Vertebral Body Tethering/ VBT

Vertebral body tethering, also known as VBT, is a surgical procedure used to correct abnormal curvature of the spine. This operation aims to restore proper spinal alignment and improve the patient’s quality of life.

What is Vertebral Body Tethering?

Vertebral body tethering is often viewed as a more comfortable and preferred alternative to other surgical treatments for scoliosis. This technique allows the spine to continue growing, which means the curvature can keep improving even after surgery. A major benefit of VBT is that spinal mobility is maintained because the flexible material used enables the spine to bend and move naturally. This flexibility leads to a smoother, more comfortable recovery and helps patients retain their range of motion and better overall quality of life.

Purposes of Vertebral Body Tethering

The primary goal of vertebral body tethering is to correct abnormal spinal curvatures, restore proper alignment, and address complications caused by spinal deformities. This procedure offers several important benefits, including enhanced physical function, decreased pain, a higher quality of life, and increased freedom of movement.

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

The ideal age range for vertebral body tethering (VBT) is typically between 9 and 17 years old, though both the patient’s age and the severity of spinal curvature are considered. For VBT to work effectively, the patient’s spine must still be growing. Because VBT relies on continued spinal growth for correction, performing the procedure after spinal maturity is unlikely to yield successful results.

Types of Vertebral Body Tethering

Traditional Vertebral Body Tethering Surgery

Traditional vertebral body tethering surgery uses a larger open incision to straighten and stabilize the spine. This method effectively corrects spinal curvature by relieving pressure on affected areas. However, it usually involves more stitches and a longer recovery period than minimally invasive techniques.

Minimally Invasive Vertebral Body Tethering Surgery

Minimally invasive vertebral body tethering surgery uses smaller incisions, a camera inserted through the rib cage, and specialized instruments. This approach typically results in fewer stitches and a quicker recovery. However, whether this method is appropriate depends on the patient’s individual condition and the severity of their spinal curvature.

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

Vertebral body tethering (VBT) surgery is notably different from traditional spinal fusion. To clearly illustrate these differences, here are the main features that distinguish VBT:

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  • 
    Minimally invasive technique
    Fewer surgical implants required (such as screws and rods)
    Corrects spinal curvature based on flexibility
    Less blood loss and lower risk of infection
    Can be done before spinal growth is complete
    Maintains spinal mobility
    Supports continued growth
    Few long-term complications
    Most patients need only one surgery
    Shorter hospital stay and easier recovery for patients and families
    
    
• 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

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  • Highly invasive procedure
  
  
  • Requires many metal implants
  
  
  • Corrects rigid (inflexible) spinal curves
  
  
  • Often needs pre-surgery blood transfusions
  
  
  • May require growing rods in younger patients
  
  
  • Significantly reduces spinal mobility
  
  
  • Associated with higher long-term complication rates
  
  
• 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 shown above, vertebral body tethering offers a distinct alternative to traditional spinal fusion. The primary benefits of VBT include:

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  Maintains greater spinal mobility compared to traditional fusion procedures
  
  

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  • Faster recovery period
  
  
  • Smaller incisions and fewer stitches
  
  
  • More aesthetically pleasing results in certain patients
  
  
• Fewer stitches and incisions
• Better aesthetic results in certain cases

Risks of Vertebral Body Tethering

Some of these risks are common to all surgeries, while others are specific to VBT. To minimize potential complications, choose a qualified clinic and experienced surgeon, and ensure you fully discuss all aspects of the procedure, preparation, and aftercare with your medical team.

• 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

Even though vertebral body tethering is typically well-tolerated, attentive aftercare is essential for a smooth recovery. Always follow your doctor’s instructions closely, manage pain responsibly under medical guidance, and participate actively in physical therapy programs to support your mobility and long-term success.
It is also important to keep the surgical site clean and protected from infection. Attending follow-up appointments as scheduled and maintaining a healthy lifestyle will further reduce the risk of complications and help you achieve the best possible outcome.

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.

* Liv Hospital Editorial Board has contributed to the publication of this content .
* Contents of this page is for informational purposes only. Please consult your doctor for diagnosis and treatment. The content of this page does not include information on medicinal health care at Liv Hospital .