Anterior vertebral body tethering

Anterior Vertebral Body Tethering (AVBT) is a surgical procedure used to treat scoliosis, a condition characterized by an abnormal curvature of the spine. AVBT is a less invasive alternative to traditional spinal fusion surgery and is particularly suitable for young patients with significant growth remaining.

Overview

AVBT is a growth modulation technique that aims to correct the spinal curvature by tethering the growth plates on the convex side of the curve. The procedure involves the placement of screws into the vertebral bodies along the curve, which are then connected by a flexible cord. As the patient grows, the tethered side of the spine grows slower than the untethered side, gradually straightening the curve.

Indications

AVBT is indicated for patients with moderate to severe scoliosis (Cobb angle of 40-65 degrees) who have significant growth remaining. This is typically determined by the patient's Risser sign, a measure of skeletal maturity.

Procedure

The procedure is performed through a thoracoscopy, a minimally invasive surgical procedure that involves small incisions in the chest wall. The surgeon places screws into the vertebral bodies along the curve and then threads a flexible cord through the screws. The cord is tensioned to compress the curve, and as the patient grows, the tethered side of the spine grows slower than the untethered side, gradually straightening the curve.

Risks and Complications

As with any surgical procedure, AVBT carries risks, including infection, bleeding, and damage to surrounding structures. Specific to AVBT, there is a risk of overcorrection, undercorrection, or tether breakage.

Postoperative Care

Following surgery, patients typically stay in the hospital for a few days for monitoring. Physical therapy is often recommended to help regain strength and flexibility in the spine.

See Also

• Scoliosis
• Spinal fusion
• Thoracoscopy
• Risser sign