08/10/2025
Vertebral Body Tethering involves the concept of bone growth modulation which is based off the Hueter-Volkmann principle, which states that bone under more pressure will grow slower and denser than bone not under stress. The bone on the inside part of the curve will grow slower and denser than the bone on the outer part of the curve which in turn creates a vertebrae more wedge shaped. While wearing a brace stops the curve from worsening, tethering actually reverses the curve. With Vertebral Body Tethering, loading is applied directly to the spine with a surgical procedure, which creates bone growth modulation and attempts to provide some correction of the spinal curve — if the patient has young with more bone growth in the future. Benefits of vertebral body tethering include less invasive than open scoliosis surgery, less surgical hardware is used, and more motion preservation than rods. The Tethering System is made up of anchors, bone screws, cord and set screws. During surgery, the scoliosis surgeon places the anchor and bone screw into the patient’s spine on the side of the spinal curve. The polymer cord is then secured to the bone screws using set screws. The surgeon then applies tension to the cord to partially reduce the curve in the person’s spine. The cord continues to straighten the spine as the patient continues to grow. Recovery can be fairly quick with the young patient being released to return to activity and to athletics about a month to six weeks after surgery. “The key issue is performing the procedure when the teen is young enough where they have at least a third of their growth spurt left. For girls that would mean doing the procedure before age 14 or 15, and for boys, before about age 16. Overall, this new scoliosis correction method is less invasive than using rods to de-rotate and straighten the curve. But again, there is a key window of time that we must adhere to.”
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