Vertebral Body Stapling
This is a technique that is used to try and prevent the need for spinal fusion. It is often recommended for patients that have progressive curves and are at high risk for future need of a spinal fusion.
Stapling works by modulating the growth of the spine. This occurs by inhibiting growth on one side of the spinal growth plates while allowing the other side to catch up. Staples are inserted onto the vertebra. The staple itself applies pressure to the convex (outer) side of the curve therefore reducing the rate in which it grows allowing the other side to “catch up”. The basic criteria for VBS are as follows:
- The child must still have years of growth
- Curve less than 35 degrees
- Usually only one major scoliosis curve
- Positive family history with someone needing a spinal fusion
- Spine flexibility
To determine whether a child still has growth left, we look at the Sanders bone age score and also whether or not a girl has had their first period yet. The above list does not automatically qualify or disqualify anyone, these are just “basic criteria.”
The concept behind stapling is not new; stapling has been used for many years on conditions like bowed legs or knock-knees. The development of the nickel and titanium staple (or c-clamp) is what has made stapling a viable option for treating scoliosis.