Vertebral Body Tethering

Vetebral Body Tethering

SAUK Statement

SAUK is aware that there is much debate surrounding a new operative technique for some types of scoliosis curves. This technique is called VBT [vertebral body tethering] and was developed in the USA, where it has only recently become widely practised.

 The position in the UK is that St Georges Hospital in London started doing this operation on the NHS but stopped doing so last year when the NHS withdrew funding. However, the operation Is now available at this hospital on a self-pay basis and is not yet funded by the NHS, although NHS England is currently reviewing its position on funding.

 The technique was originally developed for smaller, flexible idiopathic curves in patients who have some growth potential ( ie, adolescent pre/peri-menarchal, Risser 0-2, or juvenile patients). Although early results are positive and it seems that some flexibility of the spine might be preserved with VBT, it is so new that there is no good follow-up to show that this is indeed so or what the long term outcomes are. 

 Thus, at present the situation is that surgeons have an effective treatment for idiopathic scoliosis with good long term results, which is fixing the spine with screws and rods after correction of the curvature. VBT is a very new procedure that is at present used for only some cases in younger patients and needs careful assessment and good quality follow-up data. Researchers need to establish that the procedure does indeed result in greater flexibility and maintenance of the correction in the long term.

 SAUK’s view is that to establish the long-term outcome of VBT should be a priority for research, as should the feasibility of expanding the use to children at a more advanced developmental stage. Indeed, the recent BSRF/SAUK PSP recommends funding for research - Question 3 was: Could surgical procedures be improved to become less invasive, reduce scarring and increase flexibility? SPSP Final Results

 To inform our members reliably about VBT, SAUK has published a peer reviewed article in Backbone and it is reproduced on our website (Backbone article).  More information can be obtained from the British Scoliosis Society, which has released a statement, (BSS statement) and the British Scoliosis Research Foundation [BSRF], which has followed with its own statement. (BSRF statement)

 

Available in large print format on request

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