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Anterior Vertebral Body Tethering (AVBT): Technique for Idiopathic Scoliosis without fusion

Anterior Vertebral Body Tethering is a growth modulation technique for the correction of idiopathic scoliosis without fusion. This technique is different in that it involves placing pedicle screws in the anterior vertebral bodies.  This is typically done thorascopically.  The screws are attached to each other with a flexible, polyethylene terephthalate (PET) cable on the convexity of the curve. The goal of the VBT procedure is to correct the spinal deformity while maintaining motion.

What Are the Indications of Vertebral Body Tethering?

The indications for this technique is that patients that are skeletally immature (>8 years old, Sanders ≤ 4) with a high risk of progression. The curve size can be from 40-65 but it must be flexible. We determine the curves flexibility with bending xrays.

While FDA approved this technique in 2019, this is still a new technology with unknown long term outcomes. The decision between fusion and vertebral body tethering is still evolving and is a case-by-case discussion and decision between the surgeon and the family. Please see A Tale of Two Spines (PPT) for more information about fusion vs. VBT (tethering). In the right setting though and in the right patient, AVBT may be the best option.

AVBT Anterior Vertebral Body Tethering xray

AVBT – Anterior Vertebral Body Tethering xray