Vertebral Body Tethering/ VBT

Vertebral body tethering, also known as VBT, is a surgical procedure performed to correct an abnormal curvature of the spine. This type of operation aims to restore the correct alignment of the spine and improves the patient's quality of life.

What is Vertebral Body Tethering?

Vertebral body tethering is known as a more comfortable and favored method compared to other scoliosis operation methods. In this case, the patient's spine continues to grow and the curvature of the spine is corrected even after the operation.  At the same time, the patient does not lose mobility.  The spine continues to be able to bend and move thanks to the flexible structure of the material used. This enables the patient to have a very comfortable treatment process and freedom of movement.

Purposes of Vertebral Body Tethering

The main goal of vertebral body tethering operation is to correct abnormal curves in the spine. Thus, the correct alignment of the spine is ensured and problems that arise as a result of incorrect shaping are solved. Increase in physical abilities, decrease in pain, increase in quality of life and ease of movement are among the most important benefits of this treatment.

Who is Suitable for Vertebral Body Tethering?

Vertebral body tethering operation is a suitable treatment method for patients under a certain age who experience serious pain or loss of function due to curvatures in the spine. The general health condition of the patients is also one of the factors taken into consideration for this operation.
If the patient is of the appropriate age and has the capacity to complete the post-operative recovery process, the decision to operate can be made after an evaluation with the doctor. During this process, the operation process, its benefits, risks and operation candidates must be carefully evaluated. The risks and benefits of the operation should be considered in detail and the patient should be informed about them. After this, the doctor and the patient together start the process by making the decision to do the operation. We can list the issues that need to be evaluated in the decision-making process as follows:
 

• The degree of progression of scoliosis
• The patient's age and whether the spine has completed its development or not
• Failure of other treatment options
• Experiencing severe pain or loss of function
• The negative effects of scoliosis on the physical health of the patient
• The patient's general health condition and their capability to handle the operation process

Of course, each patient's situation may differ so this evaluation should be made as individually as possible and other personal factors should be included in the process.

Age Limits for Vertebral Body Tethering

Age limits for vertebral body tethering operation may vary depending on the age of the patient and the degree of curvature in the spine. However, in order for the operation to be performed successfully, the patient's spine is expected to have not completed its growth process. For this reason, the ideal age range for VBT operation can be considered as 9-17 years old. Since the operation is performed for a treatment that takes advantage of the growth and stretching of the spine, performing it on the spine of a patient who has completed its spinal development will not yield successful results.

Types of Vertebral Body Tethering

Vertebral body tethering operation can be performed with different methods. These methods may vary depending on the patient's condition and the surgeon's preference. Here are some common types of VBT surgery:

Traditional Vertebral Body Tethering Surgery

Traditional vertebral body tethering surgery is a method that usually requires a large open surgical intervention to straighten and fix the spine. This surgery can correct the curvature by reducing the pressure on the spine. However, it may require a longer healing process and more stitches.

Minimally Invasive Vertebral Body Tethering Surgery

Minimally invasive vertebral body tethering surgery is a method performed with smaller incisions, a camera system applied to the rib cage and special surgical instruments. This surgery may require fewer stitches and a shorter healing process. But for this method to be used, the patient's condition and the severity of the curvature should be taken into account.

The Differences of Vertebral Body Tethering Surgery from Typical Spinal Fusion Surgery

Vertebral body tethering surgery has serious differences compared to traditional spinal fusion surgery methods. For a better understanding, we can list these differences as follows:
Vertebral Body Tethering

• More Minimal Surgery
• Fewer Surgical Implants (Screws, Rods, etc.) Usage
• Reduction of Curvature in Proportion to its Flexibility
• Less Blood Loss and Less Risk of Infection
• It Can be Applied Before the Completion of Skeletal Development
• It Protects Spinal Movement
• It allows growth
• Long-term Complications Are Few
• For most patients, it requires a one-time surgical procedure
• The hospitalization period is short, offering a less laborious surgical process for the patient and their relatives

