we are focusing on one of the conditions which can lead to the development of scoliosis, namely, Guillain-Barré Syndrome. Many will not have heard of the condition previously, due to its rare and serious nature. It occurs when the immune system attacks part of the nervous system, and is often the result of a viral or bacterial infection.
 
One of the primary symptoms of Guillain-Barré is progressive muscle weakness, and a resulting loss in coordination. Although many sufferers of Guillain-Barré go on to recover from their condition, a lasting impact is often caused by this weakening of the muscles, which in some cases, can lead to the development of scoliosis. 
 
Such was the case for our previous patient Jonathan, who suffered with Guillain-Barré for a year, and was diagnosed with scoliosis shortly afterwards. Upon initial diagnosis, Jonathan was told he had a 19° curve and was given a corrective brace, but six months later he was told that this had progressed to a 38° curve.
 
Improved muscle strength and coordination are a huge part of our treatment process here at Scoliosis SOS, targeted by the inclusion of methods such as the PNF Technique, along with other elements of our ScolioGold programme. For this reason, our treatment approach can be incredibly beneficial for an individual who has been left weakened by the impact of Guillian-Barré, as is exemplified in Jonathan’s treatment video below:
 
 
If you would like to learn more about how we can aid the recovery of Guillian-Barre sufferers, and relieve symptoms of their scoliosis, please get in touch by calling 0207 488 4428, or by filling out our enquiry form here.