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:

  • These procedures are less invasive than spinal fusion

  • No major complications are currently associated with VBS/VBT

  • 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.