Spinal Fusion Surgery

• Highly Interventional
• Many Metal Implants Are Used
• It Provides Successful Correction of Rigid (inflexible) Curvatures
• It Needs Blood Transfusions Taken from the Patient in Advance
• Use of Growing Rods is Needed in Younger Patients
• It Greatly Reduces Spinal Movement
• High Long-Term Complication Rates Are Known

Advantages of Vertebral Body Tethering Surgery

As you can see, we can easily say that vertebral body tethering surgery offers a much different approach compared to spinal fusion surgery methods. The advantages of this approach can be listed as follows:

• Less loss of spinal movement

• Faster healing process
• Fewer stitches and incisions
• Better aesthetic results in certain cases

Risks of Vertebral Body Tethering

Of course, as with any surgical intervention, there are some risks associated with vertebral body tethering surgery. These risks should be carefully evaluated before surgery. We can list them as follows:

• Spinal damage
• Nerve damage and numbness
• Implant problems after the procedure
• Complications during the healing process
• Risk of infection
• Bleeding and blood clots
• Complications related to anesthesia
• Wound healing problems

Some of these are risks that may apply to every surgery, while others are risks specific to vertebral body tethering surgery. It should not be forgotten that when it comes to such operations, the necessary measures should be taken to minimize these risks. When it comes to your health, the priority is to do whatever it takes to avoid putting it at risk. Therefore, you should not compromise on issues such as the competence of the clinic where the surgery will be performed, the competence of the physician who will perform the surgery, and you should evaluate all the preoperative processes in detail with your physician.

Care After Vertebral Body Tethering Surgery

Care after vertebral body tethering surgery aims to ensure the successful outcome of the operation and to protect the patient's health in the best possible way. This critical process is important for the patient to have a comfortable recovery process.
The stages of postoperative care may include:

• Monitoring at the Hospital: It may be necessary to be monitored at the hospital for a short period of time after surgery. During this process, the surgical site and the general health condition are closely monitored.
• Pain Control: Postoperative pain management is important. You should use pain medication regularly, following your doctor's instructions.
• Physical Therapy: Physical therapy and rehabilitation can help strengthen and increase the flexibility of the spine in the postoperative period.
• Recovery Period: The postoperative recovery process may differ from patient to patient. The healing of the stitches and wound after surgery, the process of returning to activities and the exercise program are important elements of this period.
• Doctor's Check-ups: You should regularly attend the appointments set by your doctor. These check-ups are important to monitor the healing process of your spine and intervene when necessary.
• Healthy Lifestyle: After vertebral body tethering surgery, it is important to maintain a healthy lifestyle. Regular exercise, a balanced diet, and avoiding negative habits such as smoking can improve overall health.

Postoperative care can help the patient to maintain the successful results of the surgery in the long term. It is important to spend this process following your doctor's instructions and patiently.

Things to Be Considered After Vertebral Body Tethering Surgery

No matter how relatively comfortable the operation is, as with any surgical intervention, the period after vertebral body tethering surgery is a process that requires attention and care for patients. You need to strictly follow the instructions given by your doctor and take care of yourself. You should take care of pain control, but to avoid excessive drug use, you need to keep in touch with your doctor about it. Physical therapy programs are very important supportive methods for patients to regain their mobility and achieve the success of the surgery. For this reason, Physical therapy and rehabilitation programs must be followed.
Of course, another thing that should not be forgotten is that the surgical area is kept clean and protected from infections.  In addition, if you do not miss the necessary follow-ups and take care to live a healthy life, your chances of experiencing problems will be significantly reduced.

Physical Therapy and Rehabilitation After Vertebral Body Tethering

Physical therapy and rehabilitation is an important stage that helps the patient regain spinal health after vertebral body tethering surgery. This process fulfills functions such as restoring muscle strength, increasing flexibility and correcting posture. Therefore, the participation of patients in this process is very important for their comfort and the success of the treatment.