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 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). The aim of the procedure is to correct scoliosis while still preserving spinal flexibility.
On the 29th June 2022, the National Institute for Health and Care Excellence published their guidance for the use of VBT in the UK. Their guidance says that evidence on the safety of vertebral body tethering for idiopathic scoliosis in children and young people is limited but raises concerns of serious complications. Evidence on its efficacy is inadequate in quality and quantity. Therefore, this procedure should only be used in the context of research.
Thus, at present the situation is that long term follow up studies confirm that traditional correction of the curve with screws and rods is effective. VBT is a very new procedure that is used for selected cases, typically in younger patients and needs careful assessment and good quality follow-up data. Researchers need to establish that the procedure does indeed achieve safe correction while preserving flexibility and maintenance of the correction in the long term.
SAUK’s view is that careful evaluation of the short and the long-term outcome of VBT should be a priority for research, as should the feasibility of expanding the use of the technique to a wider spectrum of children, perhaps 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 preserve flexibility? SPSP Final Results
More information for the public can be obtained from the National Institute for Health and Care Excellence.
If you would like to talk further about any aspect of scoliosis, SAUK is here to help; please call our helpline or contact us via post or using our e-mail address info@sauk.org.uk.
