Vertebral Body Tethering

Vertebral Body Tethering

STRETCHING METHOD WITH TAPE

Today, the standard treatment of scoliosis in cases requiring surgery is fusion (fixation of the spine, elimination of movement, freezing). The fusion method can be performed anteriorly or posteriorly depending on the location of the curvature. However, the most commonly used method is to open the back and/or waist from behind and fix the spine using screw rods. This method is called posterior instrumentation and fusion.

The most important disadvantage of this method is that the spine is fixed and immobilized. However, it is still an effective method to treat a disease that can cause serious health and cosmetic problems.

What kind of method is Closed Scoliosis Surgery?
The method of stretching with tape using the closed method (endoscopic) was first applied 4 years ago in the USA. In this method, screws are inserted into the vertebrae from the front with the help of thoracoscopy from the convex side of the curvature. The convex side is then stretched with a polyester tape attached to these screws and the curve is slightly corrected. The tape placed on the convex side slows the growth of this part of the spine. The concave part, which is not banded, continues to grow and the curvature corrects itself at the end of the growth. In other words, the growth of the spine is directed in the direction we want.

Since a rope-like band is used instead of a rigid rod connecting the screws, it does not hinder the patient's movements after surgery.

There is no long incision scar as it is performed with the closed method by entering through 6 holes, 3 of which are one centimeter and 3 of which are 3 cm in size. The incisions are not visible as they will remain under the bra or bikini.

To whom can the tape stretching method be applied?
THREADED SCOLIOSIS OR BAND STRETCHING METHOD 
It can be applied in children with scoliosis who still have growth potential. The ideal age for this is between 10-14 years. Girls who have not yet menstruated or who have not menstruated for more than 1 year are the most suitable candidates.

Not applicable in children under 10 years of age

It can be applied to curvatures located in the back. The degree of curvature can be between 30 and 60 degrees. The back curvature should be correctable in bending films. Back curvature should not be accompanied by a lumbar curvature. If there is curvature in the waist, it should not be more than 25-30 degrees.
Patients to whom this method can be applied should not have excessive hunchback (kyphosis).

What is the hospitalization period after Fusionless Scoliosis Surgery?
After this surgery, a chest tube is placed in the patient. The patient is discharged after the chest tube is removed. This is usually the 3rd or 4th day after surgery. A corset is rarely used for 2-3 months after surgery. The return to school period is 2 weeks. It is more painless than posterior instrumentation and fusion. No blood transfusion is required.

What is the postoperative follow-up process in patients who have undergone stretching with tape?
Radiographic control is performed at the 6th week and 6th month after surgery. After that, radiographic follow-up is performed every 6 months until the growth is completed.

Advantages of the band-stretching method compared to classical scoliosis fusion surgery

It is a closed (endoscopic) surgery method. It leaves fewer scars and the scars remain under the swimsuit.
Bleeding is less. Faster recovery and return to school
There is no restriction of movement after surgery.
There is no sports ban after surgery.