A novel non-fusion surgical technique that aims to create a straight spine in children diagnosed with adolescent idiopathic scoliosis has been demonstrated on the ABHI Surgical Simulation Theatre at Future Surgery Show 2021.
Vertebral body tethering (VBT) is a promising new procedure currently being trialled in the UK for the first time. A simulation of the technically challenging technique was performed by Consultant Orthopaedic Surgeon Julian Leong from the world-leading Royal National Orthopaedic Hospital and leading Consultant Neurosurgeon David Baxter.
The ground-breaking technique was developed in the US, where it has recently become widely practised to correct scoliosis while still preserving spinal flexibility. Rather than treating scoliosis by fracturing the spine and fusing it together – as per a traditional spinal fusion – during VBT the individual bones of the spine are tethered together using a polyethylene cord which causes them to grow straight. For patients, it means that the spine can be left flexible rather than rigid.
While the surgery is usually done as a mini-open procedure using one small incision, the surgeons trialing it in the UK will be using a minimally-invasive keyhole thoracoscopic approach, making the demonstration a UK- and world-first.
David Baxter, Consultant Neurosurgeon, Defence Medical Services, commented: “We are proud to be the first to trial this new promising technique in the UK and to be leading a simulation of it at this year’s Future Surgery Show.
“What’s really unique and exciting about vertebral body tethering is that we’re the only people doing it at the moment in the UK and we perform it through a keyhole thoracoscope whereas the places that do it in the US and Germany do it through a bigger open cut in the chest. As a technique it is truly ground-breaking, allowing kids to get back to elite sport or dancing or swimming within a couple of weeks of having the surgery, and it straightens their spine without having to fracture it meaning it retains flexibility.”
For the last 50 years the main technique for treating adolescent idiopathic scoliosis, a condition which affects children between 10 and 18 and for which there is no definable cause, has been traditional spinal fusion. The basis of this surgery is a fusion process – fracturing the bones in the spine, putting them into the correct place and fusing them together, so they can heal into one solid unit.
While effective, the treatment means that the spine becomes rigid and usually takes 6-9 months to recover from while the bones fuse together. In the last 10 years, the desire to maintain spine motion has fuelled the development of various growth modulation procedures. One of these promising techniques that has gained traction is vertebral body tethering (VBT).
VBT is a thoracoscopic, fusionless treatment option that is considered as a new promising method for the management of adolescent idiopathic scoliosis, without causing any major complications.[1] During the procedure, screws are placed into the side of the spine which are connected by a flexible cord rather than a metal rod. The screws are placed into the middle of the vertebral body under thorascopic guidance. A polypropylene tether is then placed into the screw heads to guide future growth of the spine. For patients, the recovery period is only the length of time it takes for the scars to heal, which is approximately two weeks, meaning children can resume sports activities immediately.
Paul Benton, Managing Director, International at the ABHI added: “We are delighted to have showcased this revolutionary new technique at Future Surgery 2021. Our simulated surgical theatre is designed to celebrate collaborations between healthcare providers, clinicians and healthcare technology companies, allowing visitors to watch Britain’s best surgeons in action.”
Taking place at ExCeL London, Future Surgery is organised in partnership with the Royal College of Surgeons of England and features over 100 expert speakers - covering all that is new in the field of surgery. Throughout the show, ‘ABHI’s ‘Surgical Simulation Theatre’ is replicating a fully working operating theatre.
